the effect of health facility delivery on neonatal mortality systematic review and meta-analysis卫生设施交付在新生儿死亡率的影响的系统回顾和荟萃分析.pdf

Tura et al. BMC Pregnancy and Childbirth 2013, 13:18 /1471-2393/13/18 RESEARCH ARTICLE Open Access The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis Gurmesa Tura1*, Mesganaw Fantahun1 and Alemayehu Worku2 Abstract Background: Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, health facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of health facility delivery on neonatal mortality. Methods: The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg’s test and Egger’s test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Lairds estimator. Results: A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final p