Community level youth-led interventions to improve maternal-neonatal outcomes in low- and middle-income countries: A systematic review of randomised trials.
Autor: | MacDonald, Tonya, Rehman, Nadia, Stevens-Uninsky, Maya, Anni, Naharin Sultana, Liu, Rachel, Darling, Elizabeth K., Greene, Saara, Moll, Sandra, Mbuagbaw, Lawrence |
---|---|
Předmět: |
WELL-being
MOTHERS CINAHL database MEDICAL databases STATISTICS MIDDLE-income countries META-analysis MEDICAL information storage & retrieval systems CONFIDENCE intervals EVALUATION of human services programs SYSTEMATIC reviews HEALTH status indicators COMMUNITY health services PREGNANT women CHILD health services LOW-income countries DESCRIPTIVE statistics TEENAGE pregnancy MEDLINE ODDS ratio DATA analysis software |
Zdroj: | Journal of Global Health; 2023, Vol. 13, p1-12, 12p |
Abstrakt: | Background Evidence on the effectiveness of youth-led interventions for improving maternal-neonatal health and well-being of women and gender diverse childbearing people in low-income and middle-income countries (LMICs) is incomplete. We aimed to summarise the evidence on whether community level youth-led interventions can improve maternal and neonatal outcomes in LMICs. Methods We included experimental studies of youth-led interventions versus no intervention, standard care, or another intervention. Participants were women and gender diverse childbearing people during antepartum, intrapartum, and postpartum periods. MEDLINE, Embase, CINAHL, Global Health, Web of Science, and Cochrane Library, and grey literature were searched to January 2023. All interventions addressing and targeting maternal-neonatal health and well-being that were youth-led and community level were included. Primary outcomes of interest were maternal death and neonatal death. We excluded based on population, intervention, comparison, and outcome (PICO) and design. Two reviewers independently extracted key information from each included study and assessed risk of bias. Random-effects meta-analysis was performed where there were sufficient data. The certainty of evidence was assessed using Grading of Recommendations, Assessment, Development and Evaluation (GRADE). A narrative synthesis was done for results that could not be pooled. Results Of the 8054 records retrieved, four trials (21813 enrolled participants) met the inclusion criteria. The Cooperative for Assistance and Relieve Everywhere, Inc. (CARE) Community Score Card intervention compared to standard reproductive health services control did not significantly improve Antenatal Care coverage (difference-in-differences estimate ß =0.04; 95% confidence interval (CI)=-0.11, 0.18, P=0.610; one study, low certainty of evidence). The multi-component social mobilisation interventions compared to standard of care had no effect on adolescent/youth pregnancy (adjusted odds ratio estimate= 1.08; 95% CI=0.87, 1.33; three studies; low certainty of evidence). Conclusions Youth-led interventions in LMICs did not show a significant improvement in maternal outcomes. More studies are required to make more precise conclusions. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
Externí odkaz: |