Chlorhexidine for Umbilical Cord Care (2014-2015)

Each year three million newborns die globally, and infection causes approximately 13% of these deaths. In resource-poor, high-mortality settings, infections can account for over half of the neonatal deaths. A baby’s newly cut umbilical cord can be an entry point for bacteria, which can lead to cord infection and potentially life-threatening sepsis. Poor hygiene and lack of antisepsis at birth and in the first week of life increases the risk of deadly but preventable infections.

Evidence supports that cleansing the cut cord with 7.1% chlorhexidine digluconate, an antiseptic with a broad spectrum of activity against gram-negative and gram-positive bacteria, is an efficacious, safe, acceptable, feasible and cost-effective strategy to reduce neonatal mortality in settings where poor hygiene and high neonatal mortality are issues. For less than fifty cents a dose, chlorhexidine could save an estimated 422,000 babies over the next five years.

Chlorhexidine is in a class of health ‘solutions’ that are inexpensive, efficacious and appropriate to resource-poor settings, but there are significant gaps in manufacturing, distribution and adoption by mothers that are barriers to its widespread use.

This project team explored global health topics, analyze chlorhexidine for cord care gaps, proposed solutions to problems identified through their research, and made two trips to Bangladesh. The team contributed to a paper about the Bangladesh value chain analysis and looks forward to sharing lessons learned to help similar efforts to introduce chlorhexidine in Asia and Africa.


September 2014 – May 2015

Team Outcomes

Chlorhexidine for Umbilical Cord Care: A Value Chain Analysis in Bangladesh (paper by Jeffrey Moe and Danny Hamrick)

This Team in the News

Bangladesh: Chlorohexedine Uptake in Dhaka

Addressing Infant Mortality through Global Value Chain Analysis

My Bass Connections Pathway: Courtney Caiola

Faculty Perspectives: Jeffrey Moe

The most rewarding aspect was the collaborative working environment we developed as a team and the interactions with in-country stakeholders. I learned an immeasurable amount from both my Duke and Bangladeshi colleagues and was offered a much broader lens through which to view both the problem and potential solutions. –Courtney Caiola

Team Leaders

  • Jeffrey Moe, Fuqua School of Business
  • Nimmi Ramanujam, Pratt School of Engineering-Biomedical Engineering

/graduate Team Members

  • Courtney Caiola, Nursing-PHD
  • Peter Hogue, Business Administration-MBA, Health Sector Management
  • Benjamin Hu, Business Administration-MBA, Health Sector Management

/undergraduate Team Members

  • Kimberline Chew, Biology (BS)
  • Chelsea Ducille, Women's Studies (AB)
  • Pak-Hang (Henry) Yuen, Electrical & Computer Egr(BSE), Computer Science (BSE2)
  • Elizabeth Zieser-Misenheimer, Biology (BS)

/yfaculty/staff Team Members

  • Danny Hamrick, Social Science Research Institute-Global Value Chains Center

/zcommunity Team Members

  • US Agency for International Development
  • Bangladesh Ministry of Health
  • Save the Children Bangladesh