PT  - JOURNAL ARTICLE
AU  - Eriksson, Leif
AU  - Nga, Nguyen T
AU  - Hoa, Dinh T Phuong
AU  - Duc, Duong M
AU  - Bergström, Anna
AU  - Wallin, Lars
AU  - Målqvist, Mats
AU  - Ewald, Uwe
AU  - Huy, Tran Q
AU  - Thuy, Nguyen T
AU  - Do, Tran Thanh
AU  - Lien, Pham T L
AU  - Persson, Lars-Åke
AU  - Selling, Katarina Ekholm
TI  - Secular trend, seasonality and effects of a community-based intervention on neonatal mortality: follow-up of a cluster-randomised trial in Quang Ninh province, Vietnam
AID  - 10.1136/jech-2017-209252
DP  - 2018 Sep 01
TA  - Journal of Epidemiology and Community Health
PG  - 776--782
VI  - 72
IP  - 9
4099  - http://jech.bmj.com/content/72/9/776.short
4100  - http://jech.bmj.com/content/72/9/776.full
SO  - J Epidemiol Community Health2018 Sep 01; 72
AB  - Background Little is know about whether the effects of community engagement interventions for child survival in low-income and middle-income settings are sustained. Seasonal variation and secular trend may blur the data. Neonatal mortality was reduced in a cluster-randomised trial in Vietnam where laywomen facilitated groups composed of local stakeholders employing a problem-solving approach for 3 years. In this analysis, we aim at disentangling the secular trend, the seasonal variation and the effect of the intervention on neonatal mortality during and after the trial.Methods In Quang Ninh province, 44 communes were allocated to intervention and 46 to control. Births and neonatal deaths were assessed in a baseline survey in 2005, monitored during the trial in 2008–2011 and followed up by a survey in 2014. Time series analyses were performed on monthly neonatal mortality data.Results There were 30 187 live births and 480 neonatal deaths. The intervention reduced the neonatal mortality from 19.1 to 11.6 per 1000 live births. The reduction was sustained 3 years after the trial. The control areas reached a similar level at the time of follow-up. Time series decomposition analysis revealed a downward trend in the intervention areas during the trial that was not found in the control areas. Neonatal mortality peaked in the hot and wet summers.Conclusions A community engagement intervention resulted in a lower neonatal mortality rate that was sustained but not further reduced after the end of the trial. When decomposing time series of neonatal mortality, a clear downward trend was demonstrated in intervention but not in control areas.Trial registration number ISRCTN44599712, Post-results.