SynthesisBMJ (Clinical research ed.)2011
Effectiveness of strategies incorporating training and support of traditional birth attendants on perinatal and maternal mortality: meta-analysis.
Synthesis in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it, 105 citations in OpenAlex.
- What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers.Human resources for health · 2018Pooled it
- Innovative approaches for improving maternal and newborn health--A landscape analysis.BMC pregnancy and childbirth · 2015Pooled it
- Safe birth in cultural safety in southern Mexico: a pragmatic non-inferiority cluster-randomised controlled trial.BMC pregnancy and childbirth · 2022Trial
- Navigating strategies for intercultural maternal and newborn care in Latin America and the Caribbean: a scoping review.Health promotion international · 2026Article
- Pathways of change for essential newborn care practices and health care seeking: a process evaluation of Mamás del Río, a community-based, maternal and neonatal health intervention in the Peruvian Amazon.Health policy and planning · 2026Article
- "Descriptive Insight or Missed Accountability? Critical Methodological and Policy Gaps in a Study of Traditional Birth Attendants in Bangladesh".Health science reports · 2026Article
- Implementation of basic training in neonatal resuscitation in the outskirts of Conakry, Guinea: evaluation of neonatal mortality by 'before and after intervention' design.BMJ global health · 2026Article
- Knowledge, Attitudes, and Practices of Traditional Birth Attendants in Bangladesh: A Qualitative Study on Maternal and Newborn Healthcare in Local Community.Health science reports · 2025Article
- "I am proud to be a midwife because I save a lot of lives": survey and interviews with graduates of International Medical Corps' midwifery education programme in South Sudan.Sexual and reproductive health matters · 2025Article
- Global, regional, and national burden of maternal hemorrhage: a systematic analysis from the global burden of disease 2021 and projections to 2030.BMC pregnancy and childbirth · 2025Article
- Trends in socioeconomic inequality in mortality during childhood between 1993 and 2021 in India.BMJ global health · 2025Article
- Competency-based education and training for Community Health Workers: a scoping review.BMC health services research · 2025Article
- Factors influencing the use of obstetric care during childbirth in rural Sudan: a qualitative study among healthcare providers.Gates open research · 2025Article
- Management of the third stage of labour by Basotho traditional birth attendants.Health SA = SA Gesondheid · 2024Article
- An empirical evaluation of the impact scenario of pooling bodies of evidence from randomized controlled trials and cohort studies in medical research.BMC medicine · 2022Article
- The role of traditional birth attendants and problem of integration with health facilities in remote rural community of West Omo Zone 2021: exploratory qualitative study.BMC pregnancy and childbirth · 2022Article
- Evaluating agreement between bodies of evidence from randomized controlled trials and cohort studies in medical research: a meta-epidemiological study.BMC medicine · 2022Article
- Maternal, Sexual and Reproductive Health in Marginalised Areas: Renewing Community Involvement Strategies beyond the Worst of the COVID-19 Pandemic.International journal of environmental research and public health · 2022Article
- The Addition of Traditional Birth Attendant Care to a Home-Based Skilled Nursing Program in Rural Guatemala: A Secondary Analysis from a Quality Improvement Database.Journal of midwifery & women's health · 2022Article
- Maternal health and Indigenous traditional midwives in southern Mexico: contextualisation of a scoping review.BMJ open · 2021Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess the effectiveness of strategies incorporating training and support of traditional birth attendants on the outcomes of perinatal, neonatal, and maternal death in developing countries.
designSystematic review with meta-analysis. DATA SOURCES: Medline, Embase, the Allied and Complementary Medicine database, British Nursing Index, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, BioMed Central, PsycINFO, Latin American and Caribbean Health Sciences Literature database, African Index Medicus, Web of Science, Reproductive Health Library, and Science Citation Index (from inception to April 2011), without language restrictions. Search terms were "birth attend*", "traditional midwife", "lay birth attendant", "dais", and "comadronas". Review methods We selected randomised and non-randomised controlled studies with outcomes of perinatal, neonatal, and maternal mortality. Two independent reviewers undertook data extraction. We pooled relative risks separately for the randomised and non-randomised controlled studies, using a random effects model.
resultsWe identified six cluster randomised controlled trials (n=138 549) and seven non-randomised controlled studies (n=72 225) that investigated strategies incorporating training and support of traditional birth attendants. All six randomised controlled trials found a reduction in adverse perinatal outcomes; our meta-analysis showed significant reductions in perinatal death (relative risk 0.76, 95% confidence interval 0.64 to 0.88, P<0.001; number needed to treat 35, 24 to 70) and neonatal death (0.79, 0.69 to 0.88, P<0.001; 98, 66 to 170). Meta-analysis of the non-randomised studies also showed a significant reduction in perinatal mortality (0.70, 0.57 to 0.84, p<0.001; 48, 32 to 96) and neonatal mortality (0.61, 0.48 to 0.75, P<0.001; 96, 65 to 168). Six studies reported on maternal mortality and our meta-analysis showed a non-significant reduction (three randomised trials, relative risk 0.79, 0.53 to 1.05, P=0.12; three non-randomised studies, 0.80, 0.44 to 1.15, P=0.26).
conclusionPerinatal and neonatal deaths are significantly reduced with strategies incorporating training and support of traditional birth attendants.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.