Are birth kits a good idea?

A systematic review of the evidence

Vanora A. Hundley, Bilal I. Avan, David Braunholtz, Wendy J. Graham

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective
to identify the current state of knowledge regarding the effects of births kits on clean birth practices and on newborn and maternal outcomes.

Design
the scoping review was informed through a systematic literature review; a call for information distributed to experts in maternal and child health, relevant research centres and specialist libraries; and a search of the web sites of groups working in the area of maternal and child health. Data were synthesised to produce a summary of the state of knowledge regarding birth kits. Meta-analysis was not attempted because of the varied study designs and the heterogeneous nature of the interventions.

Participants
births kit use was identified in 51 low resource countries, but evaluations were scarce, with only nine studies reporting effects of intervention packages including births kits.

Findings
the quality of evidence for inferring causality was weak, with only one randomised controlled trial. In two studies, births kit use along with co-interventions resulted in a statistically significant increase in the likelihood of the attendant having clean hands. The impact on other aspects of cleanliness was less clear. Intervention packages which include births kits were associated with reduced newborn mortality (three studies), omphalitis (four studies), and puerperal sepsis (three studies). The one study that considered maternal mortality was not large enough to estimate relative reduction with much precision. None of the studies reported any adverse effects; however, none explicitly described looking for negative consequences.

Conclusion
providing birth kits to facilitate clean practices seems commonsense, but there is no evidence to indicate effects, positive or negative, separate from those achieved by a broader intervention package. More robust methods and knowledge systems are needed to understand the contextual factors and share relevant implementation lessons.
Original languageEnglish
Pages (from-to)204-215
Number of pages12
JournalMidwifery
Volume28
Issue number2
Early online date10 May 2011
DOIs
Publication statusPublished - Apr 2012

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Parturition
Maternal Mortality
Causality
Libraries
Meta-Analysis
Sepsis
Randomized Controlled Trials
Hand
Mothers
Mortality
Research
Maternal Health
Child Health

Keywords

  • birth kits
  • clean birth practices
  • systematic review

Cite this

Hundley, V. A., Avan, B. I., Braunholtz, D., & Graham, W. J. (2012). Are birth kits a good idea? A systematic review of the evidence. Midwifery, 28(2), 204-215. https://doi.org/10.1016/j.midw.2011.03.004

Are birth kits a good idea? A systematic review of the evidence. / Hundley, Vanora A.; Avan, Bilal I.; Braunholtz, David; Graham, Wendy J.

In: Midwifery, Vol. 28, No. 2, 04.2012, p. 204-215.

Research output: Contribution to journalArticle

Hundley, VA, Avan, BI, Braunholtz, D & Graham, WJ 2012, 'Are birth kits a good idea? A systematic review of the evidence', Midwifery, vol. 28, no. 2, pp. 204-215. https://doi.org/10.1016/j.midw.2011.03.004
Hundley, Vanora A. ; Avan, Bilal I. ; Braunholtz, David ; Graham, Wendy J. / Are birth kits a good idea? A systematic review of the evidence. In: Midwifery. 2012 ; Vol. 28, No. 2. pp. 204-215.
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