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Community-based interventions improve newborn outcomes but not maternal mortality.

A systematic review was done of the effectiveness of community-based intervention packages for preventing maternal morbidity and mortality and improving neonatal outcomes during pregnancy, delivery and the post-partum period. The review included 27 experimental and non-experimental studies which employed rigorous impact evaluation techniques, covering a wide range of interventions. Studies were from Asia (22), Africa (3), European Union (1) and South America (1). The review did not find a significant reduction in maternal mortality across all studies, but it did find a significant reduction across studies with low risk of bias. Significant reductions were observed in neonatal mortality, stillbirths and perinatal mortality. The interventions also led to reductions in maternal morbidity, increased referrals to a health facility for pregnancy-related complications, improved rates of early breastfeeding, and improved newborn care-related outcomes. The review offers evidence of the value, particularly for infants, of integrating maternal and newborn care in community settings through a range of strategies, many of which can be delivered by community health workers. The most successful packages were those which emphasised clean practices by involving family members, provision of care through trained community health workers, and strengthened referrals for mothers and newborns. 1 However, the importance of skilled delivery and facility-based emergency obstetric care still needs greater attention.

(1.) Lassi ZS, Haider BA, Bhutta ZA. Community-based intervention packages for preventing maternal morbidity and mortality and improving neonatal outcomes. The International Initiative for Impact Evaluation, March 2010.

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Title Annotation:ROUND UP: Maternal health and maternal mortality
Publication:Reproductive Health Matters
Article Type:Brief article
Geographic Code:1USA
Date:Nov 1, 2010
Words:237
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