Walker, Neff, Gayane Yenakyan, Ingrid Friberg, Jennifer Bryce. “Patterns in coverage of Maternal, Newborn, and Child Health Interventions: Projections of Neonatal and Under-5 Mortality to 2035.” Lancet 382 (September 21, 2013): 1029-38. 10.1016/S0140-6736(13)61748-1.

URL: www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)61748-1.pdf

ABSTRACT:

Urgent calls have been made for improved understanding of changes in coverage of maternal, newborn, and child health interventions, and their country-level determinants. We examined historical trends in coverage of interventions with proven eff ectiveness, and used them to project rates of child and neonatal mortality in 2035 in
74 Countdown to 2015 priority countries.

Walker et al comprehensively analyze all interventions that have been shown to impact maternal and neonatal mortality, looking at how the coverage of these interventions has changed over time in 69 key countries. The authors then evaluate potential variables underlying these changes in coverage, including metrics that correlate with a country’s rate of development (e.g. growth in GDP, the presence or absence of conflict, form of governance). Using this information, the researchers attempt to model future changes in the coverage of these interventions in order to predict how the rate of maternal and neonatal mortality will change by the year 2035. The analysis showed that three interventions (anti-malarial treatment, skilled birth attendants, and improved sanitation facilities) are less widespread currently than they were in 1990.  A few malaria-specific interventions have rapidly increased in coverage, while most other proven interventions have slowly increased in coverage. The statistical models predict that if historical trends continue, the number of under-5-deaths per year will only decrease by 28% in 2035, highlighting the need for more concentrated efforts in order to achieve international goals.