Between 250,000-280,000 women die worldwide during pregnancy and childbirth each year and children in low- and middle-income countries are 56 times more likely to die before the age of 5 than children in high-income countries. This Editorial discusses the publishing of a supplement within Reproductive Health titled Essential interventions for maternal, newborn and child health which aims to provide a scientific basis to the recommended interventions along with implementation strategies and proposed packages of care.Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Salaria, Natasha. BioMed Central; Reino UnidoFil: Valanzasca, Pilar. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Mbizvo, Michael. University of Zimbabwe; Zimbabu

Belizan, Jose

Mbizvo, Michael

Salaria, Natasha

Valanzasca, Pilar

Reproductive Health

English

PubMed

José M Belizán

Natasha Salaria

Pilar Valanzasca

Michael Mbizvo

Springer - Publisher Connector

How can we improve the use of essential evidence-based interventions?

CONICET Digital

Belizán et al. Reproductive Health 2014, 11:69http://www.reproductive-health-journal.com/content/11/1/69EDITORIAL Open AccessHow can we improve the use of essentialevidence-based interventions?José M Belizán1*, Natasha Salaria2, Pilar Valanzasca1 and Michael Mbizvo3AbstractBetween 250,000-280,000 women die worldwide during pregnancy and childbirth each year and children in low- andmiddle-income countries are 56 times more likely to die before the age of 5 than children in high-income countries.This Editorial discusses the publishing of a supplement within Reproductive Health titled Essential interventions formaternal, newborn and child health which aims to provide a scientific basis to the recommended interventionsalong with implementation strategies and proposed packages of care.Clinicians providing care have seen in a relatively shortperiod of time, a positive change in the scientific literatureavailable to support their clinical practice. Inspired bymany leaders, the concept of evidence-based interventionsfortunately permeates among health care providers, pol-icymakers and even the public. The inspiration and dedi-cated work of Iain Chalmers, who was instrumental in thedevelopment and consolidation of The Cochrane Library,has led to the best compilation of evidence-based care ofour time. With the existence of this knowledge hub, weknow what works and what does not work in healthcareand medicine. We are also aware of the uncertainties andgaps on the effect of many health care interventions.Many initiatives have shown that the implementationof several evidence-based interventions could result in asignificant reduction of maternal, neonatal and child mor-tality [1-3]. However, the last report of the Countdowninitiative of 2014, in 74 countries, shows unfinishedbusiness in achievement of high, sustained, and equitablecoverage of essential interventions (EI), showing that thegreatest coverage gaps are in family planning, interven-tions addressing newborn mortality, and case manage-ment of childhood diseases [4]. A result of interest fromthis analysis is that countries with higher levels of inter-vention coverage tend to have lower levels of child mortal-ity [4]. The low use of evidence-based practices is not onlyexplained by lack of resources, since low use of evidence-based practices is also seen in hospitals of high complexity* Correspondence: belizanj@gmail.com1Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires,ArgentinaFull list of author information is available at the end of the article© 2014 Belizán et al.; licensee BioMed CentralCommons Attribution License (http://creativecreproduction in any medium, provided the orDedication waiver (http://creativecommons.orunless otherwise stated.where resource needs are fulfilled [5-7]. Then, the poorimplementation of these beneficial evidence-based inter-ventions can be a consequence of both social inequity andprovider behavior. So, can we say that the provision ofsuch interventions can be seen as a human right? In fact,there are some examples of national laws where theprovision of evidence-based practices during labor is seenas a woman’s right [8].Contribution of research is still needed to develop andsystematically test interventions aiming to facilitate theimplementation of the EI. An emerging initiative, imple-mentation science, needs the strong commitment of manyplayers to guide the application and uptake of proveninterventions.We are very pleased that Reproductive Health is pub-lishing a supplement providing scientific basis to the EI.It aims to complement the previous “Born too Soon”supplement [9] in order to accelerate achievement of theMillennium Development Goals 4 and 5, in the low- andmiddle-income countries (LMIC), where the burden ofmaternal and newborn mortality and morbidity are thegreatest. This initiative, led by WHO, provides a list ofevidence-based interventions that have shown significantbenefits on reproductive and child health and their ap-plication would improve the health outcome of mothersand their children. The articles of this supplement showa diversity of strategies to apply the EI, as deliveredthrough the health sector, from the community up tothe referral level of health service provision.These evidence-based essential interventions are cen-tered on pre-pregnancy, pregnancy, childbirth, postnataland child health and were classified in categories based onLtd. This is an Open Access article distributed under the terms of the Creativeommons.org/licenses/by/4.0), which permits unrestricted use, distribution, andiginal work is properly credited. The Creative Commons Public Domaing/publicdomain/zero/1.0/) applies to the data made available in this article,Belizán et al. Reproductive Health 2014, 11:69 Page 2 of 3http://www.reproductive-health-journal.com/content/11/1/69their efficiency [10]. Many interventions can be providedjointly through the implementation of these packages [11]and proposed packages of care [12].Estimates from this supplement show that between250,000-280,000 women die worldwide during pregnancyand childbirth each year and that children in LMIC are 56times more likely to die before the age of 5 than childrenin high-income countries [13]. Articles in this supplementdiscuss interventions to decrease such death rates, such asfamily planning. Family planning is one of the existingcoverage gaps reported in the Countdown initiative [4],and it has been observed that the majority of unsafe abor-tions that occurred in 2008 worldwide (21.6 million), tookplace in LMIC. Other reported essential interventionsduring pregnancy could not only prevent maternal deaths,but also improve neonatal morbidity by planning pregnan-cies at appropriate intervals, helping to manage unplannedpregnancies, prevent and manage STIs such as HIV andPMTCT, and introduce home visits for women and chil-dren across the continuum of care [14].Essential childbirth and postnatal interventions can bepreventive and therapeutic. The majority of maternaland neonatal mortality is due to complications duringbirth. It is known that in LMIC most of the births occurin homes where access to adequate care at delivery isdifficult. The presence of a skilled birth attendant is a keylow-tech and low-cost opportunity for those in LMIC,along with continuous social support, postnatal and ma-ternal care delivery and community based education andhealth promotion workshops, which are all associatedwith positive outcomes. It is also estimated that practicingearly initiation of breastfeeding in developing countries,can save up to 1.45 million lives annually [15]. The role ofcommunity based delivery strategies to increase access toneeded care is vital to generate a change in developingcountries.This supplement also reviews essential interventionsfor improved child health. From all worldwide deathsestimated for 2011, 80% of the world’s under-five deathsbelong to just 25 countries (and only five countries ac-count for half of those deaths: India, Nigeria, DemocraticRepublic of the Congo, Pakistan and China). Most deathsand disabilities in children under five particularly dependon the management of infectious diseases and this supple-ment discusses interventions such as exclusive breastfeed-ing, routine immunizations and vaccinations for childrenand preventative zinc and vitamin A supplementation inchildren as interventions associated with a decrease inmortality and disease rates in children [12]. This sup-plement also shows that high coverage of an expandedimmunization program is one of the most cost-effectiveinterventions for reducing mortality and morbidity in thissegment of the population. Therefore, it is key that healthprofessionals and policy makers are aware that a great partof the solution depends on the adequate allocation of theavailable resources and the implementation of cost-effective interventions or packages [14]. In summary, thereis a lot of information showing the benefits that thedeployment of the EI would have in the population.Some countries have shown that such deployment canbe reached and also there are some studies showingsuccessful interventions to change provider’s behaviortowards the implementation of evidence-based practices[4,15]. All the actors in the maternal and child arena mustbe committed to achieve such a task. National and healthauthorities must be accountable in taking action toachieve the goals of mortality reduction. Health careproviders are major players in this endeavor, includingbeing amenable to their own change on their currentpractice. A movement in the research arena is needed,that is supported by the financial agencies to help theresearch teams to focus more on implementation science.Research strategies should be developed and tested aimedat providing efficient interventions to implement the EIand to assess their effectiveness on health outcomes.These strategies should also look for the quality of carewhen these interventions are deployed. Of major import-ance in this process is the monitoring/review/audit ofpractices and taking actions to correct problems to im-prove coverage with quality. Social organizations shouldadvocate more on the rights of the women and children toreceive the EI. Social communicators should empower thepopulation with the knowledge of the EI and the rights toreceive them.The joint effort of many players would significantlyimprove health and quality of life of mothers, theirchildren and their families.Authors’ contributionJMB is the editor-in-chief, NS is the journal development editor, PV is theassistant editor and MM is a section editor for Reproductive Health. All authorsread and approved the final manuscript.Author details1Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires,Argentina. 2BioMed Central, London, UK. 3University of Zimbabwe, Harare,Zimbabwe.Received: 5 September 2014 Accepted: 5 September 2014Published: 12 September 2014References1. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, Bellagio ChildSurvival Study Group: How many child deaths can we prevent this year?Lancet 2003, 362(9377):65–71.2. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L,Lancet Neonatal Survival Steering Team: Evidence-based, cost-effectiveinterventions: how many newborn babies can we save? Lancet 2005,365(9463):977–988.3. Bhutta ZA, Das JK, Walker N, Rizvi A, Campbell H, Rudan I, Black RE,Lancet Diarrhoea and Pneumonia Interventions Study Group: Interventionsto address deaths from childhood pneumonia and diarrhoea equitably:what works and at what cost? Lancet 2013, 381(9875):1417–1429.4. Requejo JH, Bryce J, Barros AJ, Berman P, Bhutta Z, Chopra M, Daelmans B,de Francisco A, Lawn J, Maliqi B, Mason E, Newby H, Presern C, Starrs A,Belizán et al. Reproductive Health 2014, 11:69 Page 3 of 3http://www.reproductive-health-journal.com/content/11/1/69Victora CG: Countdown to 2015 and beyond: fulfilling the health agendafor women and children. Lancet 2014. doi:10.1016/S0140-6736(14)60925-9.[Epub ahead of print].5. Vogel JP, Souza JP, Gülmezoglu AM, Mori R, Lumbiganon P, Qureshi Z,Carroli G, Laopaiboon M, Fawole B, Ganchimeg T, Zhang J, Torloni MR,Bohren M, Temmerman M: Use of antenatal corticosteroids and tocolyticdrugs in preterm births in 29 countries: an analysis of the WHOMulticountry Survey on Maternal and Newborn Health. Lancet 2014.doi:10.1016/S0140-6736(14)60580-8. [Epub ahead of print].6. Karolinski A, Micone P, Mercer R, Gibbons L, Althabe F, Belizán JM, MessinaA, Lapidus A, Correa A, Taddeo C, Lambruschini R, Bertin M, Dibiase L,Montes Varela D, Laterra C, AMBA Perinatal Network Research Group:Evidence-based maternal and perinatal healthcare practices in publichospitals in Argentina. Int J Gynaecol Obstet 2009, 105(2):118–122.7. Contreras García Y, Olavaria Bennett S, Pérez SM, Haemmerli Díaz P,Cafferata ML, Belizán JM: Practices in the care of the low-risk delivery inhospitals in southern Chile. Ginecol Obstet Mex 2007, 75(1):24–30.8. Belizán JM, Cafferata ML: The right to be accompanied at birth: new lawsin Argentina and Uruguay. Reprod Health Matters 2005, 13(26):158–159.9. Reproductive Health. [http://www.reproductive-health-journal.com/supplements/10/S1] webcite.10. Lassi ZS, Salam RA, Das JK, Bhutta ZA: Essential interventions for maternal,newborn and child health: background and methodology. Reprod Health2014, 11(Suppl 1):S1.11. Lassi ZS, Mallick D, Das JK, Mal L, Salam RA, Bhutta ZA: Essentialinterventions for child health. Reprod Health 2014, 11(Suppl 1):S4.12. Lassi ZS, Kumar R, Mansoor T, Salam RA, Das JK, Bhutta ZA: Essentialinterventions: implementation strategies and proposed packages ofcare. Reprod Health 2014, 11(Suppl 1):S5.13. Lassi ZS, Mansoor T, Salam RA, Das JK, Bhutta ZA: Essential pre-pregnancyand pregnancy interventions for improved maternal, newborn and childhealth. Reprod Health 2014, 11(Suppl 1):S2.14. Salam RA, Mansoor T, Mallick D, Lassi ZS, Das JK, Bhutta ZA: Essentialchildbirth and postnatal interventions for improved maternal andneonatal health. Reprod Health 2014, 11(Suppl 1):S3.15. Althabe F, Buekens P, Bergel E, Belizán JM, Campbell MK, Moss N, Hartwell T,Wright LL, Guidelines Trial Group: A behavioral intervention to improveobstetrical care. N Engl J Med 2008, 358(18):1929–1940.doi:10.1186/1742-4755-11-69Cite this article as: Belizán et al.: How can we improve the use ofessential evidence-based interventions? Reproductive Health 2014 11:69.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color ﬁgure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submit

Crossref

LAReferencia - Red Federada de Repositorios Institucionales de Publicaciones Científicas Latinoamericanas

Belizán et al. Reproductive Health 2014, 11:69http://www.reproductive-health-journal.com/content/11/1/69EDITORIAL Open AccessHow can we improve the use of essentialevidence-based interventions?José M Belizán1*, Natasha Salaria2, Pilar Valanzasca1 and Michael Mbizvo3AbstractBetween 250,000-280,000 women die worldwide during pregnancy and childbirth each year and children in low- andmiddle-income countries are 56 times more likely to die before the age of 5 than children in high-income countries.This Editorial discusses the publishing of a supplement within Reproductive Health titled Essential interventions formaternal, newborn and child health which aims to provide a scientific basis to the recommended interventionsalong with implementation strategies and proposed packages of care.Clinicians providing care have seen in a relatively shortperiod of time, a positive change in the scientific literatureavailable to support their clinical practice. Inspired bymany leaders, the concept of evidence-based interventionsfortunately permeates among health care providers, pol-icymakers and even the public. The inspiration and dedi-cated work of Iain Chalmers, who was instrumental in thedevelopment and consolidation of The Cochrane Library,has led to the best compilation of evidence-based care ofour time. With the existence of this knowledge hub, weknow what works and what does not work in healthcareand medicine. We are also aware of the uncertainties andgaps on the effect of many health care interventions.Many initiatives have shown that the implementationof several evidence-based interventions could result in asignificant reduction of maternal, neonatal and child mor-tality [1-3]. However, the last report of the Countdowninitiative of 2014, in 74 countries, shows unfinishedbusiness in achievement of high, sustained, and equitablecoverage of essential interventions (EI), showing that thegreatest coverage gaps are in family planning, interven-tions addressing newborn mortality, and case manage-ment of childhood diseases [4]. A result of interest fromthis analysis is that countries with higher levels of inter-vention coverage tend to have lower levels of child mortal-ity [4]. The low use of evidence-based practices is not onlyexplained by lack of resources, since low use of evidence-based practices is also seen in hospitals of high complexity* Correspondence: belizanj@gmail.com1Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires,ArgentinaFull list of author information is available at the end of the article© 2014 Belizán et al.; licensee BioMed CentralCommons Attribution License (http://creativecreproduction in any medium, provided the orDedication waiver (http://creativecommons.orunless otherwise stated.where resource needs are fulfilled [5-7]. Then, the poorimplementation of these beneficial evidence-based inter-ventions can be a consequence of both social inequity andprovider behavior. So, can we say that the provision ofsuch interventions can be seen as a human right? In fact,there are some examples of national laws where theprovision of evidence-based practices during labor is seenas a woman’s right [8].Contribution of research is still needed to develop andsystematically test interventions aiming to facilitate theimplementation of the EI. An emerging initiative, imple-mentation science, needs the strong commitment of manyplayers to guide the application and uptake of proveninterventions.We are very pleased that Reproductive Health is pub-lishing a supplement providing scientific basis to the EI.It aims to complement the previous “Born too Soon”supplement [9] in order to accelerate achievement of theMillennium Development Goals 4 and 5, in the low- andmiddle-income countries (LMIC), where the burden ofmaternal and newborn mortality and morbidity are thegreatest. This initiative, led by WHO, provides a list ofevidence-based interventions that have shown significantbenefits on reproductive and child health and their ap-plication would improve the health outcome of mothersand their children. The articles of this supplement showa diversity of strategies to apply the EI, as deliveredthrough the health sector, from the community up tothe referral level of health service provision.These evidence-based essential interventions are cen-tered on pre-pregnancy, pregnancy, childbirth, postnataland child health and were classified in categories based onLtd. This is an Open Access article distributed under the terms of the Creativeommons.org/licenses/by/4.0), which permits unrestricted use, distribution, andiginal work is properly credited. The Creative Commons Public Domaing/publicdomain/zero/1.0/) applies to the data made available in this article,Belizán et al. Reproductive Health 2014, 11:69 Page 2 of 3http://www.reproductive-health-journal.com/content/11/1/69their efficiency [10]. Many interventions can be providedjointly through the implementation of these packages [11]and proposed packages of care [12].Estimates from this supplement show that between250,000-280,000 women die worldwide during pregnancyand childbirth each year and that children in LMIC are 56times more likely to die before the age of 5 than childrenin high-income countries [13]. Articles in this supplementdiscuss interventions to decrease such death rates, such asfamily planning. Family planning is one of the existingcoverage gaps reported in the Countdown initiative [4],and it has been observed that the majority of unsafe abor-tions that occurred in 2008 worldwide (21.6 million), tookplace in LMIC. Other reported essential interventionsduring pregnancy could not only prevent maternal deaths,but also improve neonatal morbidity by planning pregnan-cies at appropriate intervals, helping to manage unplannedpregnancies, prevent and manage STIs such as HIV andPMTCT, and introduce home visits for women and chil-dren across the continuum of care [14].Essential childbirth and postnatal interventions can bepreventive and therapeutic. The majority of maternaland neonatal mortality is due to complications duringbirth. It is known that in LMIC most of the births occurin homes where access to adequate care at delivery isdifficult. The presence of a skilled birth attendant is a keylow-tech and low-cost opportunity for those in LMIC,along with continuous social support, postnatal and ma-ternal care delivery and community based education andhealth promotion workshops, which are all associatedwith positive outcomes. It is also estimated that practicingearly initiation of breastfeeding in developing countries,can save up to 1.45 million lives annually [15]. The role ofcommunity based delivery strategies to increase access toneeded care is vital to generate a change in developingcountries.This supplement also reviews essential interventionsfor improved child health. From all worldwide deathsestimated for 2011, 80% of the world’s under-five deathsbelong to just 25 countries (and only five countries ac-count for half of those deaths: India, Nigeria, DemocraticRepublic of the Congo, Pakistan and China). Most deathsand disabilities in children under five particularly dependon the management of infectious diseases and this supple-ment discusses interventions such as exclusive breastfeed-ing, routine immunizations and vaccinations for childrenand preventative zinc and vitamin A supplementation inchildren as interventions associated with a decrease inmortality and disease rates in children [12]. This sup-plement also shows that high coverage of an expandedimmunization program is one of the most cost-effectiveinterventions for reducing mortality and morbidity in thissegment of the population. Therefore, it is key that healthprofessionals and policy makers are aware that a great partof the solution depends on the adequate allocation of theavailable resources and the implementation of cost-effective interventions or packages [14]. In summary, thereis a lot of information showing the benefits that thedeployment of the EI would have in the population.Some countries have shown that such deployment canbe reached and also there are some studies showingsuccessful interventions to change provider’s behaviortowards the implementation of evidence-based practices[4,15]. All the actors in the maternal and child arena mustbe committed to achieve such a task. National and healthauthorities must be accountable in taking action toachieve the goals of mortality reduction. Health careproviders are major players in this endeavor, includingbeing amenable to their own change on their currentpractice. A movement in the research arena is needed,that is supported by the financial agencies to help theresearch teams to focus more on implementation science.Research strategies should be developed and tested aimedat providing efficient interventions to implement the EIand to assess their effectiveness on health outcomes.These strategies should also look for the quality of carewhen these interventions are deployed. Of major import-ance in this process is the monitoring/review/audit ofpractices and taking actions to correct problems to im-prove coverage with quality. Social organizations shouldadvocate more on the rights of the women and children toreceive the EI. Social communicators should empower thepopulation with the knowledge of the EI and the rights toreceive them.The joint effort of many players would significantlyimprove health and quality of life of mothers, theirchildren and their families.Authors’ contributionJMB is the editor-in-chief, NS is the journal development editor, PV is theassistant editor and MM is a section editor for Reproductive Health. All authorsread and approved the final manuscript.Author details1Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires,Argentina. 2BioMed Central, London, UK. 3University of Zimbabwe, Harare,Zimbabwe.Received: 5 September 2014 Accepted: 5 September 2014Published: 12 September 2014References1. Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, Bellagio ChildSurvival Study Group: How many child deaths can we prevent this year?Lancet 2003, 362(9377):65–71.2. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L,Lancet Neonatal Survival Steering Team: Evidence-based, cost-effectiveinterventions: how many newborn babies can we save? Lancet 2005,365(9463):977–988.3. Bhutta ZA, Das JK, Walker N, Rizvi A, Campbell H, Rudan I, Black RE,Lancet Diarrhoea and Pneumonia Interventions Study Group: Interventionsto address deaths from childhood pneumonia and diarrhoea equitably:what works and at what cost? Lancet 2013, 381(9875):1417–1429.4. Requejo JH, Bryce J, Barros AJ, Berman P, Bhutta Z, Chopra M, Daelmans B,de Francisco A, Lawn J, Maliqi B, Mason E, Newby H, Presern C, Starrs A,Belizán et al. Reproductive Health 2014, 11:69 Page 3 of 3http://www.reproductive-health-journal.com/content/11/1/69Victora CG: Countdown to 2015 and beyond: fulfilling the health agendafor women and children. Lancet 2014. doi:10.1016/S0140-6736(14)60925-9.[Epub ahead of print].5. Vogel JP, Souza JP, Gülmezoglu AM, Mori R, Lumbiganon P, Qureshi Z,Carroli G, Laopaiboon M, Fawole B, Ganchimeg T, Zhang J, Torloni MR,Bohren M, Temmerman M: Use of antenatal corticosteroids and tocolyticdrugs in preterm births in 29 countries: an analysis of the WHOMulticountry Survey on Maternal and Newborn Health. Lancet 2014.doi:10.1016/S0140-6736(14)60580-8. [Epub ahead of print].6. Karolinski A, Micone P, Mercer R, Gibbons L, Althabe F, Belizán JM, MessinaA, Lapidus A, Correa A, Taddeo C, Lambruschini R, Bertin M, Dibiase L,Montes Varela D, Laterra C, AMBA Perinatal Network Research Group:Evidence-based maternal and perinatal healthcare practices in publichospitals in Argentina. Int J Gynaecol Obstet 2009, 105(2):118–122.7. Contreras García Y, Olavaria Bennett S, Pérez SM, Haemmerli Díaz P,Cafferata ML, Belizán JM: Practices in the care of the low-risk delivery inhospitals in southern Chile. Ginecol Obstet Mex 2007, 75(1):24–30.8. Belizán JM, Cafferata ML: The right to be accompanied at birth: new lawsin Argentina and Uruguay. Reprod Health Matters 2005, 13(26):158–159.9. Reproductive Health. [http://www.reproductive-health-journal.com/supplements/10/S1] webcite.10. Lassi ZS, Salam RA, Das JK, Bhutta ZA: Essential interventions for maternal,newborn and child health: background and methodology. Reprod Health2014, 11(Suppl 1):S1.11. Lassi ZS, Mallick D, Das JK, Mal L, Salam RA, Bhutta ZA: Essentialinterventions for child health. Reprod Health 2014, 11(Suppl 1):S4.12. Lassi ZS, Kumar R, Mansoor T, Salam RA, Das JK, Bhutta ZA: Essentialinterventions: implementation strategies and proposed packages ofcare. Reprod Health 2014, 11(Suppl 1):S5.13. Lassi ZS, Mansoor T, Salam RA, Das JK, Bhutta ZA: Essential pre-pregnancyand pregnancy interventions for improved maternal, newborn and childhealth. Reprod Health 2014, 11(Suppl 1):S2.14. Salam RA, Mansoor T, Mallick D, Lassi ZS, Das JK, Bhutta ZA: Essentialchildbirth and postnatal interventions for improved maternal andneonatal health. Reprod Health 2014, 11(Suppl 1):S3.15. Althabe F, Buekens P, Bergel E, Belizán JM, Campbell MK, Moss N, Hartwell T,Wright LL, Guidelines Trial Group: A behavioral intervention to improveobstetrical care. N Engl J Med 2008, 358(18):1929–1940.doi:10.1186/1742-4755-11-69Cite this article as: Belizán et al.: How can we improve the use ofessential evidence-based interventions? Reproductive Health 2014 11:69.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submit

http://dx.doi.org/10.1186/1742-4755-11-69

How can we improve the use of essential evidence-based interventions?

Abstract

Similar works

Full text

Available Versions

Springer - Publisher Connector

CONICET Digital

Crossref

LAReferencia - Red Federada de Repositorios Institucionales de Publicaciones Científicas Latinoamericanas