Evidence-based, cost-effective interventions: how many newborn babies can we save? - PubMed (original) (raw)
Evidence-based, cost-effective interventions: how many newborn babies can we save?
Gary L Darmstadt et al. Lancet. 2005 Mar.
Abstract
In 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% of neonatal deaths worldwide. At 90% coverage, intrapartum and postnatal packages have similar effects on neonatal mortality--two-fold to three-fold greater than that of antenatal care. However, running costs are two-fold higher for intrapartum than for postnatal care. A combination of universal--ie, for all settings--outreach and family-community care at 90% coverage averts 18-37% of neonatal deaths. Most of this benefit is derived from family-community care, and greater effect is seen in settings with very high neonatal mortality. Reductions in neonatal mortality that exceed 50% can be achieved with an integrated, high-coverage programme of universal outreach and family-community care, consisting of 12% and 26%, respectively, of total running costs, plus universal facility-based clinical services, which make up 62% of the total cost. Early success in averting neonatal deaths is possible in settings with high mortality and weak health systems through outreach and family-community care, including health education to improve home-care practices, to create demand for skilled care, and to improve care seeking. Simultaneous expansion of clinical care for babies and mothers is essential to achieve the reduction in neonatal deaths needed to meet the Millennium Development Goal for child survival.
Comment in
- Stagnation of Ghana's under-5 mortality rate.
Pond B, Addai E, Kwashie ST. Pond B, et al. Lancet. 2005 May 28-Jun 3;365(9474):1846. doi: 10.1016/S0140-6736(05)66610-X. Lancet. 2005. PMID: 15924977 No abstract available.
Similar articles
- Saving newborn lives in Asia and Africa: cost and impact of phased scale-up of interventions within the continuum of care.
Darmstadt GL, Walker N, Lawn JE, Bhutta ZA, Haws RA, Cousens S. Darmstadt GL, et al. Health Policy Plan. 2008 Mar;23(2):101-17. doi: 10.1093/heapol/czn001. Epub 2008 Feb 11. Health Policy Plan. 2008. PMID: 18267961 - Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?
Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, Sankar MJ, Blencowe H, Rizvi A, Chou VB, Walker N; Lancet Newborn Interventions Review Group; Lancet Every Newborn Study Group. Bhutta ZA, et al. Lancet. 2014 Jul 26;384(9940):347-70. doi: 10.1016/S0140-6736(14)60792-3. Epub 2014 May 19. Lancet. 2014. PMID: 24853604 Review. - Community-based antenatal and perinatal interventions and newborn survival.
Sule SS, Onayade AA. Sule SS, et al. Niger J Med. 2006 Apr-Jun;15(2):108-14. doi: 10.4314/njm.v15i2.37091. Niger J Med. 2006. PMID: 16805163 - Community-based maternal and newborn educational care packages for improving neonatal health and survival in low- and middle-income countries.
Lassi ZS, Kedzior SG, Bhutta ZA. Lassi ZS, et al. Cochrane Database Syst Rev. 2019 Nov 5;2019(11):CD007647. doi: 10.1002/14651858.CD007647.pub2. Cochrane Database Syst Rev. 2019. PMID: 31686427 Free PMC article. - Community-based intervention packages for improving perinatal health in developing countries: a review of the evidence.
Schiffman J, Darmstadt GL, Agarwal S, Baqui AH. Schiffman J, et al. Semin Perinatol. 2010 Dec;34(6):462-76. doi: 10.1053/j.semperi.2010.09.008. Semin Perinatol. 2010. PMID: 21094420 Review.
Cited by
- mHealth interventions to reduce maternal and child mortality in Sub-Saharan Africa and Southern Asia: A systematic literature review.
Bossman E, Johansen MA, Zanaboni P. Bossman E, et al. Front Glob Womens Health. 2022 Aug 25;3:942146. doi: 10.3389/fgwh.2022.942146. eCollection 2022. Front Glob Womens Health. 2022. PMID: 36090599 Free PMC article. - Predictors of Postnatal Care Service Utilization Among Women of Childbearing Age in The Gambia: Analysis of Multiple Indicators Cluster Survey.
Barrow A, Jobe A. Barrow A, et al. Int J Womens Health. 2020 Sep 9;12:709-718. doi: 10.2147/IJWH.S268824. eCollection 2020. Int J Womens Health. 2020. PMID: 32982475 Free PMC article. - Designing for action: adapting and implementing a community-based newborn care package to affect national change in Uganda.
Waiswa P, Namazzi G, Kerber K, Peterson S. Waiswa P, et al. Glob Health Action. 2015 Mar 31;8:24250. doi: 10.3402/gha.v8.24250. eCollection 2015. Glob Health Action. 2015. PMID: 25843494 Free PMC article. - Special issue: newborn health in Uganda.
Kerber K, Peterson S, Waiswa P. Kerber K, et al. Glob Health Action. 2015 Mar 31;8:27574. doi: 10.3402/gha.v8.27574. eCollection 2015. Glob Health Action. 2015. PMID: 25843501 Free PMC article. No abstract available. - High neonatal mortality rates in rural India: what options to explore?
Upadhyay RP, Chinnakali P, Odukoya O, Yadav K, Sinha S, Rizwan SA, Daral S, Chellaiyan VG, Silan V. Upadhyay RP, et al. ISRN Pediatr. 2012;2012:968921. doi: 10.5402/2012/968921. Epub 2012 Nov 18. ISRN Pediatr. 2012. PMID: 23213561 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical