title: Interventions to Improve Neonatal Health and Later Survival: An Overview of Systematic Reviews.
abstract: BACKGROUND
  Evidence-based interventions and strategies are needed to improve child survival in countries with a high burden of neonatal and child mortality. An overview of systematic reviews can focus implementation on the most effective ways to increase child survival.
  
  
  METHODS
  In this overview we included published Cochrane and other systematic reviews of experimental and observational studies on antenatal, childbirth, postnatal and child health interventions aiming to prevent perinatal/neonatal and child mortality using the WHO list of essential interventions. We assessed the methodological quality of the reviews using the AMSTAR criteria and assessed the quality of the outcomes using the GRADE approach. Based on the findings from GRADE criteria, interventions were summarized as effective, promising or ineffective.
  
  
  RESULTS
  The overview identified 148 Cochrane and other systematic reviews on 61 reproductive, maternal, newborn and child health interventions. Of these, only 57 reviews reported mortality outcomes. Using the GRADE approach, antenatal corticosteroids for preventing neonatal respiratory distress syndrome in preterm infants; early initiation of breastfeeding; hygienic cord care; kangaroo care for preterm infants; provision and promotion of use of insecticide treated bed nets (ITNs) for children; and vitamin A supplementation for infants from six months of age, were identified as clearly effective interventions for reducing neonatal, infant or child mortality. Antenatal care, tetanus immunization in pregnancy, prophylactic antimalarials during pregnancy, induction of labour for prolonged pregnancy, case management of neonatal sepsis, meningitis and pneumonia, prophylactic and therapeutic use of surfactant, continuous positive airway pressure for neonatal resuscitation, case management of childhood malaria and pneumonia, vitamin A as part of treatment for measles associated pneumonia for children above 6 months, and home visits across the continuum of care, were identified as promising interventions for reducing neonatal, infant, child or perinatal mortality.
  
  
  CONCLUSIONS
  Comprehensive adoption of the above six effective and 11 promising interventions can improve neonatal and child survival around the world. Choice of intervention and degree of implementation currently depends on resources available and policies in individual countries and geographical settings.
  
  
  BACKGROUND
  This review was part of doctoral thesis which was funded by University of Adelaide, Australia.
authors.affiliation: Australian Research Centre for Health of Women and Babies, Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Australia.
authors.forename: Zohra S
authors.initials: ZS
authors.lastname: Lassi
authors.affiliation: Australian Research Centre for Health of Women and Babies, Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Australia.
authors.forename: Philippa F
authors.initials: PF
authors.lastname: Middleton
authors.affiliation: Australian Research Centre for Health of Women and Babies, Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Australia ; Liggins Institute, University of Auckland, New Zealand.
authors.forename: Caroline
authors.initials: C
authors.lastname: Crowther
authors.affiliation: Robert Harding Chair in Global Child Health & Policy Centre for Global Child Health Hospital for Sick Children, Toronto, Canada ; Center of Excellence for Women and Child Health, The Aga Khan University, Karachi, Pakistan.
authors.forename: Zulfiqar A
authors.initials: ZA
authors.lastname: Bhutta
mesh_terms: D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D007223:Infant; D000068104:Infant Health; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000517:prevention & control*
keywords: Child mortality; Infant mortality; Neonatal mortality; Perinatal mortality; Stillbirths; Survival