Effectiveness of add-on interventions to a standard clean delivery kit for facility- or home-based perinatal care: systematic literature review

A birth kit is a collection of single use, disposable supplies (commodities) to ensure six clean practices at the time of delivery. The birth kit packets usually include soap, gloves, antiseptic, cord tie / blade and a plastic sheet. Birth kits are already in use in more than 50 developing countries. The six clean practices at the time of delivery recommended by the World Health Organisation on which the standard birth kit is based comprise: 1. clean surface for delivery, 2. clean hands of the birth attendant, 3. clean cutting of the umbilical cord, 4. clean perineum, 5. clean cord tying, and 6. clean cord care. A standard clean delivery includes soap, antiseptic, a clamp / cord tie, a clean blade, a clean sheet, gloves, an instruction leaflet, and sanitary pads / cotton. The following possible additions were considered in this review: checklists, misoprostol, antenatal corticosteroids, antibiotics, vitamin K (baby), vitamin A, postpartum iron (mother), albendazole (mother), a hat, recommendations for kangaroo mother care, vouchers, a partograph, an infant mucus extractor, contraceptives, bednets, Intermittent Preventive Treatment (mother), oxytocin, magnesium sulphate, emollients (preterm infants), vaginal antiseptic (chlorhexidine) and maternal nutritional supplements. Use of the add-ons both in a facility-based and in a home-based setting was considered.