Table 7. Summary of Findings(SOF).
| WHO SCC compared to Usual care without WHO SCC for laboring mothers and newborn evaluation and management | |||||
|---|---|---|---|---|---|
| Patient or population: health professionals, laboring mothers, and newborns. | |||||
| Setting: sub-district, district, and tertiary health care. | |||||
| Intervention: WHO SCC | |||||
| Comparison: Usual care without WHO SCC | |||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | The certainty of the evidence (GRADE) | |
| The risk with Usual care without WHO SCC | The risk with WHO SCC | ||||
| Preeclampsia management. | 195 per 1,000 | 631 per 1,000 (362 to 838) | OR 7.05 (2.34 to 21.29) | 5667 (7 RCTs) | ⨁⨁⨁◯ MODERATE a |
| Maternal infection management. | 110 per 1,000 | 805 per 1,000 (253 to 1,000) | RR 7.29 (2.29 to 23.27) | 5667 (7 RCTs) | ⨁⨁⨁◯ MODERATE a |
| Partograph. | 190 per 1,000 | 472 per 1,000 (287 to 664) | OR 3.81 (1.72 to 8.43) | 5357 (6 RCTs) | ⨁⨁⨁◯ MODERATE a |
| Still birth. | 21 per 1,000 | 20 per 1,000 (19 to 21) | OR 0.92 (0.87 to 0.96) | 299952 (5 RCTs) | ⨁⨁⨁◯ MODERATE b |
| Early neonatal death. | 19 per 1,000 | 20 per 1,000 (19 to 21) | OR 1.07 (1.01 to 1.13) | 293467 (5 RCTs) | ⨁◯◯◯ VERY LOW b, c, d |
| Maternal death. | 1 per 1,000 | 1 per 1,000 (1 to 1) | OR 1.06 (0.77 to 1.45) | 159936 (3 RCTs) | ⨁⨁◯◯ LOW d, e |
| Postpartum counselling. | 5 per 1,000 | 601 per 1,000 (223 to 1,000) | RR 132.51 (49.27 to 356.36) | 1876 (4 observational studies) | ⨁⨁◯◯ LOW f, g |
*The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; OR: Odds ratio; RR: Risk ratio.
GRADE Working Group grades of evidence.
High certainty: We are very confident that the actual effect lies close to that of the estimate of the impact.
Moderate certainty: We are moderately confident in the effect estimate: The real impact is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited: The actual impact may be significantly different from the estimate of the effect.
Very low certainty: We have very little confidence in the effect estimate: The exact result is likely to be substantially different from the estimate of effect.
Explanations
a. Five studies are pre-and -post-intervention studies and two cluster -randomized trials were included. Downgraded one level for risk of bias of included studies.
b. Two clusters -randomized, three pre-and-post intervention studies were included. Downgraded one level for risk of bias of included studies.
c. Lowered one level for inconsistent outcomes across studies.
d. Wide and statistically non-significant confidence interval.
e. One cluster-randomized trial and two pre-and -post-intervention studies were included. Downgraded one level for risk of bias of included studies.
f. One cluster-randomized and three pre-and -post-intervention studies were involved. Lowered one level for risk of included studies.
g. Wider confidence interval.