Table 3.

Effectiveness of interventions to increase AVB use

Study	Overall AVB rate	VE rate	Forceps rate
Low/middle-income countries (10 studies, 12 datasets*)
Ameh (Kenya)47		Increase†
Berglund et al‡ (Ukraine)	NS change
Sequeira Dmello et al (Tanzania)42		Increase†
Dominico et al (Tanzania)30		Increase
Dumont et al (Mali)*40	NS change
Dumont et al (Senegal)*40	Increase*
Geelhoed et al (Mozambique)31		Increase
Gülmezoglu et al (Mexico)*		NS change
Gülmezoglu et al (Thailand)*		NS change
Mogilevkina et al (Ukraine)46		Increase†	Decrease†
Nolens et al (Uganda)29		Increase†
Sorensen et al (Tanzania)26		NS change
High-income countries (six studies)
Bardos et al (USA)38		NS change	Increase†
Becker et al (USA)39	NS change	Decrease†	Increase†
Cottrell et al (USA)27	NS change	Decrease†	Increase†
Skinner et al (Australia)43		Decrease†	Increase†
Solt et al (USA)44	NS change	Decrease†	Increase†
Takeda and Ohashi (Japan)45		Decrease	Increase

*Multi-country study with two separate datasets.

†Statistically significant.

‡Effect in two out of three sites.

AVB, assisted vaginal birth; NS, non-significant; VE, vacuum extraction.