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Notice bibliographique (sans auteurs) :

Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014 Jul 26;384(9940):347-70

Auteur·e(s) :

Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, Sankar MJ, Blencowe H, Rizvi A, Chou VB, Walker N

Année de publication :

2014

URL(s) :

https://www.ncbi.nlm.nih.gov/pubmed/24853604
https://doi.org/10.1016/S0140-6736(14)60792-3

Résumé (français)  :

Abstract (English)  :

Progress in newborn survival has been slow, and even more so for reductions in stillbirths. To meet Every Newborn targets of ten or fewer neonatal deaths and ten or fewer stillbirths per 1000 births in every country by 2035 will necessitate accelerated scale-up of the most effective care targeting major causes of newborn deaths. We have systematically reviewed interventions across the continuum of care and various delivery platforms, and then modelled the effect and cost of scale-up in the 75 high-burden Countdown countries. Closure of the quality gap through the provision of effective care for all women and newborn babies delivering in facilities could prevent an estimated 113,000 maternal deaths, 531,000 stillbirths, and 1·325 million neonatal deaths annually by 2020 at an estimated running cost of US$4·5 billion per year (US$0·9 per person). Increased coverage and quality of preconception, antenatal, intrapartum, and postnatal interventions by 2025 could avert 71% of neonatal deaths (1·9 million [range 1·6-2·1 million]), 33% of stillbirths (0·82 million [0·60-0·93 million]), and 54% of maternal deaths (0·16 million [0·14-0·17 million]) per year. These reductions can be achieved at an annual incremental running cost of US$5·65 billion (US$1·15 per person), which amounts to US$1928 for each life saved, including stillbirths, neonatal, and maternal deaths. Most (82%) of this effect is attributable to facility-based care which, although more expensive than community-based strategies, improves the likelihood of survival. Most of the running costs are also for facility-based care (US$3·66 billion or 64%), even without the cost of new hospitals and country-specific capital inputs being factored in. The maximum effect on neonatal deaths is through interventions delivered during labour and birth, including for obstetric complications (41%), followed by care of small and ill newborn babies (30%). To meet the unmet need for family planning with modern contraceptives would be synergistic, and would contribute to around a halving of births and therefore deaths. Our analysis also indicates that available interventions can reduce the three most common cause of neonatal mortality--preterm, intrapartum, and infection-related deaths--by 58%, 79%, and 84%, respectively.

Sumário (português)  :

Resumen (español)  :

Remarques :

Argument (français) :

La suppression de l’écart de qualité par la prestation de soins efficaces à toutes les femmes et nouveau-nés qui accouchent dans les établissements pourrait prévenir environ 113 000 décès maternels, 531 000 mortinaissances et 1 325 millions de décès néonatals d’ici 2020 à un coût estimatif de 4. 5 milliards de $ par an (0,9 $ par personne)

Argument (English):

Closure of the quality gap through the provision of effective care for all women and newborn babies delivering in facilities could prevent an estimated 113,000 maternal deaths, 531,000 stillbirths, and 1·325 million neonatal deaths annually by 2020 at an estimated running cost of US$4·5 billion per year (US$0·9 per person)

Argumento (português):

Abordar a lacuna de qualidade através da prestação de cuidados efetivos a todas as mulheres e recém-nascidos que dão à luz em instituições poderia evitar uma estimativa de 113.000 mortes maternas, 531.000 natimortos e 1.325 milhões de mortes neonatais até 2020 no Canadá. um custo estimado de US $ 4,5 bilhões por ano (US $ 0,9 por pessoa)

Argumento (español):

Mots-clés :

➡ enquête ; protocoles ; santé publique ; mort-né ; mortalité maternelle ; mortalité périnatale ; consentement éclairé

Auteur·e de cette fiche :

Bernard Bel — 08 Jul 2018