Alma-Ata: Rebirth and revision 6 - Interventions to address maternal, newborn, and child survival: what difference can integrated primary health care strategies make?

被引:239
作者
Bhutta, Zulfiqar A. [1 ]
Ali, Samana [1 ]
Cousens, Simon [2 ]
Ali, Talaha M. [1 ]
Haider, Batool Azra [1 ]
Rizvi, Arjumand [1 ]
Okong, Pius [3 ]
Bhutta, Shereen Z. [4 ]
Black, Robert E. [5 ]
机构
[1] Aga Khan Univ, Dept Paediat & Child Hlth, Karachi, Pakistan
[2] London Sch Hyg & Trop Med, London WC1, England
[3] Nsambya Hosp, Dept Obstet & Gynaecol, Kampala, Uganda
[4] Jinnah Postgrad Med Ctr, Dept Obstet & Gynaecol, Karachi, Pakistan
[5] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Baltimore, MD USA
关键词
D O I
10.1016/S0140-6736(08)61407-5
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Several recent reviews of maternal, newborn, and child health (MNCH) and mortality have emphasised that a large range of interventions are available with the potential to reduce deaths and disability. The emphasis within MNCH varies, with skilled care at facility levels recommended for saving maternal lives and scale-up of community and household care for improving newborn and child survival. Systematic review of new evidence on potentially useful interventions and delivery strategies identifies 37 key promotional, preventive, and treatment interventions and strategies for delivery in primary health care. Some are especially suitable for delivery through community support groups and health workers, whereas others can only be delivered by linking community-based strategies with functional first-level referral facilities. Case studies of MNCH indicators in Pakistan and Uganda show how primary health-care interventions can be used effectively. Inclusion of evidence-based interventions in MNCH programmes in primary health care at pragmatic coverage in these two countries could prevent 20-30% of all maternal deaths (up to 32% with capability for caesarean section at first-level facilities), 20-21% of newborn deaths, and 29-40% of all postneonatal deaths in children aged less than 5 years. Strengthening MNCH at the primary health-care level should be a priority for countries to reach their Millennium Development Goal targets for reducing maternal and child mortality.
引用
收藏
页码:972 / 989
页数:18
相关论文
共 96 条
[71]   Women's health in a rural community in Kerala, India: do caste and socioeconomic position matter? [J].
Mohindra, K. S. ;
Haddad, Slim ;
Narayana, D. .
JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH, 2006, 60 (12) :1020-1026
[72]   Maintaining quality of health services after abolition of user fees: A Uganda case study [J].
Nabyonga-Orem, Juliet ;
Karamagi, Humphrey ;
Atuyambe, Lynn ;
Bagenda, Fred ;
Okuonzi, Sam A. ;
Walker, Oladapo .
BMC HEALTH SERVICES RESEARCH, 2008, 8 (1)
[73]   Community based programs to prevent poisoning in children 0-15 years [J].
Nixon, J ;
Spinks, A ;
Turner, C ;
McClure, R .
INJURY PREVENTION, 2004, 10 (01) :43-46
[74]   The relative persuasiveness of gain-framed and loss-framed messages for encouraging disease prevention behaviors: A meta-analytic review [J].
O'Keefe, Daniel J. ;
Jensen, Jakob D. .
JOURNAL OF HEALTH COMMUNICATION, 2007, 12 (07) :623-644
[75]   Costs and financing of improvements in the quality of maternal health services through the Bamako Initiative in Nigeria [J].
Ogunbekun, I ;
Adeyi, O ;
Wouters, A ;
Morrow, RH .
HEALTH POLICY AND PLANNING, 1996, 11 (04) :369-384
[76]   Strengthening emergency obstetric care in Thanh Hoa and Quang Tri provinces in Vietnam [J].
Otchere, S. A. ;
Binh, H. T. .
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2007, 99 (02) :165-172
[77]   The challenges of improving emergency obstetric care in two rural districts in Mali [J].
Otchere, S. A. ;
Kayo, A. .
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS, 2007, 99 (02) :173-182
[78]   Does kangaroo mother care save lives? [J].
Pattinson, R. C. ;
Bergh, A. -M. ;
Malan, A. F. ;
Prinsloo, R. .
JOURNAL OF TROPICAL PEDIATRICS, 2006, 52 (06) :438-441
[79]   Quantifying errors without random sampling [J].
Carl V Phillips ;
Luwanna M LaPole .
BMC Medical Research Methodology, 3 (1)
[80]   Effects of treating postnatal depression on mother-infant interaction and child development - Systematic review [J].
Poobalan, A. S. ;
Aucott, L. S. ;
Ross, L. ;
Smith, W. C. S. ;
Helms, P. J. ;
Williams, J. H. G. .
BRITISH JOURNAL OF PSYCHIATRY, 2007, 191 :378-386