Article type
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Abstract
Background: Malaysia has explored many opportunities to achieve its mortality indicators for Millennium Development Goals (MDG) 4 and 5. One of these was to examine whether interventions with high level of evidence have been implemented into the health service.
Objectives: To identify interventions from the Cochrane Database with clear evidence of benefit for reducing maternal and neonatal mortality and select for implementation interventions expected to reduce maternal and neonatal mortality in Malaysia.
Methods: This project consisted of four phases:
1. using prespecified criteria and duplicate data extraction, we identified Cochrane Reviews with clear evidence for reducing maternal or neonatal mortality or selected surrogate outcomes;
2. examination of local obstetric and neonatal registry data for evidence of current level of implementation of the selected interventions;
3. stakeholder presentations and selection of interventions for implementation;
4. Development of strategies for implementation and monitoring.
We evaluated stakeholder’s responses to the presentations.
Results: We present the results of phases 1-3. We found 50 Cochrane Reviews describing 29 maternal and 21 neonatal interventions with clear evidence for reducing MDG 4 and 5 mortality indicators. Evidence on current implementation could be obtained for only two of these interventions. Interventions were presented at a series of stakeholder meetings. Stakeholders were engaged in the presentations, felt the interventions were informative, and could be used to change practice. Interventions selected were kangaroo mother care, probiotics for preterm infants, aspirin to prevent pre-eclampsia and calcium supplementation. Stakeholders wanted more discussion on implementation and help with developing implementation and intervention monitoring strategies.
Conclusions: We have identified interventions with clear evidence of benefit in being able to optimize our Malaysian MDGs. Stakeholders were keen to implement them. Malaysian registries could be better used to monitor use of important interventions. Our approach could be applied to other areas of health care.
Objectives: To identify interventions from the Cochrane Database with clear evidence of benefit for reducing maternal and neonatal mortality and select for implementation interventions expected to reduce maternal and neonatal mortality in Malaysia.
Methods: This project consisted of four phases:
1. using prespecified criteria and duplicate data extraction, we identified Cochrane Reviews with clear evidence for reducing maternal or neonatal mortality or selected surrogate outcomes;
2. examination of local obstetric and neonatal registry data for evidence of current level of implementation of the selected interventions;
3. stakeholder presentations and selection of interventions for implementation;
4. Development of strategies for implementation and monitoring.
We evaluated stakeholder’s responses to the presentations.
Results: We present the results of phases 1-3. We found 50 Cochrane Reviews describing 29 maternal and 21 neonatal interventions with clear evidence for reducing MDG 4 and 5 mortality indicators. Evidence on current implementation could be obtained for only two of these interventions. Interventions were presented at a series of stakeholder meetings. Stakeholders were engaged in the presentations, felt the interventions were informative, and could be used to change practice. Interventions selected were kangaroo mother care, probiotics for preterm infants, aspirin to prevent pre-eclampsia and calcium supplementation. Stakeholders wanted more discussion on implementation and help with developing implementation and intervention monitoring strategies.
Conclusions: We have identified interventions with clear evidence of benefit in being able to optimize our Malaysian MDGs. Stakeholders were keen to implement them. Malaysian registries could be better used to monitor use of important interventions. Our approach could be applied to other areas of health care.