Effect of the Mamás del Río programme on essential newborn care: a three-year before-and-after outcome evaluation of a community-based, maternal and neonatal health intervention in the Peruvian Amazon.

Background: Despite remarkable progress in maternal and neonatal health, regional inequalities persist in Peru. In rural areas of Amazonian Loreto, access to quality care is difficult, home births are frequent, and neonatal mortality is high. We conducted a prospective before-and-after study to assess the effect after implementation and over time of a community-based intervention on essential newborn care (ENC).

Prevalence of essential newborn care in home and facility births in the Peruvian Amazon: analysis of census data from programme evaluation in three remote districts of the Loreto region.

Background: Essential newborn care (ENC) covers optimal breastfeeding, thermal care, and hygienic cord care. These practices are fundamental to save newborn lives. Despite neonatal mortality remaining high in some parts of Peru, no comprehensive data on ENC is available.

Readiness of health facilities to provide safe childbirth in Liberia: a cross-sectional analysis of population surveys, facility censuses and facility birth records.

Background: The provision of quality obstetric care in health facilities is central to reducing maternal mortality, but simply increasing childbirth in facilities not enough, with evidence that many facilities in sub-Saharan Africa do not fulfil even basic requirements for safe childbirth care. There is ongoing debate on whether to recommend a policy of birth in hospitals, where staffing and capacity may be better, over lower level facilities, which are closer to women's homes and more accessible. Little is known about the quality of childbirth care in Liberia, where facility births have increased in recent decades, but maternal mortality remains among the highest in the world.

Tracking progress towards universal health coverage for essential health services in China, 2008-2018.

Introduction: We comprehensively evaluate whether the Chinese Government's goal of ensuring Universal Health Coverage for essential health services has been achieved.

Methods: We used data from the 2008, 2013 and 2018 National Health Services Survey to report on the coverage of a range of Sustainable Development Goals (SDG) indicator 3.8.

Does hospital variation in intrapartum-related perinatal mortality among caesarean births reflect differences in quality of care? Cross-sectional study in 21 hospitals in Burkina Faso.

Objectives: To examine hospital variation in crude and risk-adjusted rates of intrapartum-related perinatal mortality among caesarean births.

Design: Secondary analysis of data from the DECIDE (DECIsion for caesarean DElivery) cluster randomised trial postintervention phase.

Setting: 21 district and regional hospitals in Burkina Faso.

Triangulating evidence for the causal impact of single-intervention zinc supplement on glycaemic control for type 2 diabetes: systematic review and meta-analysis of randomised controlled trial and two-sample Mendelian randomisation.

Although previous studies suggested the protective effect of Zn for type 2 diabetes (T2D), the unitary causal effect remains inconclusive. We investigated the causal effect of Zn as a single intervention on glycaemic control for T2D, using a systematic review of randomised controlled trials and two-sample Mendelian randomisation (MR). Four primary outcomes were identified: fasting blood glucose/fasting glucose, HbA1c, homeostatic model assessment for insulin resistance (HOMA-IR) and serum insulin/fasting insulin level.

A systematic review of the profile and density of the maternal and child health workforce in China.

Background: To track progress in maternal and child health (MCH), understanding the health workforce is important. This study seeks to systematically review evidence on the profile and density of MCH workers in China.

Methods: We searched 6 English and 2 Chinese databases for studies published between 1 October 1949 and 20 July 2020.

Excess mortality among patients with severe mental disorders and effects of community-based mental healthcare: a community-based prospective study in Sichuan, China.

Background: High-quality primary care reduces premature mortality in the general population, but evidence for psychiatric patients in China is scarce.

Aims: To confirm excess mortality in patients with severe mental illness (SMI), and to examine the impact of community-based mental healthcare and other risk factors on their mortality.

Method: We included 93 655 patients in 2012 and 100 706 in 2013 from the national mental health surveillance system in Sichuan, China to calculate the standardised mortality ratio (SMR).

Abortion metrics: a scoping review of abortion measures and indicators.

Consensus is lacking on the most appropriate indicators to document progress in safe abortion at programmatic and country level. We conducted a scoping review to provide an extensive summary of abortion indicators used over 10 years (2008-2018) to inform the debate on how progress in the provision and access to abortion care can be best captured. Documents were identified in PubMed and Popline and supplemented by materials identified on major non-governmental organisation websites.

Socio-demographic factors of cesarean births in Nha Trang city, Vietnam: a community-based survey.

Background: The cesarean section rate in Vietnam has been increasing especially in urban area. However, limited evidence identified regarding socio-demographic factors of the cesarean section birth. The objective of this study was to determine the current cesarean birth rate and the associated socio-demographic factors among mothers in Nha Trang city, south-central Vietnam.

Direct maternal deaths attributable to HIV in the era of antiretroviral therapy: evidence from three population-based HIV cohorts with verbal autopsy.

Objective: To assess whether HIV is associated with an increased risk of mortality from direct maternal complications.

Design: Population-based cohort study using data from three demographic surveillance sites in Eastern and Southern Africa.

Methods: We use verbal autopsy data, with cause of death assigned using the InSilicoVA algorithm, to describe the association between HIV and direct maternal deaths amongst women aged 20-49 years.

Does women's age matter in the SDGs era: coverage of demand for family planning satisfied with modern methods and institutional delivery in 91 low- and middle-income countries.

Background: The Sustainable Development Goals (SDGs) include specific targets for family planning (SDG 3.7) and birth attendance (SDG 3.1.

What the percentage of births in facilities does not measure: readiness for emergency obstetric care and referral in Senegal.

Introduction: Increases in facility deliveries in sub-Saharan Africa have not yielded expected declines in maternal mortality, raising concerns about the quality of care provided in facilities. The readiness of facilities at different health system levels to provide both emergency obstetric and newborn care (EmONC) as well as referral is unknown. We describe this combined readiness by facility level and region in Senegal.

Testing the assumptions of an indicator of unmet need for obstetric surgery in Ghana: A cross-sectional study of linked hospital and population-based delivery data.

Background: The Unmet Obstetric Need (UON) indicator has been widely used to estimate unmet need for life-saving surgery at birth; however, its assumptions have not been verified. The objective of this study was to test two UON assumptions: (a) Absolute maternal indications (AMIs) require surgery for survival and (b) 1%-2% of deliveries develop AMIs, implying that rates of surgeries for AMIs below this threshold indicate excess mortality from these complications.

Methods: We used linked hospital and population-based data in central Ghana.

Uptake of maternal care and childhood immunization among ethnic minority and Han populations in Sichuan province: a study based on the 2003, 2008 and 2013 health service surveys.

Background: China has made remarkable progress in maternal and child health (MCH) over the last thirty years, but socio-economic inequalities persist. Ethnicity has become an important determinant of poor MCH outcomes, but little rigorous analytical work has been done in this area. To understand the socio-economic factors that explain ethnic variation in uptake of MCH care, we report the findings from an analysis in Sichuan province.

Barriers to accessing maternal healthcare among ethnic minority women in Western China: a qualitative evidence synthesis.

Quantitative evidence suggests that ethnic disparities in maternal healthcare use are substantial in Western China, but the reasons for these remain under-researched. We undertook a systematic review of English and Chinese databases between January 1, 1990 and February 23, 2018 to synthesize qualitative evidence on barriers faced by ethnic minority women in accessing maternal healthcare in Western China. Four English and 6 Chinese language studies across 8 provinces of Western China and 13 ethnic minority groups were included.

Global epidemiology of use of and disparities in caesarean sections.

In this Series paper, we describe the frequency of, trends in, determinants of, and inequalities in caesarean section (CS) use, globally, regionally, and in selected countries. On the basis of data from 169 countries that include 98·4% of the world's births, we estimate that 29·7 million (21·1%, 95% uncertainty interval 19·9-22·4) births occurred through CS in 2015, which was almost double the number of births by this method in 2000 (16·0 million [12·1%, 10·9-13·3] births). CS use in 2015 was up to ten times more frequent in the Latin America and Caribbean region, where it was used in 44·3% (41·3-47·4) of births, than in the west and central Africa region, where it was used in 4·1% (3·6-4·6) of births.

Relaxation of the one child policy and trends in caesarean section rates and birth outcomes in China between 2012 and 2016: observational study of nearly seven million health facility births.

Objective: To examine how the relaxation of the one child policy and policies to reduce caesarean section rates might have affected trends over time in caesarean section rates and perinatal and pregnancy related mortality in China.

Design: Observational study.

Setting: China's National Maternal Near Miss Surveillance System (NMNMSS).

Access to maternal health services: geographical inequalities, United Republic of Tanzania.

Objective: To determine if improved geographical accessibility led to increased uptake of maternity care in the south of the United Republic of Tanzania.

Methods: In a household census in 2007 and another large household survey in 2013, we investigated 22 243 and 13 820 women who had had a recent live birth, respectively. The proportions calculated from the 2013 data were weighted to account for the sampling strategy.

Ethnicity and maternal and child health outcomes and service coverage in western China: a systematic review and meta-analysis.

Background: There is a dearth of accurate information about health outcomes and health service coverage among ethnic minorities in China. We assessed maternal and child health (MCH) outcomes and service coverage among ethnic minorities compared with Han populations in western China.

Methods: We did a systematic review searching English (Embase, MEDLINE, Web of Science) and Chinese (China National Knowledge Infrastructure [CNKI], VIP, Wanfang) databases for population-based studies comparing MCH indicators between ethnic minorities between Jan 1, 1990, and Nov 9, 2016, in any language.