Abstract
Worldwide, 250,000–280,000 women die during pregnancy and childbirth every year and an estimated 6.55 million children die under the age of five. The majority of maternal deaths occur during or immediately after childbirth, while 43% of child death occurs during the first 28 days of life. However, the progress in limiting these has been slow and sporadic. In this supplement of five papers, we aim to systematically assess and summarize essential interventions for reproductive, maternal, newborn and child health from relevant systematic reviews. This paper is an introductory paper detailing the background and methodology used for grading interventions. The following three papers summarize the evidence on essential interventions for pre-pregnancy, pregnancy, childbirth, postnatal (mother and neonatal) and child heath while the last paper describes the essential interventions as per the level of health care delivery and their proposed packages of care.
Highlights
Worldwide, 250,000–280,000 women die during pregnancy and childbirth every year and an estimated 6.55 million children die under the age of five
Access to antenatal health visits and medicines can prevent death from hypertensive disorders, while death due to sepsis can be averted by screening for prenatal maternal infection and sexually transmitted infections (STIs) during antenatal visits and with hygienic infection control measures during birth provided by skilled birth attendant (SBA)
Relevant reviews for each intervention were identified from the following electronic databases: the Cochrane database of systematic reviews, the Cochrane database of abstract reviews of effectiveness (DARE), the Cochrane database of systematic reviews of randomized control trials (RCT’s), and PubMed
Summary
250,000–280,000 women die during pregnancy and childbirth every year and an estimated 6.55 million children die under the age of five. The rates of no access to skilled birth care and emergency obstetric care are higher in LMICs where majority of deaths and morbidity related to complications of childbirth take place [8]. Interventions to avert maternal mortalities can prevent neonatal deaths; evidence suggests that 77% of all neonatal deaths occurs where the coverage of skilled birth attendance is 50% or even less [10]. Among children under the age of five years, infection is the major cause of severe morbidity and mortality Simple interventions such as proper nutrition, sanitation, hygiene, complete and timely immunization along with preventive and therapeutic interventions for the management of diarrhoea and pneumonia can save a major portion of these preventable under-five deaths. According to the recent estimates, scaling up of these key evidence-based interventions coverage to at least 80% and that for immunization to at least 90%, can eliminate 95% of diarrhoea and 67% of pneumonia deaths in children younger than 5 years by 2025 at a cost of $6·715 billion [12]
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