Date of Award

Spring 5-11-2013

Degree Type


Degree Name

Master of Public Health (MPH)


Public Health

First Advisor

Ike Solomon Okosun

Second Advisor

Rodney Lyn



Complications due to pregnancy and child bearing are among the leading causes of death and disability among women of child bearing age in developing countries. Skilled antenatal care (ANC) and care during delivery are indispensably important in the reduction of Maternal Mortality Rates (MMR). Interventions to increase use of maternal care have been implemented. Meta-analysis is important to ascertain the effectiveness of these interventions.


The objective of this study was to conduct a systematic review and meta-analysis of the effectiveness of interventions implemented in developing countries to improve use of antenatal services and skilled care during delivery.


Interventions were identified from MEDLINE, PAIS International and GLOBAL HEALTH databases. Meta-analysis was performed. Effect sizes (ES) were calculated as odds ratios. Random effects model was used for meta-analysis.

Main results

A total of 1960 articles were retrieved data bases. Final selection resulted into 12 articles for delivery care and 13 articles for antenatal care. Results for delivery and antenatal care interventions showed that, overall effect size was significant; 2.406 (95% CI 1.847 - 3.135), P-value <=0.001 and 2.548 (95% CI 1.207-5.382), P=0.014 respectively. Heterogeneity between studies was significantly high for both delivery and antenatal care interventions. Subgroup analysis with moderator variables such as study design, types of outcomes and region of study did not show any evidence of these variables to have contributed to the observed high heterogeneity.


Interventions were significantly effective. Heterogeneity was substantially high. Subgroup analysis did not show any evidence of such variables to have contributed to the observed heterogeneity.

Key words: antenatal, delivery,