U-M Project Investigators
Cheryl Moyer, PhD, MPH
Associate Professor
Learning Health Sciences
Sarah Compton, PhD, MPH
Research Associate Professor
Obstetrics and Gynecology
Emily Treleaven, PhD, MPH
Assistant Professor
Survey Research Center
Elisa Maffioli, PhD, MA, MS
Assistant Professor
Health Management and Policy
Collaborators
Kwame Nkrumah University of Science and Technology
Suntreso Government Hospital

Improving early identification of neonatal jaundice using community health workers and a hand-held “Bili-Ruler” in northern Ghana

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Neonatal jaundice, a common condition that is easily treatable with light-based therapy if identified early, poses significant risks in low-resource settings like Ghana. Due to cultural practices that keep newborns mostly indoors, the yellow pigmentation associated with jaundice often goes unnoticed, leading to severe outcomes, including neurological damage or death. The lack of access to transcutaneous bilirubin (TCB) meters, due to their high cost, prompts reliance on delayed serum bilirubin tests, exacerbating the risks. This project aims to address this challenge using the low-cost Bili-Ruler, a hand-held icterometer developed by Professor Anne CC Lee, validated for its accuracy in assessing bilirubin levels through visual comparison against standardized color gradations.

The main objective of this proposal is to measure the impact of training Community Health Nurses (CHNs) and Public Health Nurses (PHNs) in Techiman, Ghana, to use the Bili-Ruler for early detection of neonatal jaundice. The project will involve recruiting and training CHN/PHNs, equipping them with the Bili-Ruler, and evaluating its effectiveness through home visits. Key impact metrics include the number of newborns identified with elevated bilirubin, those referred and diagnosed with jaundice, and the subsequent treatment outcomes. Additionally, the project will explore healthcare providers' and mothers' perceptions of the Bili-Ruler's usefulness.

The interdisciplinary team includes experts in nursing, biostatistics, epidemiology, health economics, and demography, ensuring a comprehensive approach to evaluation and implementation. The proposed study will also include quantitative and qualitative analyses to assess the Bili-Ruler's cost-effectiveness and the socio-demographic factors influencing follow-up and treatment adherence. Insights gained will guide future large-scale implementations and policy development, addressing health inequities in neonatal jaundice management in Ghana and similar low-resource settings.

Technical Solutions
Women and Communities as Effectors of Health
Ghana