ArticleGlobal health, science and practice2019
Evaluating WHO-Recommended Interventions for Preterm Birth: A Mathematical Model of the Potential Reduction of Preterm Mortality in Sub-Saharan Africa.
Article in Global health, science and practice, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 37 citations in OpenAlex.
- Determinants of preterm birth among newborns delivered at public referral hospitals in Bahir Dar City, Northwest Ethiopia, 2024.BMC public health · 2025Article
- Establishment of a neonatal nursery in a rural district hospital in Malawi: a retrospective review of neonatal outcomes in Neno District Hospital (2014-2021).BMC pediatrics · 2025Article
- Diet quality indexes for use during pregnancy: a scoping review.Nutrition reviews · 2024Article
- Infant mortality in Ghana: investing in health care infrastructure and systems.Health affairs scholar · 2024Article
- Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia.PloS one · 2024Article
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- Trends and causes of neonatal mortality from 2010 to 2017 at a Health and Demographic Surveillance site in Northern Ethiopia.Global health action · 2023Article
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- Improving the Duration and Rate of Home-Based Kangaroo Mother Care: A Before-and-After Intervention Study.Cureus · 2023Article
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- Respiratory Interventions for Preterm Infants in LMICs: A Prospective Study From Cape Town, South Africa.Frontiers in global women's health · 2022Article
- Predominance of Atopobium vaginae at Midtrimester: a Potential Indicator of Preterm Birth Risk in a Nigerian Cohort.mSphere · 2021Article
- Prospective cohort study of mortality in very low birthweight infants in a single centre in the Eastern Cape province, South Africa.BMJ paediatrics open · 2021Article
- Advances in paediatrics in 2019: current practices and challenges in allergy, endocrinology, gastroenterology, public health, neonatology, nutrition, nephrology, neurology, respiratory diseases and rheumatic diseases.Italian journal of pediatrics · 2020Review
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPreterm birth, a leading cause of neonatal mortality, has the highest burden in low-income countries. In 2015, the World Health Organization (WHO) published recommendations for interventions to improve preterm outcomes. Our analysis uses the Maternal and Neonatal Directed Assessment of Technology (MANDATE) model to evaluate the potential effects that WHO-recommended interventions could have had on preterm mortality in sub-Saharan Africa in 2015.
methodsWe modeled preterm birth subconditions causing mortality (respiratory distress syndrome, intraventricular hemorrhage, necrotizing enterocolitis, sepsis, birth asphyxia, and low birth weight). For each subcondition, models were populated with estimates of WHO-recommended intervention prevalence, case fatality, coverage, and efficacy. Various scenarios modeled improved coverage of single and combined interventions compared with baseline.
resultsIn 2015, approximately 500,000 neonatal deaths due to preterm birth occurred in sub-Saharan Africa. Single interventions with the greatest impact on preterm mortality included oxygen/continuous positive airway pressure (44,000 lives saved), cord care (38,500 lives saved), and breastfeeding (30,200 lives saved). Combined with improved diagnosis/transfer to a hospital, the impact of interventions showed greater reductions in mortality (oxygen/continuous positive airway pressure, 134,100 lives saved; antibiotics, 28,600 lives saved). Combined interventions had the greatest impact. Together, hospital delivery with comprehensive care for respiratory distress syndrome saved 190,600 lives, and comprehensive thermal care, breastfeeding, and prevention/treatment for sepsis saved 94,400 lives.
conclusionIn 2015, WHO-recommended interventions could have saved the lives of nearly 300,000 infants born preterm in sub-Saharan Africa. Combined interventions are necessary to maximize impact. Mathematical models such as MANDATE can estimate effects on health outcomes to allow health officials to prioritize implementation strategies.
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