Will GiveWell fund Community-based intervention packages to reduce maternal and neonatal mortality by 1st January 2027? DRAFT
GiveWell has recommended grants to over 10 charities over the years. They are currently investigating 12 charity areas with other areas of research in the pipeline including Community-based intervention packages to reduce maternal and neonatal mortality.
** The following sections are quoted from GiveWell’s explanation of the topic **
“In 2018, 2.5 million infants died in the first 28 days of life. Sub-Saharan Africa and South Asia comprise 79% of global neonatal mortality. In 2017, 295,000 women and girls died from complications arising from pregnancy and childbirth, and 86% of those deaths occurred in Sub-Saharan Africa and South Asia.
A range of preconception, antenatal, and neonatal interventions have shown individual effectiveness in preventing neonatal mortality. These interventions are typically packaged according to their delivery mode and target populations.Intervention packages are heterogeneous in terms of which interventions are included and how they are delivered (via home visits or women’s groups)...
Intervention packages included in this evidence assessment may include some combination of:
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Basic antenatal, natal and postnatal care
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Preventive essential newborn care including: ensuring warmth, immediate skin-to-skin care, early breastfeeding, umbilical cord care, eye care, Vitamin K administration, and immunization
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Breastfeeding counselling
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Management and referral of sick newborns
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Skills development in behavior change communication
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Community mobilization strategies to promote birth and newborn care preparedness.
…A Cochrane Collaboration systematic review has found that on average, these packages are associated with the following statistically significant (p<0.05) effects:
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25% reduction in neonatal mortality11
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19% reduction in stillbirths12
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25% reduction in maternal morbidity13
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20% reduction in maternal mortality (marginally significant, p=0.05)
…However, heterogeneity in program design and setting underlying these data prevents us from using this aggregate evidence to endorse any specific program design…
The DCP-3 volume on reproductive, maternal, child, and newborn health indicates that "home-based and community-based neonatal care" interventions cost between roughly $500 and $6,000 per life saved.20 This may put certain intervention package programs in the range of cost-effectiveness of programs we would consider as potential top charities. We have not vetted these estimates. In the future, we may estimate the cost-effectiveness of specific intervention packages as implemented by identified charities.”