Systematic review of effect of community-level interventions to reduce maternal mortality

摘要: The objective was to provide a systematic review of the effectiveness community-level interventions reduce maternal mortality. We searched published papers using Medline, Embase, Cochrane library, CINAHL, BNI, CAB ABSTRACTS, IBSS, Web Science, LILACS and African Index Medicus from inception or at least 1982 June 2006; unpublished works National Research Register website, metaRegister WHO International Trial Registry portal. hand major references. Selection criteria were maternity childbearing age women, comparative study designs with concurrent controls, death as an outcome. carried out selection, data abstraction quality assessment independently in duplicate. found five cluster randomised controlled trials (RCT) eight cohort studies interventions. summarised results odds ratios (OR) confidence intervals (CI), combined Peto method for meta-analysis. Two high RCTs, aimed improving perinatal care practices, showed reduction mortality reaching statistical significance (OR 0.62, 95% CI 0.39 0.98). Three equivalence RCTs minimal goal-oriented versus usual antenatal no difference (1.09, 0.53 2.25). low did not contribute further evidence. Community-level improved practices can bring about This challenges view that investment such is worthwhile. Programmes improve should be evaluated techniques generate