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Appendix 4.5: Included items dealing with complex interventions and maternal mortality Author (year) (IV)/(EV) Alwen (2005) (-)/(+) Bashir (1995) (-)/(-) Campbell (2005) (+)/(+) Mbaruku (1995) (-)/(-) Target population Women in general Women in general Women in general Women in general Brief intervention description Targeted outcome(s) Safe Motherhood programmes in Upper Egypt: training; revised curricula; publication of medical protocols and services standards; upgrading of facilities; community outreach programmes; media campaigns. Free access to obstetric care for ‘deserving cases’; subsidies; training and refresher courses for TBAs; community education; introduction of specialised services; obstetric flying squad. Maternal mortality Maternal mortality Safe Motherhood programmes. Maternal mortality There were 22 parts to the intervention: 1. Obstetrician nominated leader for intervention, change of traditional hierarchy, greater delegation to nurses and midwives. Maternal mortality Findings summary Appendix 4.5 Maternal mortality ratio (MMR) dropped by 52% between 1992-2000 (from 174 to 84/100,000 live births). Trends in city-level (Faisalabad, Pakistan) maternal mortality, from 0.86/1,000 live births in 1989 to 0.64/1,000 live births in 1993. The maternal mortality ratio (MMR) declined from 174 to 84/100,000 live births between 1992-93 and 2000. Improvements in parts of Egypt were due in part to extensive training, revised curricula, the publication of medical protocols and services standards, the upgrading of facilities, and successful community outreach programmes and media campaigns. Average maternal mortality ratio for two years before intervention was 849/100,000 live births and 275/100,000 in the period following implementation of intervention. What are the effects of different models of delivery for improving maternal and infant health outcomes for poor people in urban areas in low income and lower middle income countries? 226
Author (year) (IV)/(EV) Target population Brief intervention description Targeted outcome(s) 2. Regular monthly meetings were arranged to enable staff to be informed and receive feedback 3. Efforts made to utilise available resources and refer to outside donors only when local resources exhausted, e.g. using local carpenters 4. Schedules for regular maintenance were started in order to prevent breakdown. 5. Maintenance of working skills was guaranteed by a number of activities. 6. Improvement of patient management by early diagnosis and treatment of diseases known to be common causes of death. 7. Efforts made to improve resuscitation of patients – training auxiliaries 8. Use of broad-spectrum antibiotics preoperatives was emphasised 9. Peripheral antenatal clinics were instructed to refer all cases of clinical anaemia early for correction 10. Better management routines in cases of severe anaemia introduced Findings summary Appendix 4.5 What are the effects of different models of delivery for improving maternal and infant health outcomes for poor people in urban areas in low income and lower middle income countries? 227
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Systematic review What are the effe
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Contents List of abbreviations ....
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List of abbreviations AIDS Acquired
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Executive summary Background Execut
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Executive summary be to retrospecti
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Background many LICs and LMCs, it i
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Background Cross-sectional surveys
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Background For some causes of mater
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Background informal settlements on
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Background review focused on explic
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Types of intervention Interventions
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Box 2.2: Websites searched AFD (Age
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second stage previously described f
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using qualitative analysis to attem
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Figure 3.1: Filtering of papers fro
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Middle East and North Africa (8%) S
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Search results access or satisfacti
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4. Synthesis results Summary Synthe
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Synthesis results Four studies focu
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Drug treatments (including micronut
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Synthesis results Training and audi
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Synthesis results order to be effec
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Synthesis results government admini
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HIV/AIDS and Malaria, as well as no
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Synthesis results ASSESSING THE COS
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and birthing care services, includi
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Synthesis results of settings were
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Figure 4.1: Causal chain for matern
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4.3 Summary of results of causal ch
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5. Strengths and limitations Summar
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6. Conclusions and recommendations
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Conclusions and recommendations Urb
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References Bakr A F, Karkour T (200
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References Deschamps M M, Noel F, B
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References Lim S, Dandona L, Hoisin
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References Shantharam Baliga B, Rag
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References Channon A A, Falkingham
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References Jowett M (2000) Safe Mot
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References Rice J, Rice J S (2009)
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Appendices Appendix 1.1: Authorship
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Appendix 2.1: Inclusion and exclusi
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Appendix 2.2: Search strategy for e
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Appendix 2.2 Infant* OR Matern* OR
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OR/ 12-13 11 AND 14 Limit 15 to pub
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Appendix 2.4: Journals handsearched
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POOR PROFILE Is the study populatio
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infants (
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Appendix 2.5 Intervention (surgical
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Appendix 2.5 Intervention (service
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MORTALITY OUTCOME TYPES Which morta
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positive neutral negative unclear/n
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yes no unclear/not stated N/A Study
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surveillance system none of the abo
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no SELECTION CHARACTERISTICS Is inf
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Appendix 2.5 QUANTITATIVE DATA ADJU
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RESEARCHER RELATIONSHIP Has the rel
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Were the inclusion/exclusion criter
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person-years). 3.5 Was follow-up ti
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Appendix 2.7 Appendix 2.7: Quality
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triangulation, or for not triangula
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Was the study approved by an ethics
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Item Yes No Not clear 3. The viewpo
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Appendix 2.9: Electronic databases
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Web of Knowledge (including ISI Cit
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Study Setting Intervention type Abo
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Study Setting Intervention type Alw
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Study Setting Intervention type Ben
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Study Setting Intervention type Ble
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Study Setting Intervention type Cob
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Study Setting Intervention type Des
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Study Setting Intervention type Faw
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Study Setting Intervention type Jak
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Study Setting Intervention type Kup
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Study Setting Intervention type Mar
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Study Setting Intervention type Nah
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Study Setting Intervention type Pad
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Study Setting Intervention type Str
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Study Setting Intervention type Zia
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Appendix 3.2 Adam G K, Abdulla M A,
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Appendix 3.2 Balkus J, Bosire R, Jo
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Appendix 3.2 Boerma J T, Stroh G (1
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Appendix 3.2 Chiwuzie J, Okojie O,
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Appendix 3.2 De Alencar A E, Arraes
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Appendix 3.2 Ekman B, Pathmanathan
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Appendix 3.2 Garg R, Omwomo W, Witt
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Appendix 3.2 Gupta R, Sachdev H P,
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Appendix 3.2 Hutton G, Schellenberg
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Appendix 3.2 Khandker S R, Latif M
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Appendix 3.2 Lindblade K A, Eisele
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Appendix 3.2 Menéndez C, Bardají
Page 181 and 182: Appendix 3.2 Nduati R, John G, Mbor
Page 183 and 184: Appendix 3.2 O'Rourke K (1995a) The
Page 185 and 186: Appendix 3.2 Prual A, De Bernis L,
Page 187 and 188: Appendix 3.2 Sabitu K, Alti-Mu'azu
Page 189 and 190: Appendix 3.2 Smith J B, Coleman N A
Page 191 and 192: Appendix 3.2 Van Rheenen P, De Moor
Page 193 and 194: Appendix 3.2 Xiang X, Wang L, Xu L
Page 195 and 196: Appendix 3.4 Appendix 3.4: Studies
Page 197 and 198: Appendix 3.4 International Bank for
Page 199 and 200: Appendix 3.5 Appendix 3.5: Studies
Page 201 and 202: Orji (2003) (-)/(-) Shihadeh (2001)
Page 203 and 204: Chinayon (1998) (+)/(+) Kamilya (20
Page 205 and 206: Nahar (2004) (-)/(-) Tukur (2007) (
Page 207 and 208: Ndibazza (2010) (++)/(+) Antiretrov
Page 209 and 210: Bergstrom (1991) (+)/(+) Women with
Page 211 and 212: Enakpene (2010) (+)/(-) Etuk (2000a
Page 213 and 214: Pereira (1996) (-)/(-) Saleem (2007
Page 215 and 216: Author (year) (IV)/(EV) Joshi (2007
Page 217 and 218: Author (year) (IV)/(EV) Aaby (2005)
Page 219 and 220: Author (year) (IV)/(EV) Martins (20
Page 221 and 222: Author (year) (IV)/(EV) de Muylder
Page 223 and 224: Author (year) (IV)/(EV) Provider mo
Page 225 and 226: Appendix 4.4: Included items dealin
Page 227 and 228: Author (year) (IV)/(EV) Target Popu
Page 229 and 230: Author (year) (IV)/(EV) Colonna (19
Page 231: Author (year) (IV)/(EV) Kuhn (2008)
Page 235 and 236: Author (year) (IV)/(EV) Mswia (2003
Page 237 and 238: Appendix 4.6: Included items dealin
Page 239 and 240: Appendix 4.8 Appendix 4.8: Economic
Page 241 and 242: Author (year) (IV)/(EV) and setting
Page 243 and 244: Appendix 4.9: Included items identi
Page 245 and 246: Author (year) (IV)/(EV) Poor urban
Page 247 and 248: Author (year) (IV)/(EV) Poor urban
Page 249 and 250: Appendix 4.10: High-quality include
Page 251: The authors of this report were sup
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