Cochrane · systematic review · CD007647
Community‐based maternal and newborn educational care packages for improving neonatal health and survival in low‐ and middle‐income countries
Lassi, ZS, Kedzior, SGE, Bhutta, ZA · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
NeonatalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
39
current version
GRADE rated
38
No studies
1
Included studies
NR
No studies 1 · 2.6%Ungraded 0 · 0%Very low 17 · 43.6%Low 12 · 30.8%Moderate 8 · 20.5%High 1 · 2.6%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Community health educational interventions compared to control in LMICs
Population: developing countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neonatal mortality Community health educational interventions vs control | RR 0.87 [0.78, 0.96] | 26 studies · 553111 participants | Low Downgraded: risk of bias |
Early neonatal mortality Community health educational interventions vs control | RR 0.74 [0.66, 0.84] | 15 studies · 321588 participants | Very low Downgraded: risk of bias |
Late neonatal mortality Community health educational interventions vs control | RR 0.54 [0.4, 0.74] | 11 studies · 186643 participants | Very low Downgraded: risk of bias |
Perinatal mortality Community health educational interventions vs control | RR 0.83 [0.75, 0.91] | 15 studies · 262613 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
Community health educational one‐to‐one and group and both counselling (subgroup) compared to control in LMICs
Population: developing countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neonatal mortality ‐ One‐to‐one counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.92 [0.71, 1.2] | 8 studies · 105735 participants | Very low Downgraded: risk of bias |
Neonatal mortality ‐ Group counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.83 [0.74, 0.92] | 12 studies · 211164 participants | Low Downgraded: risk of bias |
Neonatal mortality ‐ Both group and one‐to‐one counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.9 [0.76, 1.06] | 6 studies · 236212 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Early neonatal mortality ‐ Group counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.7 [0.61, 0.8] | 9 studies · 122151 participants | Low Downgraded: risk of bias |
Early neonatal mortality ‐ One‐to‐one counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 1.3 [1.01, 1.67] | 1 study · 18747 participants | Low Downgraded: risk of bias |
Early neonatal mortality ‐ Both one‐to‐one and group counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.78 [0.65, 0.93] | 5 studies · 180690 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Late neonatal mortality ‐ Group counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.5 [0.31, 0.81] | 7 studies · 118239 participants | Very low Downgraded: risk of bias |
Late neonatal mortality ‐ Both group and one‐to‐one counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.72 [0.57, 0.91] | 4 studies · 68404 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Perinatal mortality ‐ One‐to‐one counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.88 [0.57, 1.34] | 2 studies · 23829 participants | Very low Downgraded: risk of bias |
Perinatal mortality ‐ Group counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.85 [0.77, 0.94] | 8 studies · 156505 participants | Low Downgraded: risk of bias |
Perinatal mortality ‐ Both group and one‐to‐one counselling Community health educational one‐to‐one and group and both counselling (subgroup) vs control | RR 0.78 [0.67, 0.9] | 5 studies · 82279 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Community health educational ANC period and PNC period and both periods (subgroup) compared to control in LMICs
Population: developing countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neonatal mortality ‐ Education provided during ANC period only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.84 [0.64, 1.09] | 3 studies · 47849 participants | Very low Downgraded: risk of bias |
Neonatal mortality ‐ Education provided during PNC period only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 1.02 [0.84, 1.24] | 3 studies · 172882 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Neonatal mortality ‐ Education provided in both ANC and PNC periods Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.85 [0.76, 0.96] | 20 studies · 332380 participants | Very low Downgraded: risk of bias |
Early neonatal mortality ‐ Education provided during ANC period only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.64 [0.43, 0.95] | 2 studies · 33209 participants | Very low Downgraded: risk of bias |
Early neonatal mortality ‐ Education provided during PNC period only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 1.03 [0.94, 1.12] | 1 study · 111529 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Early neonatal mortality ‐ Education provided during both ANC and PNC periods Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.76 [0.68, 0.84] | 12 studies · 176850 participants | Very low Downgraded: risk of bias |
Late neonatal mortality ‐ Education provided during ANC period only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.87 [0.54, 1.4] | 1 study · 30952 participants | Very low Downgraded: risk of bias |
Late neonatal mortality ‐ Education provided during both ANC and PNC periods Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.52 [0.38, 0.72] | 10 studies · 155691 participants | Very low Downgraded: risk of bias |
Perinatal mortality ‐ Education provided during PNC only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.89 [0.78, 1.02] | 1 study · 60480 participants | High |
Perinatal mortality ‐ Education provided during ANC period only Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.9 [0.59, 1.39] | 2 studies · 33513 participants | Very low Downgraded: risk of bias |
Perinatal mortality ‐ Education provided during both ANC and PNC periods Community health educational ANC period and PNC period and both periods (subgroup) vs control | RR 0.81 [0.72, 0.91] | 12 studies · 168620 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Community health educational intervention for family members and mothers and for mothers only (subgroup) compared to control in LMICs
Population: developing countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neonatal mortality ‐ Intervention given to mothers and family members Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.84 [0.74, 0.95] | 13 studies · 282817 participants | Low Downgraded: risk of bias |
Neonatal mortality ‐ Intervention given to mothers only Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.9 [0.77, 1.05] | 13 studies · 270294 participants | Very low Downgraded: risk of bias |
Early neonatal mortality ‐ Intervention given to mothers and family members Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.7 [0.56, 0.87] | 7 studies · 99097 participants | Very low Downgraded: risk of bias |
Early neonatal mortality ‐ Intervention given to mothers only Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.78 [0.68, 0.9] | 8 studies · 222491 participants | Very low Downgraded: risk of bias |
Late neonatal mortality ‐ Intervention given to mothers and family members Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.69 [0.51, 0.92] | 4 studies · 76388 participants | Low Downgraded: risk of bias, imprecision, inconsistency |
Late neonatal mortality ‐ Intervention given to mothers only Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.5 [0.31, 0.78] | 7 studies · 110255 participants | Very low Downgraded: risk of bias |
Perinatal mortality ‐ Intervention given to mothers and family members Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.83 [0.72, 0.96] | 7 studies · 141824 participants | Low Downgraded: risk of bias |
Perinatal mortality ‐ Intervention given to mothers only Community health educational intervention for family members and mothers and for mothers only (subgroup) vs control | RR 0.83 [0.72, 0.96] | 8 studies · 120789 participants | Low Downgraded: risk of bias |
Community health educational interventions compared to control in LMICs: Sensitivity analysis on primary outcomes
Population: developing countries
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Neonatal mortality Community health educational interventions vs control | RR 0.88 [0.79, 0.98] | 22 studies · 497258 participants | Moderate Downgraded: inconsistency |
Early neonatal mortality Community health educational interventions vs control | RR 0.71 [0.62, 0.82] | 11 studies · 26472 participants | Moderate Downgraded: inconsistency |
Late neonatal mortality Community health educational interventions vs control | RR 0.51 [0.36, 0.72] | 9 studies · 150867 participants | Moderate Downgraded: inconsistency |
Perinatal mortality Community health educational interventions vs control | RR 0.84 [0.75, 0.94] | 12 studies · 262613 participants | Moderate Downgraded: inconsistency |
aInconsistency. Community health educational interventions vs control | no estimate extracted | NR | No studies |