Home Based Phototherapy for Neonatal Jaundice
Home Based Phototherapy for Neonatal Jaundice
The main purpose of the study is to deliver community health worker based prevention, early
 screening and management of neonatal Jaundice using battery powered LED phototherapy device
 at the household level.
Bangladesh like other low and middle-income countries has a high burden of hyperbilirubinemia
 induced neonatal morbidity and mortality. Approximately 60%-80% of newborns develop neonatal
 jaundice and 18% of infants are at risk for adverse outcomes from neonatal jaundice. Severe
 neonatal jaundice can put neonates at risk for long term neuro-developmental impairments and
 death. Delay in diagnosis and treatment of severe neonatal jaundice can result in brain
 damage to the newborn that is preventable with timely treatment.

 Approximately 14 million infants per year in low to middle-income countries (LMIC) are at
 risk from neonatal jaundice progressing to extreme hyperbilirubinemia and brain damage.
 Nearly 80% of the 481,000 cases of extreme hyperbilirubinemia are in LMIC because infants are
 identified too late or health facility treatment is inaccessible or inadequate.

 New, low-cost, easy to use screening and phototherapy treatment technologies enable our
 proposed redesign of care delivery in LMIC to save infant's brains. The investigators plan to
 shift care from specialists and hospitals to community health workers (CHW) and homes.
 Investigators will integrate CHW-led prevention during pregnancy, with timely household
 screening and treatment. Investigators will reach infants before brain damage occurs and
 treat infants who would not otherwise be treated.

 LMIC including Bangladesh have had difficulty addressing neonatal jaundice because of the
 expense and logistics of providing timely prevention, screening and treatment to families.
 This study aim to test 3 hypothesis:

 H1: Prenatal modules for pregnant mothers will increase breastfeeding rates at 1 hour of life
 and at 3 months of age.

 H2: CHWs can screen 80% of newborns by 48 hours of age for jaundice and are skilled in
 identifying sick infants.

 H3: CHW-led household screening for neonatal jaundice will increase the rate of indicated
 treatment for neonatal jaundice compared to current practice.

 Investigators will conduct formative research to engage Government and other stakeholders to
 develop intervention package for prevention and treatment of neonatal jaundice and
 configuring and adapting LED phototherapy device to use for home treatment. Investigators
 will then conduct randomized control trial to implement the intervention package in
 intervention community and will assess the effectiveness of the intervention package.
 Investigators will compare the rates of indicated treatment for neonatal jaundice in the
 intervention and treatment arms.
Inclusion Criteria:

 -  The mothers are at late 2nd or early 3rd trimester of their pregnancy and agreed to
 enroll as study participants

 -  They are planning to stay in the study village for the next 12 months (if a mother is
 planning to give birth at her natal home and then return, she will still not be a
 candidate for enrollment)

 Exclusion Criteria:

 -  Pregnant mother with confirmed multiple pregnancy.

 -  Pregnant mother with medically identified psychological disorder.

 -  Any known maternal danger sign.