BU academic leads group to develop a tool to support decision makers in the use of clean birth kits

29 June 2012

BU academic reviews use of clean birthing kits in less developed countries.

Working with an international group of experts (the Birth Kit Working Group), Professor Vanora Hundley developed a decision support tool to assist policy makers and programme managers making decisions about clean birth.

Every day approximately 800 women worldwide die from causes related to pregnancy or childbirth and many of these women die from conditions that we know how to prevent. Achieving a clean birth requires the application of skills by the care provider and the availability of a few essential supplies. For several decades clean birth kits have been recommended as a means of ensuring those supplies.

Most kits contain a small bar of soap for hand washing, a plastic sheet to serve as the delivery surface, clean string for tying the umbilical cord, a new razor blade for cutting the cord, and pictorial instructions that illustrate the sequence of delivery events. Evidence suggests that as part of a package that includes education, clean birth kits are associated with reductions in newborn mortality and both newborn and maternal sepsis, a condition that occurs when the body has a severe response to bacteria.

The new decision support tool, which utilises available country data, will assist policy makers and programme managers making decisions about using clean birth kits at national and sub-national level. The completed tool is available to download.

Vanora Hundley, Professor of Midwifery in the School of Health and Social Care at BU said: “Preliminary testing with programme managers in Pakistan suggests that the tool is useful in stimulating discussion and in helping decision makers conceptualise how birth kits could be used to strengthen clean birth practices in areas where supply chains are erratic. However, further work is needed to explore how national level evidence can be incorporated into the process and how the tool can be adapted for use in others countries.”

It is estimated that if women giving birth at home in less developed countries had access to clean birth practices maternal mortality from infections could be reduced by 20 per cent. In addition, newborn mortality as a result of tetanus could be reduced by 30 per cent.