IMPROVING BIRTH OUTCOMES
MEETING THE CHALLENGE IN THE DEVELOPING WORLD
Judith R. Bale, Barbara J. Stoll, and Adetokunbo O. Lucas, Editors
THE NATIONAL ACADEMIES PRESS
Washington, D.C.
www.nap.edu
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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.
Support for this project was provided by the Centers for Disease Control and Prevention, the U.S. Agency for International Development, and the National Institute for Child Health and Human Development, National Institutes of Health, U.S. Department of Health and Human Services. The views presented in this report are those of the Institute of Medicine Committee on Improving Birth Outcomes and are not necessarily those of the funding agencies.
Library of Congress Cataloging-in-Publication Data
Improving birth outcomes : meeting the challenge in the developing world / Committee on Improving Birth Outcomes, Board on Global Health ; Judith R. Bale, Barbara J. Stoll, and Adetokunbo O. Lucas, editors.
p. ; cm.
Includes bibliographical references.
ISBN 0-309-08614-0, 0-309-52796-1 (PDF)
1. Infants (Newborn)—Developing countries—Mortality—Prevention. 2. Infants (Newborn)—Diseases—Developing countries—Prevention. 3. Fetal death—Developing countries—Prevention. 4. Fetus—Diseases—Developing countries—Prevention. 5. Mothers—Developing countries—Mortality—Prevention. 6. Infant health services—Developing countries. 7. Maternal health services—Developing countries. 8. Pregnancy—Complications—Developing countries—Prevention.
[DNLM: 1. Pregnancy Complications—prevention & control. 2. Pregnancy Outcome. 3. Developing Countries. 4. Infant Mortality. 5. Maternal Mortality. WQ 240 I34 2003] I. Bale, Judith R. II. Stoll, Barbara J. III. Lucas, Adetokunbo O. IV. Institute of Medicine (U.S.). Committee on Improving Birth Outcomes.
RJ60.D44I465 2003
362.1′989201′091724—dc22
2003014374
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Advisers to the Nation on Science, Engineering, and Medicine
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COMMITTEE ON IMPROVING BIRTH OUTCOMES
ADETOKUNBO O. LUCAS (Co-Chair), Professor of International Health, Nigeria
BARBARA J. STOLL (Co-Chair),
Emory University School of Medicine, Atlanta, GA
ANNA ALISJAHBANA,
University of Pajajaran, Bandung, Indonesia
ABHAY BANG,
Society for Education, Action & Research in Community Health, Gadchiroli, India
LAURA CAULFIELD,
The Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD
ROBERT GOLDENBERG,
University of Alabama at Birmingham, Birmingham, AL
MARGE KOBLINSKY,
Mother Care/John Snow, Arlington, VA
MICHAEL KRAMER,
McGill University, Montreal, Quebec, Canada
AFFETTE MCCAW-BINNS,
University of the West Indies, Jamaica, WI
KUSUM NATHOO,
University of Zimbabwe Medical School, Harare, Zimbabwe
HARSHAD SANGHVI,
Maternal and Neonatal Health Program, JHPIEGO Corp., Baltimore, MD
JOE LEIGH SIMPSON,
Baylor College of Medicine, Houston, TX
Staff
JUDITH R. BALE, Board Director and Study Director (until October 2002)
ALISON J. MACK, Consultant
SHIRA H. FISCHER, Research Assistant
JASON PELLMAR, Project Assistant
STEPHANIE BAXTER-PARROTT, Project Assistant (until July 2000)
LAURIE SPINELLI, Project Assistant (until July 2002)
BOARD ON GLOBAL HEALTH
DEAN JAMISON (Chair), Director,
Program on International Health, Education, and Environment, University of California at Los Angeles, and the World Health Organization, Geneva, Switzerland
YVES BERGEVIN, Chief,
Health Section, UNICEF, New York, NY
PATRICIA DANZON, Professor,
Health Care Systems Development, University of Pennsylvania, Philadelphia, PA
RICHARD FEACHEM, Executive Director,
The Global Fund, Geneva, Switzerland
NOREEN GOLDMAN, Professor,
Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, NJ
MARGARET HAMBURG, Vice President for Biological Programs,
Nuclear Threat Initiative, Washington, DC
JEFF KOPLAN, Vice President for Academic Health Affairs,
Emory University, Atlanta, GA
ADEL A. F. MAHMOUD, President,
Merck Vaccines, Whitehouse Station, NJ
JOHN WYN OWEN, Secretary,
Nuffield Trust, London, United Kingdom
MARK L. ROSENBERG, Executive Director,
The Task Force for Child Survival and Development, Emory University, Decatur, GA
SUSAN SCRIMSHAW, Dean,
School of Public Health, University of Illinois at Chicago, Chicago, IL
JAIME SEPULVEDA AMOR,
National Institute of Public Health, Mexico
DAVID CHALLONER (Institute of Medicine Foreign Secretary), Vice President for Health Affairs, Emeritus,
University of Florida, Gainesville, FL
Reviewers
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the NRC’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:
CARLA ABOUZHAR, World Health Organization
H. DAVID BANTA, Consultant in Health Care Technology Assessment, Paris
FERNANDO C. BARROS, PAHO/WHO Latin American Center for Perinatology and Human Development, Montevideo, Uruguay
CYNTHIA BEALL, Case Western Reserve University
ZULFIQAR A. BHUTTA, The Aga Khan University
HOOSEN M. COOVADIA, University of Natal
ANTHONY COSTELLO, Institute of Child Health at Great Ormond Street, University College, London
LUELLA KLEIN, Department of Gynecology and Obstetrics, Emory University School of Medicine
ANVER KULIEV, Reproductive Genetics Institute
ALLAN ROSENFIELD, Columbia University
HELEN SMITS, Universidade Eduardo Mondlane
ANN TINKER, Save the Children Foundation
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the conclusions or recommendations nor did they see the final draft of the report before its release. The review of this report was overseen by ELAINE L. LARSON, Columbia University, New York, New York, and by ELENA NIGHTINGALE, National Research Council, Washington, DC. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
Acknowledgments
The Institute of Medicine acknowledges the committee for undertaking the development of both this comprehensive report and the companion report, Reducing the Impact of Birth Defects: Meeting the Challenge in the Developing World.
The successful completion of this report has required the input of many experts. The committee thanks the researchers and public health professionals who presented papers and provided insights at the workshop held in conjunction with the first committee meeting (see Appendix A). The committee also thanks the many experts who provided technical review and suggestions during the development of the report: Carlos Barros; Charles Carpenter; Myron Essex; Jean-Pierre Habicht; Joy Lawn; Reynaldo Martorell; and Catherine Wilfert.
The committee would like to thank staff and consultants in the Institute of Medicine whose contributions were instrumental to developing and producing this report: Judith Bale, who coordinated committee and other expert input; Alison Mack, who transformed report text; Pamela Mangu, who organized the first committee meeting; and Laurie Spinelli and Shira Fischer for their superb support at different stages of the report. Also valuable in the early development of the report was consultation with Helen Gelband, a paper prepared by Jeffrey Stringer, research provided by Patricia Cuff, Katherine Oberholtzer, Vanessa Larson, and interns Kevin Crosby, Nikki Williams, and Maria Vassileva. Appreciation is extended to Rona Briere for her expert editing of the report. Other staff who were instrumental in the final stages of this report include Bronwyn Schrecker,
Janice Mehler (National Academies), Jennifer Otten, Jennifer Bitticks, Stacey Knobler, and the NAP production staff. Andrea Cohen is acknowledged for her careful monitoring of study finances.
The committee appreciates the financial support for this report, which was provided by the Centers for Disease Control and Prevention, the U.S. Agency for International Development, and the National Institute for Child Health and Human Development, National Institutes of Health.
