PROCEDIMIENTOS DE LA OFICINA DE ESCALAFÓN

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APPENDIX 10: Table of Included Studies

Source Patient Population/

Countries

Intervention Trial Design Outcomes Results

Carlo WA, et al. 2010

ENC: 57,643 infants NRP: 62,366 infants Infants ≥1500 grams & ≥ 28 weeks gestation

Rural areas of Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan & Zambia)

Train-the-Trainer model

1.WHO ENC program 2.NRP training (except in Argentina) Physicians, nurses, birth attendants, and mothers trained

Pre-/Post- design, cluster- randomized controlled triali

Primary- Early neonatal death, all causes (within 7 days) Secondary- Stillbirths & perinatal mortality After ENC: Decreased stillbirths (RR 0.69; 95% CI 0.54, 0.88, p=0.003) No change in early neonatal deaths (RR 0.99; 95% CI 0.81, 1.22) No change in perinatal mortality (RR 0.85; 95% CI 0.70, 1.02) After NRP: No change in stillbirths, early neonatal death or perinatal mortalty Garces A, et al. 2012

(Guatemala)

*Part of Carlo WA, et.al trial above)

4798 infants Infants ≥1500 grams Rural Guatemala

Train-the-Trainer model

1.WHO ENC program Physicians, nurses, & birth attendants

Pre-/Post- design, prospective trial

Primary- Early neonatal death, all causes (within 7 days) Secondary- Stillbirths & perinatal mortality Decreased stillbirths (RR 0.40; 95% CI 0.25, 0.64) No change in early neonatal deaths (RR 1.05; 95% CI 0.7, 1.57) Decrease in perinatal mortality (RR 0.72; 95% CI 0.54, 0.97) Edmond A, et al. 2002 (Brazil)

Number not reported, though national birth registration with 2420 births in the area

Rural Brazil

ProNatal project: Open antenatal clincs, maternity facilities, family planning clinic, breastfeeding clinic, improvement of children’s services and clinics, introduction of community health agents, & teaching in public health & pediatrics to nursing and medical students in the community

Pre-/Post-design, prospective trail

Undefined, though data reported for maternal, infant and child mortality and morbidities as well as

demographics

Changes in infant mortality initially reported as inaccurate for “underregistration” Later data collection with improvent in infant mortality without any data reported

Kwast B. 1996 (Bolivia & Guatemala)

Number not reported Rural Bolivia & Guatemala

MotherCare project Bolivia: Development of women’s groups, & perinatal action protocols for birth attendants and women, training of birth attendants, women and husbands, & strengthening of referral resources MotherCare project Guatemala: Train 400 birth attendants, implementation of protocols for perinatal complications, and sensitization of providers to women and birth attendants

Non-randomized trial (Guatemala)

Ongoing prospective trial (Bolivia)

Undefined, though outcomes reported for perinatal mortality (Bolivia & Guatemala) & early neonatal deaths (Guatemala)

Improvement in perinatal mortality from 105 to 38 per 1000 deaths (Bolivia) Improvement in perinatal mortality in the referrals from 22 to 12.% No improvement in early neonatal deaths.

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ABBREVIATIONS

LIC – Low income countries

LMIC - Low-middle income countries AAP – American Academy of Pediatrics HBB – Helping Babies Breathe

ECEB – Essential Care for Every Baby WHO – World Health Organization ENC – Essential Newborn Care MINSA – Ministry of Health QI – Quality Improvement

CQI – Continuous Quality Improvement SILAIS – Local Health System in Nicaragua NRP – Neonatal Resuscitation Program

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Bhutta ZA, Das JK, Bahl R, et al. for The Lancet Newborn Interventions Review Group and The Lancet Every Newborn Study Group. (2014). Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet 2014; published online May 20. http://dx.doi.org/10.1016/S0140-6736(14)60792-3.

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Godar, S. S., Somannavar, M. S., Clark, R., Lockyer, J. M., Revankar, A. P., Fidler, H. M., ... & Singhal, N. (2013). Stillbirth and newborn mortality in India after helping babies breathe training. Pediatrics, 131(2), e344-e352.

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http://www.inide.gob.ni/endesa/Endesa_2006/InformeFinal06_07.pdf. Accessed 1 April 2016. Kwast BE. Reduction of maternal and perinatal mortality in rural and peri-urban settings: what works?. European Journal of Obstetrics & Gynecology and Reproductive Biology.

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