{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:54:19Z","timestamp":1791269659068,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Neonatal health is a global concern, particularly in Sub\u2010Saharan Africa where the neonatal mortality ratio exceeds Sustainable Development Goals targets. To address this, midwifery\u2010led care models have been proposed as safe and cost\u2010effective solutions. However, their use and impact in Kenya remain under\u2010researched. This study aimed to evaluate the effects of one of these models on neonatal health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hospitals, Siakago and Runyenjes, were chosen for a Randomized Controlled Trial involving 164 mothers and 60 midwives. Data were collected using questionnaires, observation, and record reviews. Data were analyzed using descriptive statistics and chi\u2010square tests to determine relationships between study variables. At the time of the baseline survey, poor neonatal health outcomes were observed. Midwives in the intervention group then received education on the midwifery\u2010led care model, whereas the control group received no education. After 6\u2009months of monitoring the model's implementation, a post\u2010intervention survey was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Findings showed a 24.0% reduction in neonatal asphyxia in the intervention group, compared to a 6.6% reduction in the control group. The non\u2010complication rate increased by 12.7% in the intervention group and by 1.4% in the control group. Both groups experienced an increase in preterm and low birth weight babies by 7.6% and 7.9%, respectively. A chi\u2010square test indicated a significant association between the intervention and improved neonatal health outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementing a midwifery\u2010led care model had a positive impact on some neonatal health outcomes, but not all. County policymakers should use these findings to develop standardized policy guidelines for midwifery\u2010led care models, aiming to enhance neonatal health outcomes across the county. These findings can also inform policy decisions at national and international levels in developing evidence\u2010based frameworks to enhance neonatal care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/birt.70129","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:36:21Z","timestamp":1791268581000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neonatal Health Outcomes Before and After Introduction of a Midwifery\u2010Led Care Model in Embu County, Kenya: A Randomized Controlled Trial"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9369-4229","authenticated-orcid":false,"given":"Consolata","family":"Kirigia","sequence":"first","affiliation":[{"name":"School of Nursing and Public Health Chuka University  Chuka Kenya"},{"name":"School of Nursing University of Embu  Embu Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8937-013X","authenticated-orcid":false,"given":"Lucy","family":"Gitonga","sequence":"additional","affiliation":[{"name":"School of Nursing and Public Health Chuka University  Chuka Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2281-9661","authenticated-orcid":false,"given":"Sundays","family":"Mukhwana","sequence":"additional","affiliation":[{"name":"School of Nursing and Public Health Chuka University  Chuka Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"UNICEF World Health Organization United Nations Population Fund andThe World Bank \u201cTrends in Maternal Mortality: 2000 to 2020\u201d(2023)."},{"key":"e_1_2_11_3_1","unstructured":"World Health Organization \u201cMidwife\u2010Led Care Delivers Positive Pregnancy and Birth Outcomes\u201d(2022) [Internet] https:\/\/www.who.int\/workforcealliance\/media\/news\/2013\/midwifecochrane\/en\/#:~:text=In%20midwife%2Dled%20care%2C%20the referral%20with%20other%20care%20providers."},{"key":"e_1_2_11_4_1","volume-title":"Trends in Maternal Mortality: 2000 to 2020","author":"World Health Organization","year":"2023"},{"key":"e_1_2_11_5_1","volume-title":"Kenya Demographic and Health Survey (KDHS) 2022. Key Indicators Report","author":"KNBS","year":"2023"},{"key":"e_1_2_11_6_1","unstructured":"Ministry of Health \u201cKenya Progress Report on Health and Health\u2010Related SDGs\u201d(2020)."},{"issue":"1","key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1016\/S2214-109X(20)30397-1","article-title":"Potential Impact of Midwives in Preventing and Reducing Maternal and Neonatal Mortality and Stillbirths: A Lives Saved Tool Modelling Study","volume":"9","author":"Nove A.","year":"2021","journal-title":"Lancet Global Health"},{"key":"e_1_2_11_8_1","unstructured":"International Confederation of Midwives \u201cPosition Statement on Midwifery Led Care the First Choice for All Women\u201d(2018) [Internet] https:\/\/www.internationalmidwives.org\/assets\/files\/statement\u2010files\/2018\/04\/eng\u2010midwifery\u2010led\u2010care\u2010the\u2010first\u2010choice\u2010for\u2010all\u2010women.pdf."},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijnurstu.2021.104129","article-title":"A Comparison Between Midwifery and Obstetric Care at Birth in Spain: A Cross\u2010Sectional Study of Perinatal Outcomes","volume":"126","author":"Martin\u2010Arribas A.","year":"2022","journal-title":"International Journal of Nursing Studies"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.55975\/FDXF5818"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh\u20102020\u2010004475"},{"key":"e_1_2_11_12_1","volume-title":"The Global Strategy for Women's, Children's and Adolescents' Health (2016\u20132030)","author":"Every Woman Every Child","year":"2015"},{"key":"e_1_2_11_13_1","volume-title":"Survey Sampling; Theory & Methods","author":"Nassiuma D.","year":"2000"},{"key":"e_1_2_11_14_1","first-page":"84","article-title":"Improving Maternal and Neonatal Health by a Midwife\u2010Led Continuity Model of Care\u2014An Observational Study in One Government Hospital in Palestine","volume":"10","author":"Berit M.","year":"2019","journal-title":"Lancet"}],"container-title":["Birth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70129","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/birt.70129","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/birt.70129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:36:24Z","timestamp":1791268584000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/birt.70129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":13,"alternative-id":["10.1111\/birt.70129"],"URL":"https:\/\/doi.org\/10.1111\/birt.70129","archive":["Portico"],"relation":{},"ISSN":["0730-7659","1523-536X"],"issn-type":[{"value":"0730-7659","type":"print"},{"value":"1523-536X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,5]]},"assertion":[{"value":"2023-08-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"birt.70129"}}