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PubMed · 15749072

Evidence-based neonatal care.

Henry L Halliday
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Abstract

Randomized controlled trials were introduced into neonatal care in the 1950s when high inspired oxygen concentrations were discovered to be the cause of an epidemic of blindness in preterm babies due to retinopathy of prematurity. Systematic reviews of many randomized controlled trials were published in an important textbook in 1992, 'Effective Care of the Newborn Infant', which was the starting point for the Neonatal Module of the Cochrane Collaboration. The 171 systematic reviews of interventions in neonatology published in the Cochrane Library provide evidence for neonatal care in many areas of the speciality. Some areas, such as management of respiratory distress with surfactant and assisted ventilation, are well covered by reviews, but others, such as resuscitation at birth and management of jaundice, are much less evidence based. Most of the systematic reviews deal with neonatal care in the developed world, and there are only a few of interest to carers in the developing world.

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Developing CountriesHumansInfant, NewbornInfant, PrematureInfant, Very Low Birth WeightIntensive Care, NeonatalNeonatal ScreeningNeonatologyOxygenRandomized Controlled Trials as TopicRetinopathy of PrematurityJournal ArticleReview

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BibTeXRIS

Henry L Halliday. 2004-12-23. Evidence-based neonatal care.. https://doi.org/10.1016/j.bpobgyn.2004.10.014

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Costs of surgeries in low- and middle-income countries: a systematic literature review.

BACKGROUND: Surgical care is essential for achieving global health equity, yet low- and middle-income countries (LMICs) face major gaps in access and planning, partly due to limited evidence on the costs and resource requirements of surgical interventions. Understanding these costs is vital for designing efficient and equitable health systems. METHODS: We conducted a systematic literature review (covering MEDLINE, EMBASE, Global Health, EconLit and grey literature) to identify studies reporting the costs of surgeries in LMICs from January 2000 to June 2023. Minor and major surgical procedures were considered, focusing on therapeutic procedures (excluding diagnostic interventions). Studies that clearly identified, quantified and costed hospital resources and services deployed in the provision of surgical care, and included at least two of the surgical production factors (ie, consumables, diagnostics, personnel, infrastructure and overhead) in the costing were included. Costs were standardised to 2023 International dollars (I$) for comparability. RESULTS: A total of 74 studies from 29 countries met the inclusion criteria, with 210 cost estimates across 65 procedure groups. Costs varied widely: from I$1.54 for a caesarean section in Tanzania to I$618 098 for paediatric cataract surgery in Zambia. Full costing studies reported higher estimates than partial costing studies. Most studies (60%) originated from upper-middle-income countries, with limited data (10%) from low-income settings. CONCLUSION: This review provides a reference list of surgical procedure costs across LMICs, highlighting considerable cost variation by procedure, specialty and country. The findings underscore the need for better-quality, standardised cost data-especially from low-income countries-to inform national surgical plans, universal health coverage benefit packages and reimbursement policies.

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