Systematic review of effect of community-level interventions to reduce maternal mortality
<p>Abstract</p> <p>Background</p> <p>The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality.</p> <p>Methods</p> <p>We searched published papers using Medline, Embase, Co...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2009-01-01
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| Series: | BMC Pregnancy and Childbirth |
| Online Access: | http://www.biomedcentral.com/1471-2393/9/2 |
| _version_ | 1818757185388150784 |
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| author | Deeks Jonathan J Meads Catherine A Gülmezoglu A Metin Khan Khalid S Winter Heather R Kidney Elaine MacArthur Christine |
| author_facet | Deeks Jonathan J Meads Catherine A Gülmezoglu A Metin Khan Khalid S Winter Heather R Kidney Elaine MacArthur Christine |
| author_sort | Deeks Jonathan J |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality.</p> <p>Methods</p> <p>We searched published papers using Medline, Embase, Cochrane library, CINAHL, BNI, CAB ABSTRACTS, IBSS, Web of Science, LILACS and African Index Medicus from inception or at least 1982 to June 2006; searched unpublished works using National Research Register website, metaRegister and the WHO International Trial Registry portal. We hand searched major references.</p> <p>Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. We carried out study selection, data abstraction and quality assessment independently in duplicate.</p> <p>Results</p> <p>We found five cluster randomised controlled trials (RCT) and eight cohort studies of community-level interventions. We summarised results as odds ratios (OR) and confidence intervals (CI), combined using the Peto method for meta-analysis. Two high quality cluster RCTs, aimed at improving perinatal care practices, showed a reduction in maternal mortality reaching statistical significance (OR 0.62, 95% CI 0.39 to 0.98). Three equivalence RCTs of minimal goal-oriented versus usual antenatal care showed no difference in maternal mortality (1.09, 95% CI 0.53 to 2.25). The cohort studies were of low quality and did not contribute further evidence.</p> <p>Conclusion</p> <p>Community-level interventions of improved perinatal care practices can bring about a reduction in maternal mortality. This challenges the view that investment in such interventions is not worthwhile. Programmes to improve maternal mortality should be evaluated using randomised controlled techniques to generate further evidence.</p> |
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| format | Article |
| id | doaj.art-5ad9153183f04dcfabb56e98bc52bd90 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-18T06:06:55Z |
| publishDate | 2009-01-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-5ad9153183f04dcfabb56e98bc52bd902022-12-21T21:18:31ZengBMCBMC Pregnancy and Childbirth1471-23932009-01-0191210.1186/1471-2393-9-2Systematic review of effect of community-level interventions to reduce maternal mortalityDeeks Jonathan JMeads Catherine AGülmezoglu A MetinKhan Khalid SWinter Heather RKidney ElaineMacArthur Christine<p>Abstract</p> <p>Background</p> <p>The objective was to provide a systematic review of the effectiveness of community-level interventions to reduce maternal mortality.</p> <p>Methods</p> <p>We searched published papers using Medline, Embase, Cochrane library, CINAHL, BNI, CAB ABSTRACTS, IBSS, Web of Science, LILACS and African Index Medicus from inception or at least 1982 to June 2006; searched unpublished works using National Research Register website, metaRegister and the WHO International Trial Registry portal. We hand searched major references.</p> <p>Selection criteria were maternity or childbearing age women, comparative study designs with concurrent controls, community-level interventions and maternal death as an outcome. We carried out study selection, data abstraction and quality assessment independently in duplicate.</p> <p>Results</p> <p>We found five cluster randomised controlled trials (RCT) and eight cohort studies of community-level interventions. We summarised results as odds ratios (OR) and confidence intervals (CI), combined using the Peto method for meta-analysis. Two high quality cluster RCTs, aimed at improving perinatal care practices, showed a reduction in maternal mortality reaching statistical significance (OR 0.62, 95% CI 0.39 to 0.98). Three equivalence RCTs of minimal goal-oriented versus usual antenatal care showed no difference in maternal mortality (1.09, 95% CI 0.53 to 2.25). The cohort studies were of low quality and did not contribute further evidence.</p> <p>Conclusion</p> <p>Community-level interventions of improved perinatal care practices can bring about a reduction in maternal mortality. This challenges the view that investment in such interventions is not worthwhile. Programmes to improve maternal mortality should be evaluated using randomised controlled techniques to generate further evidence.</p>http://www.biomedcentral.com/1471-2393/9/2 |
| spellingShingle | Deeks Jonathan J Meads Catherine A Gülmezoglu A Metin Khan Khalid S Winter Heather R Kidney Elaine MacArthur Christine Systematic review of effect of community-level interventions to reduce maternal mortality BMC Pregnancy and Childbirth |
| title | Systematic review of effect of community-level interventions to reduce maternal mortality |
| title_full | Systematic review of effect of community-level interventions to reduce maternal mortality |
| title_fullStr | Systematic review of effect of community-level interventions to reduce maternal mortality |
| title_full_unstemmed | Systematic review of effect of community-level interventions to reduce maternal mortality |
| title_short | Systematic review of effect of community-level interventions to reduce maternal mortality |
| title_sort | systematic review of effect of community level interventions to reduce maternal mortality |
| url | http://www.biomedcentral.com/1471-2393/9/2 |
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