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      Antenatal Care Predicts Neonatal Mortality in Eastern Africa: A Systematic Review and Meta-analysis of Observational Studies

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          Abstract

          Background

          Sub-Saharan African countries, especially the Eastern region, present the dismal picture of neonatal mortality (NM) in the globe. The majority of these deaths could be avoided if effective health measures are provided throughout pregnancy and childbirth. Although antenatal care (ANC) is assumed as one of the viable interventions that contribute to neonatal survival, the effect of ANC on NM was not systematically analyzed in Eastern Africa. Thus, the study aimed to determine the pooled effect of ANC on NM in Eastern Africa.

          Methods

          PubMed, EMBASE, CINAHL, and HINARI databases were searched using appropriate keywords from January 1, 1990 to February 12, 2021. Independent authors selected eligible articles and extracted data. The risk of a bias assessment tool for nonrandomized studies was used to assess the quality of the study. Comprehensive meta-analysis version 2 was used for meta-analysis. The random-effect model was employed, and the outcome is expressed as a risk ratio with 95% confidence interval (CI).

          Results

          In total, 1149 studies were identified through database search, and only 27 studies were included in the meta-analysis. Having at least 1 ANC visit during pregnancy reduced the risk of neonatal death by 42% compared to their counterparts (RR = 0.58, 95% CI [0.47, 0.71]). The pooled prevalence of NM was 8.5% (95% CI [7.3, 9.6]), with NM rate of 46.3/1000 live births.

          Conclusion

          The study indicated that NM might be decreased even with a single ANC visit when compared to no visits. Scaling up ANC services through ANC promotion and tackling service-related barriers could potentially reduce NM in Eastern Africa.

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          Most cited references56

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          Bias in meta-analysis detected by a simple, graphical test

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            Is Open Access

            Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement

            Systematic reviews should build on a protocol that describes the rationale, hypothesis, and planned methods of the review; few reviews report whether a protocol exists. Detailed, well-described protocols can facilitate the understanding and appraisal of the review methods, as well as the detection of modifications to methods and selective reporting in completed reviews. We describe the development of a reporting guideline, the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Protocols 2015 (PRISMA-P 2015). PRISMA-P consists of a 17-item checklist intended to facilitate the preparation and reporting of a robust protocol for the systematic review. Funders and those commissioning reviews might consider mandating the use of the checklist to facilitate the submission of relevant protocol information in funding applications. Similarly, peer reviewers and editors can use the guidance to gauge the completeness and transparency of a systematic review protocol submitted for publication in a journal or other medium.
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              Meta-analysis in clinical trials

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                Author and article information

                Contributors
                (View ORCID Profile)
                (View ORCID Profile)
                Journal
                Journal of Neonatology
                Journal of Neonatology
                SAGE Publications
                0973-2179
                0973-2187
                March 2022
                January 14 2022
                March 2022
                : 36
                : 1
                : 42-54
                Affiliations
                [1 ] School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
                [2 ] Department of Environmental Health Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
                [3 ] Department of Midwifery, College of Medicine and Health Sciences, Dire Dawa University, Ethiopia
                Article
                10.1177/09732179211068806
                3810ec29-ccad-4e44-bae8-39b6fc67266d
                © 2022

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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