Evidence-based, cost-effective interventions: how many newborn babies can we save?

@article{Darmstadt2005EvidencebasedCI,
  title={Evidence-based, cost-effective interventions: how many newborn babies can we save?},
  author={Gary L. Darmstadt and Zulfiqar Ahmed Bhutta and Simon Cousens and Taghreed Adam and Neff Walker and Luc de Bernis},
  journal={The Lancet},
  year={2005},
  volume={365},
  pages={977-988}
}
Key MethodIn this second article of the neonatal survival series, we identify 16 interventions with proven efficacy (implementation under ideal conditions) for neonatal survival and combine them into packages for scaling up in health systems, according to three service delivery modes (outreach, family-community, and facility-based clinical care). All the packages of care are cost effective compared with single interventions. Universal (99%) coverage of these interventions could avert an estimated 41-72…Expand

Figures, Tables, and Topics from this paper

Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes.
TLDR
Assessment of the effectiveness of community-based intervention packages in reducing maternal and neonatal morbidity and mortality; and improving neonatal outcomes suggests concerns regarding insufficient information on sequence generation and regarding failure to adequately address incomplete outcome data. Expand
Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes.
TLDR
A review of 18 prospective randomised and quasi-experimental trials evaluating the effectiveness of community-based intervention packages in reducing maternal and neonatal mortality and morbidities; and improving neonatal outcomes found no reduction in maternal mortality and significant reduction was observed in maternal morbidity. Expand
Enhancing neonatal survival: what can we do today?
TLDR
It is suggested that in resource-limited settings, the first level health facility may be able to look after short-stay babies that weigh more than 1500 g and that have no respiratory distress and the FRU may look after MLBW babies, with or with respiratory distress, and VLBW babies without respiratory distress by giving special care. Expand
Community-based intervention packages for improving perinatal health in developing countries: a review of the evidence.
TLDR
All published, large-scale, controlled studies that were implemented in a rural setting, included a control group, and reported neonatal and/or perinatal mortality as outcomes are identified. Expand
Neonatal survival in the Republic of Moldova – cost-effective evidence-based interventions
  • P. Stratulat, A. Curteanu, T. Caraus
  • Medicine
  • The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2015
TLDR
It is concluded that due to common efforts of primary, facility-based care and public health sectors, 90% of coverage of perinatal cost-effective qualitatively implemented interventions could prevent 83 neonatal deaths, while 99% of Coverage could prevent 142 deaths. Expand
Evaluating implementation strategies for essential newborn care interventions in low- and low middle-income countries: a systematic review
TLDR
Improved reporting of implementation research in this setting is necessary to learn how to improve service delivery and outcomes and thereby reduce neonatal mortality, particularly poor description of interventions and implementation outcomes. Expand
Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?
TLDR
The analysis indicates that available interventions can reduce the three most common cause of neonatal mortality--preterm, intrapartum, and infection-related deaths--by 58, 79, and 84%, respectively. Expand
Staged implementation of a two-tiered hospital-based neonatal care package in a resource-limited setting in Eastern Uganda
TLDR
It is illustrated how simple changes in practice, provision of basic equipment and protocols, ongoing training and dedicated neonatal staff can reduce neonatal mortality substantially even without specialist equipment. Expand
Impact of packaged interventions on neonatal health: a review of the evidence.
TLDR
The evidence base for the impact of neonatal health intervention packages is a weak foundation for guiding effective implementation of public health programmes addressing Neonatal health, and significant investment in effectiveness trials carefully tailored to local health needs and conducted at scale in developing countries is required. Expand
Management of Newborn Infections in Primary Care Settings: A Review of the Evidence and Implications for Policy?
TLDR
Although methodological limitations preclude estimating the precise contribution of antibiotics toward neonatal mortality reduction in community settings in low income countries, available data suggest substantial benefit of case management approaches using antibiotics for neonatal sepsis in such settings. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 194 REFERENCES
Systematic scaling up of neonatal care in countries
TLDR
To scale up neonatal care, two interlinked processes are required: a systematic, data-driven decision-making process, and a participatory, rights-based policy process; and systematically strengthening supply of, and demand for, services. Expand
Neonatal Survival 4 Neonatal survival: a call for action
TLDR
Developing, implementation, and monitoring of national action plans for neonatal survival is a priority, and the running costs of the selected packages at 90% coverage in the 75 countries with the highest mortality rates to be US$4·1 billion a year, in addition to current expenditures. Expand
Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries: A Review of the Evidence
TLDR
A package of priority interventions to include in programs is identified and research priorities for advancing the state of the art in neonatal health care are formulated for future research and program learning. Expand
Neonatal survival: a call for action
TLDR
Development, implementation, and monitoring of national action plans for neonatal survival is a priority and the running costs of the selected packages at 90% coverage in the 75 countries with the highest mortality rates are estimated to be US4.1 billion dollars a year. Expand
Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India
TLDR
Home-based neonatal care, including management of sepsis, is acceptable, feasible, and reduced neonatal and infant mortality by nearly 50% among the authors' malnourished, illiterate, rural study population. Expand
Reducing child mortality: can public health deliver?
TLDR
The importance of separating biological or behavioural interventions from the delivery systems required to put them in place is highlighted, and the need to tailor delivery strategies to the stage of health-system development is discussed. Expand
Risk approach strategy in neonatal care
TLDR
This study applied a risk-approach strategy involving extra care to at-risk neonates by optimum utilization of existing resources to a cohort of newborns in rural India and concluded that this strategy is effective and could be applied in rural areas with similar problems. Expand
How many child deaths can we prevent this year?
TLDR
The findings show that the interventions needed to achieve the millennium development goal of reducing child mortality by two-thirds by 2015 are available, but that they are not being delivered to the mothers and children who need them. Expand
Meta-analysis of intervention trials on case-management of pneumonia in community settings
TLDR
The consistency of findings of all the studies shows that the case-management strategy has a substantial effect on infant and under-5 mortality, at least in settings with infant mortality rates of 90/1000 livebirths or more. Expand
Effect of pneumonia case management on mortality in neonates, infants, and preschool children: a meta-analysis of community-based trials.
TLDR
Estimates of mortality impact of the case-management approach proposed by WHO, which has a substantial effect on neonatal, infant, and child mortality and should be incorporated into primary health care are provided. Expand
...
1
2
3
4
5
...