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Perinatal interventions and survival in resource-poor settings: which work, which don't, which have the jury out?

Osrin, D; Prost, A; (2010) Perinatal interventions and survival in resource-poor settings: which work, which don't, which have the jury out? ARCH DIS CHILD , 95 (12) 1039 - 1046. 10.1136/adc.2009.179366.

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Abstract

Perinatal conditions make the largest contribution to the burden of disease in low-income countries. Although postneonatal mortality rates have declined, stillbirth and early neonatal mortality rates remain high in many countries in Africa and Asia, and there is a concentration of mortality around the time of birth. Our article begins by considering differences in the interpretation of 'intervention' to improve perinatal survival. We identify three types of intervention: a single action, a collection of actions delivered in a package and a broader social or system approach. We use this classification to summarise the findings of recent systematic reviews and meta-analyses. After describing the growing evidence base for the effectiveness of community-based perinatal care, we discuss current concerns about integration: of women's and children's health programmes, of community-based and institutional care, and of formal and informal sector human resources. We end with some thoughts on the complexity of choices confronting women and their families in low-income countries, particularly in view of the growth in non-government and private sector healthcare.

Type: Article
Title: Perinatal interventions and survival in resource-poor settings: which work, which don't, which have the jury out?
DOI: 10.1136/adc.2009.179366
Keywords: RANDOMIZED CONTROLLED-TRIAL, 4-MILLION NEONATAL DEATHS, TRADITIONAL BIRTH ATTENDANTS, INTRAPARTUM-RELATED DEATHS, MIDDLE-INCOME COUNTRIES, MATERNAL MORTALITY, CHILD SURVIVAL, SCALE-UP, NEWBORN-CARE, OVERCOME CHALLENGES
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
URI: http://discovery.ucl.ac.uk/id/eprint/351650
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