Executive Summary
Background
A low-cost and scalable approach to delivering chlorhexidine to neonates, suitable for
settings in which a large proportion of births occur in the home, is needed. The
Chlorhexidine Operations Research study (CHX OR study) sought to develop such an
approach by addressing questions related to chlorhexidine distribution and use, behavior
change, and community perception in a rural area of Bangladesh with a high level of home
births. The study distributed chlorhexidine through routine channels on a small scale, worked
through family members (rather than the system of CHWs and VHWs used in the randomized
trial) to apply the chlorhexidine to neonates, and applied various behavior change
communication approaches to raise awareness of chlorhexidine and teach people how to
apply it. Our aim was to gain experience and collect data that would facilitate the introduction
and widespread use of chlorhexidine for cord cleansing