O311 Protecting Women Who Deliver at Home From Pph: The Use of Clean Delivery Kits in Northwestern Bangladesh

Quaiyum, Md. Abdul; Prata, Ndola; Holston, Martine; Hossain, Sakawat; Rahman, Syeda Jesmin

doi:10.1016/s0020-7292(12)60741-3

Cited by 1 publication

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“…Postpartum haemorrhage was also lower in the intervention group in three studies [ 11 , 30 , 39 ]. Maternal mortality was lower in the intervention group in three of the five studies that measured this outcome [ 11 , 30 , 46 ], but the difference was not statistically significant in any of them. One of these five studies [ 38 ] also tested the effect of hand washing separately from the supply kits.…”

Section: Resultsmentioning

confidence: 98%

“…Eight studies reported data on the effect of kits on maternal outcomes [ 10 , 11 , 13 , 30 , 38 – 40 , 46 ] (See Table 6 ). They were all community-based interventions except for the study by Ouma et al [ 11 ], which was a study on an emergency kit for use in facilities.…”

Section: Resultsmentioning

confidence: 99%

“…Regarding the follow-up of participants and providers, there was a low risk of bias in 50% and 75% of the included studies, respectively. Observational studies with and without a comparison group [ 13 , 32 – 34 , 36 , 38 – 44 , 46 ] had a low risk of bias regarding the selection of participants (82%) and conflict of interest of authors (91%). The methods and measurement of the outcomes (information and detection bias) had a low risk of bias in 55% of studies as well as control of confounders.…”

Section: Resultsmentioning

confidence: 99%

“…The groups using supply kits showed a statistically significant positive effect on neonatal outcomes; including reduced cord infection [ 13 , 40 , 42 ], sepsis [ 35 , 43 ], neonatal mortality [ 10 , 30 , 43 ] and perinatal mortality [ 30 ]. Several studies showed a statistically significant decrease in maternal adverse outcomes in the group using supply kits (see Table 6 ) including reduction in puerperal infection [ 13 , 30 , 40 ] and postpartum haemorrhage [ 11 , 30 , 39 ] and a non-significant reduction in maternal mortality [ 11 , 30 , 46 ].Meta-analysis was deemed inappropriate due to the heterogeneity in the study designs, in the content of the supply kits, in the definition of compliance in use of supply kits and in the outcomes measured.…”

Section: Discussionmentioning

confidence: 99%

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Supply kits for antenatal and childbirth care: a systematic review

et al. 2017

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IntroductionIt is critical to increase the uptake of interventions proven to be effective to improve maternal and perinatal outcomes. Supply kits have been suggested to be a feasible strategy designed to ensure timely availability and effective follow-up of care.ObjectiveWe conducted a systematic review to summarize the evidence on the uptake, effectiveness and safety of supply kits for maternal care.Search strategyMEDLINE, the Cochrane Pregnancy and Childbirth Group’s Trials Register, Campbell Collaboration, Lilacs, Embase and unpublished studies were searched.Selection criteriaStudies that reported the efficacy, safety and use of supply kits for maternal healthcare were eligible. Participants were pregnant women or in childbirth. Supply kits were defined as a collection of medicines, supplies or instruments packaged together with the aim of conducting a healthcare task.Data collection and analysisTwo reviewers independently performed the screening, data extraction, and methodological and quality assessment.Main results24 studies were included: 4 of them were systematic reviews and 20 primary studies. Eighteen studies evaluated a so-called “clean delivery kit”. In all but two studies, the kits were used by more than half of the participants. A meta-analysis was deemed inappropriate due to the heterogeneity in study design, in the components of the interventions implemented, in the content of the kits, and in outcomes. Nine studies assessed neonatal outcomes and found statistically significant reductions in cord infection, sepsis and tetanus-related mortality in the intervention group. Three studies showed evidence of reduced neonatal mortality (OR 0.52, 0.60 and 0.71) with statistically significant confidence intervals in all cases. Four studies reported odd ratios for maternal mortality, but only one showed evidence of a statistically significant decrease in this outcome but it was ascribed to hand washing prior to childbirth and not with the use of kits.ConclusionThis review suggests potential benefits in the use of supply kits to improve maternal and neonatal health. However, the observational nature of the studies, the heterogeneity and the use of kits incorporated within complex interventions limit the interpretation of the findings.Electronic supplementary materialThe online version of this article (10.1186/s12978-017-0436-9) contains supplementary material, which is available to authorized users.

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