Table 3 Tested alternatives
| Â | Intervention described in literature | Results | Reference | Intervention implemented in the model |
|---|---|---|---|---|
1 | The use of clean delivery kits lowered neonatal infections | Infections of the umbilical cord were reduced by 50% | [39] | Provide motivation package, such as delivery kits, to pregnant women in the communities during delivery with the aim of increasing birth preparedness and skilled birth deliveries; this is in a setting where deliveries in government facilities are free for the population |
2 | Motorbike ambulances suited to remote areas were provided to the community | Communal referral measures with motorcycle ambulances increased obstetric outcomes, reduced referral time and operating costs in Malawi by 76% | [40] | Motorbike ambulance, where coupons are given to the mothers to ease access to health facilities during delivery |
3 | Campaigns and strengthening educational interventions | Engagement with regular awareness, educative sessions and collective action to get pregnant women to health units reduced neonatal deaths by 62% in Bolivia | [41] | Use low cost information and communication technologies for increased awareness and to disseminate localized information, such as films during antenatal care sessions, village meetings or worship places; these are regular sessions at least monthly |
4 | Facility Kangaroo Mother Care (KMC) was used and substantial mortality benefit for babies lower than 2000Â g was seen | Effect was 51% reduction in mortality | [42] | Facilitate the implementation of the KMC to prevent neonatal hypothermia; only 10% of health facilities in Uganda had evidence of practicing KMC [3] |
5 | Regular in service neonatal resuscitation and supervision in China | Regular in service neonatal resuscitation and supervision improved neonatal outcomes and lowered neonatal deaths by 18% | [43] | Provision of regular in service skills in neonatal resuscitation and supervision to ensure this is done correctly and consistently |
6 | Skills in labour management | Skilled birth attendance reduce neonatal mortality by 25% | [44] | Skills in labour management as well skilled attendance at every delivery; includes monitoring of women in labour using a partograph and intervening correctly and promptly; currently, skilled birth attendance is 68% [33] |
7 | Malaria prevention | Malaria prevention improves neonatal health by 40% | [45] | Strengthen the use of insecticide-treated nets and provision of intermittent preventive treatment of malaria in pregnancy (IPTp); 52% of the mothers got IPTp during pregnancy [46] |
8 | Anaemia prevention | Improved neonatal survival by 20–30% | [47] | Increase the coverage of anaemia prevention by giving iron and folic acid to pregnant women; currently, 75% of women receive iron tablets [33] |
9 | Combination of anaemia and malaria prevention | Reduced the risk of dying of neonates by 76% | [48] | Give both iron/folic supplements and IPTp |
10 | Tetanus prevention | Tetanus toxoid prevented cases of neonatal death from neonatal tetanus by 43% | [49] | Increase the coverage of tetanus prevention; currently, vaccine coverage for tetanus toxoid is 56% [33] |