Otherwise uncomplicated home deliveries using unclean techniques can put mothers and neonates at risk of tetanus, maternal sepsis, and neonatal sepsis. Untreated, these conditions can be life-threatening to the mother and/or child.
Mechanism of Action
Clean delivery kits (CDKs) for home use are designed to prevent infection by facilitating the “6 cleans” of birth: clean hands, clean perineum, clean delivery surface, clean cord cutting instrument, clean cord care, and nothing unclean introduced to the vagina. The WHO recommends a minimum of four items in CDKs: 1) soap for cleaning hands and perineum, 2) a clean plastic sheet of 1m² as a delivery surface, 3) a clean razor blade for cutting the cord, and 4) clean cord ties. Most CDKs supplement this with pictorial instructions for use. More complex kits may include latex gloves, apron, and gauze. CDKs are typically packaged in small paperboard boxes or sealed plastic bags, designed to be easy to carry. Depending on the region, CDKs may be fully subsidized (free), partially subsidized (and sold below cost), or more rarely, sold without subsidy as a commercial enterprise.
Current use in High-Resource Settings
Birth attendants typically assemble their own birth kits in high-resource settings using a combination of disposable and re-usable equipment costing hundreds of dollars.
Application in Low-Resource Settings
CDK availability and impact varies by geography. In Nepal, CDKs produced by Maternal and Child Health Products Pvt. Ltd. (MCHP) are widely available in rural drug shops at affordable retail prices of approximately $0.38. UNFPA programs also support nongovernmental organizations and government traditional birth attendant training programs with CDKs. Although the formal evidence base remains relatively thin, studies across South Asia, Egypt and Tanzania have shown reduced rates of infection among mothers and neonates using CDKs. As a secondary effect, some CDK programs have noted that broad promotion of the CDK raises awareness of clean practices and the importance of antenatal care, possibly contributing to positive health behaviors not specific to the CDK.
Associated Technologies in Development
Ceramic Umbilical Cord Finger Scissors, SafeSnip