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


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 ofa 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.

SUBMITTER: Osrin D 

PROVIDER: S-EPMC3428881 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature

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

Osrin David D   Prost Audrey A  

Archives of disease in childhood 20101026 12


<h4>Unlabelled</h4>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<h4>Intervention</h4  ...[more]

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