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Rationale and Approach to Evaluating Interventions for Newborn Care in Low- and Middle-Income Countries
Leila Harrison1, Tyler Vaivada1, Rahima Yasin2
1Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
Insights
This study outlines a systematic methodology for synthesizing evidence on newborn interventions in low- and middle-income countries (LMICs). It ensures comprehensive and up-to-date information for improving neonatal survival rates.
Area of Science:
- Global Health
- Neonatal Medicine
- Evidence Synthesis
Background:
- The neonatal period is critical, accounting for nearly half of under-5 deaths, primarily due to preventable causes like preterm birth, birth asphyxia, and infections.
- There's a growing body of evidence for interventions to reduce neonatal mortality and morbidity in low- and middle-income countries (LMICs).
- Synthesizing this expanding evidence base requires a systematic and comprehensive approach.
Purpose of the Study:
- To describe the methodological approach used for systematic overviews and reviews of newborn interventions.
- To ensure the synthesis of the best available evidence for effective newborn interventions in LMICs.
- To provide a framework for ongoing evidence synthesis in neonatal health.
Main Methods:
- Conducted an extensive literature-scoping exercise to identify relevant interventions and existing systematic reviews.
- Employed three evidence synthesis strategies: conducting new reviews, updating existing reviews, and utilizing high-quality existing reviews.
- Prioritized trial data from studies conducted in low- and middle-income countries (LMICs).
Main Results:
- A systematic methodology was developed and applied to synthesize evidence on newborn interventions.
- The approach successfully integrated new reviews, updated existing ones, and leveraged high-quality existing syntheses.
- Prioritization of LMIC data ensured relevance to the target populations.
Conclusions:
- A comprehensive methodological framework for summarizing evidence on newborn intervention effectiveness has been established.
- This systematic approach is crucial for guiding interventions and improving neonatal outcomes in LMICs.
- The described methodology facilitates the synthesis of the best available evidence for newborn health.
Introduction:
The neonatal period is the most vulnerable time in a child's life, contributing to almost half of all deaths in children under 5 years. Many of these deaths are preventable and are mainly caused by preterm birth, birth asphyxia, or serious infections. Over the past decade, the evidence base for interventions to prevent and manage these causes of neonatal mortality and morbidity in low- and middle-income countries (LMICs) has expanded significantly. This growth calls for a comprehensive and systematic approach to synthesizing the available evidence. This paper describes the methodological approach taken before and during the conduct of the systematic overviews and reviews described in the online supplementary material (for all online suppl. material, see
Methods:
Alongside consultation with a newborn technical advisory group, the overall evidence synthesis approach began with an extensive literature-scoping exercise to establish a universe of interventions that were relevant to neonatal health and survival and to identify the associated systematic reviews examining their effectiveness. Three main approaches were taken to synthesize the evidence based on the availability of prior evidence. New systematic reviews were conducted for topics lacking an existing comprehensive synthesis. Existing systematic reviews with search dates prior to 2020 were updated. High-quality, up-to-date systematic reviews were used without modification. In all cases, trial data from studies conducted in LMICs were sought and prioritized for analysis.
Conclusion:
A comprehensive approach to summarizing the best available evidence for newborn intervention effectiveness is described.
Introduction:
The neonatal period is the most vulnerable time in a child's life, contributing to almost half of all deaths in children under 5 years. Many of these deaths are preventable and are mainly caused by preterm birth, birth asphyxia, or serious infections. Over the past decade, the evidence base for interventions to prevent and manage these causes of neonatal mortality and morbidity in low- and middle-income countries (LMICs) has expanded significantly. This growth calls for a comprehensive and systematic approach to synthesizing the available evidence. This paper describes the methodological approach taken before and during the conduct of the systematic overviews and reviews described in the online supplementary material (for all online suppl. material, see
Methods:
Alongside consultation with a newborn technical advisory group, the overall evidence synthesis approach began with an extensive literature-scoping exercise to establish a universe of interventions that were relevant to neonatal health and survival and to identify the associated systematic reviews examining their effectiveness. Three main approaches were taken to synthesize the evidence based on the availability of prior evidence. New systematic reviews were conducted for topics lacking an existing comprehensive synthesis. Existing systematic reviews with search dates prior to 2020 were updated. High-quality, up-to-date systematic reviews were used without modification. In all cases, trial data from studies conducted in LMICs were sought and prioritized for analysis.
Conclusion:
A comprehensive approach to summarizing the best available evidence for newborn intervention effectiveness is described.
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