Interventions to improve neonatal and child survival

Article type
Year
Authors
Lassi Z1, Middleton P1, Crowther C2, Bhutta Z3
1University of Adelaide, Australia
2University of Auckland, Australia
3Sickkids Hospital Toronto, Canada
Abstract
Background: Evidence-based interventions and strategies are needed to improve child survival in countries with a high burden of neonatal and child mortality. Several systematic reviews have been published that have looked at the impact of single interventions for reducing these deaths; however, there is no overview on those systematic reviews.

Objectives: The objective of this overview is to identify the effective interventions that can improve neonatal and child survival.

Methods: This overview included all published Cochrane and non-Cochrane systematic reviews of experimental and observational studies on antenatal, natal, postnatal and child health interventions aiming to prevent neonatal/perinatal and child mortality. The methodological quality of the reviews was assessed using the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) criteria and the quality of the outcomes reported was assessed using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) approach. Based on the findings from GRADE criteria, interventions were summarized as effective, promising or ineffective.

Results: The overview identified 148 Cochrane and non-Cochrane systematic reviews on 61 reproductive, maternal, newborn and child health interventions. Of these, only 57 reviews reported mortality outcomes. Using the GRADE approach, corticosteroids for preventing neonatal respiratory distress syndrome in preterm infants; early initiation of breastfeeding; kangaroo care for preterm infants; and vitamin A supplementation for infants from six months of age, were identified as effective interventions for reducing neonatal, infant or child mortality.

Conclusions: Implementing these effective interventions will improve neonatal and child survival around the world. Choosing which interventions to implement will depend on resources available in individual countries.