Factors associated with mortality due to neonatal pneumonia in India: a protocol for systematic review and planned
N Sreekumaran Nair1, Leslie Edward Lewis2, Theophilus Lakiang1
1Public Health Evidence South Asia (PHESA),Manipal University, Manipal, India.
Insights
This systematic review examines factors contributing to neonatal pneumonia deaths in India, aiming to inform strategies for reducing infant mortality. Evidence synthesis will identify key determinants to improve neonatal survival rates.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- India faces the highest global burden of neonatal deaths, with a significant proportion attributed to pneumonia.
- Neonatal pneumonia is a leading cause of mortality in developing nations, necessitating targeted interventions.
Purpose of the Study:
- To systematically review and synthesize evidence on factors associated with mortality due to neonatal pneumonia in India.
- To address the gap in consolidated evidence to guide public health strategies and improve neonatal outcomes.
Main Methods:
- Systematic review of observational studies on neonatal pneumonia in India, published in English.
- Comprehensive literature search across nine databases, including grey literature, with rigorous study selection and risk of bias assessment.
- Meta-analysis and narrative synthesis to determine pooled effect estimates and identify factors influencing neonatal mortality, assessed using AMSTAR and GRADE criteria.
Main Results:
- This section is to be populated upon completion of the review; the protocol outlines the methodology for result synthesis.
Conclusions:
- This systematic review protocol provides a framework for identifying critical factors in neonatal pneumonia mortality in India.
- Findings will inform evidence-based interventions and policy recommendations to reduce the neonatal mortality rate in India.
Introduction:
India contributes to the highest number of neonatal deaths globally. It also has the greatest number of pneumonia-related neonatal deaths in the developing world. We aim to systematically review the evidence for the factors associated with mortality due to neonatal pneumonia in the Indian context, to address the lack of consolidated evidence on this important issue.
Methods And Analysis:
This protocol is part of a series of three reviews on neonatal pneumonia in India. Observational studies reporting on outcome of neonatal pneumonia in the Indian context, and published in English in peer-reviewed and indexed journals will be eligible for inclusion. Outcomes of this review will be the factors determining mortality due to neonatal pneumonia. A total of nine databases will be searched. Electronic and hand searching of published and grey literature will be performed. Selection of studies will be done in title, abstract and full text screening stages. Risk of bias, independently assessed by two authors, will be evaluated. Meta-analysis will be performed and heterogeneity assessed. Pooled effect estimates will be stated with 95% confidence intervals. Narrative synthesis will be done where meta-analysis cannot be performed. Publication bias will be evaluated and sensitivity analysis performed according to study quality. Quality of this review will be evaluated using AMSTAR (Assessing the Methodological quality of Systematic Reviews) and GRADE (Grades of Recommendation, Assessment, Development & Evaluation). A summary of findings table will be reported using GRADEPro.
Ethics And Dissemination:
Since this is a review involving analysis of secondary data which is available in the public domain, and does not involve human participants, ethical approval was not required. The findings of the study will be shared with all stakeholders of this research. Knowledge dissemination workshops will be conducted with relevant stakeholders to transfer the evidence, tailored to the stakeholder (eg, policy briefs, publications, information booklets, etc).
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