The aim of this study is to develop and evaluate a community-based home visit intervention in sub-Saharan Africa to improve the coverage of a timely birth dose of HBV vaccine and neonatal care practices that can improve child survival. We will conduct a baseline formative study, in which we use mixed (anthropological and epidemiological) investigative methods to develop a locally adapted, sustainable home visit intervention package. We will then assess the impact of the intervention developed during the formative study on the HBV birth dose vaccine coverage and on the neonatal mortality rate through a cluster randomized controlled trial. The study will be conducted in Senegal, Burkina Faso, and Madagascar, countries with high prevalence of chronic HBV infection and elevated neonatal mortality rates, and whose national immunization schedules for HBV commence at 6-8 weeks of age.
During the baseline study, in order to develop a locally adapted, sustainable intervention package, the anthropological team will investigate existing concepts, practices and strategies around pregnancy, birth, and newborn health. We will explore local concepts and diagnostic categories related to “hepatitis B”. In the cluster randomized controlled trial, the anthropological team will assist in training CHWs and healthcare workers in health facilities; to conduct a qualitative evaluation of intervention from parents’ perspectives. The anthropological sub-studies will be undertaken with teams in Burkina Faso (Groupe de Recherche Action en Santé), Madagascar (IRD), and Senegal.