Table 1

Health system domain application to ECS

Operational domainFocus of the research and operational issues of specific health programmeLocationStudy designOutcomeUsers of the research outputLimitations
Training interventions
Carlo WA, McClure EM, Chomba E, et al. Newborn care training of midwives and neonatal and perinatal mortality rates in a developing country. Pediatrics 2010;126:e1064–71. doi:10.1542/peds.2009–3464Facility-based essential newborn care and resuscitation trainingZambiaBefore and afterNeonatal mortality, stillbirthHealthcare providers, programme managers, policy-makersBefore and after design
Petroze RT, Byiringiro JC, Ntakiyiruta G, et al. Can focused trauma education initiatives reduce mortality or improve resource utilisation in a low-resource setting? World J Surg 2015;39:926–33. doi:10.1007/s00268-014-2899-yFocused trauma educationRwandaPre–post studyEmergency department mortalityHealthcare provider, programme managers, policy-makersBefore and after design, no causation
Bhoi S, Thakur N, Verma P, et al. Does community emergency care initiative improve the knowledge and skill of healthcare workers and laypersons in basic emergency care in India? J Emerg Trauma Shock 2016;9:10–6. doi:10.4103/0974–2700.173870Community emergency careIndiaPre–post studyImprovement in knowledge and skillHealthcare provider, programme managers, policy-makersBefore and after design
Neonatal health
Carlo WA, McClure EM, Chomba E, et al. Newborn care training of midwives and neonatal and perinatal mortality rates in a developing country. Pediatrics 2010;126:e1064–71. doi:10.1542/peds.2009–3464Population-based essential newborn care and resuscitation trainingArgentina, Democratic Republic of Congo, Guatemala, India, Pakistan and ZambiaActive baseline pre–post study, cluster RCTNeonatal mortality, stillbirthHealthcare providers, programme managers, policy-makersBefore and after design
Out-of-hospital care
Pasha O, Goldenberg RL, McClure EM, et al. Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the global network’s EmONC trial). BMC Pregnancy Childbirth 2010;10:82. doi:10.1186/1471-2393-10-82Community and facility-based practicesArgentina, Guatemala, India, Kenya, Pakistan and ZambiaCluster RCTMaternal and neonatal mortality and morbiditiesHealthcare providers, programme managers and policy-makersComplex expensive intervention
Murad MK, Husum H. Trained lay first responders reduce trauma mortality: a controlled study of rural trauma in Iraq. Prehosp Disaster Med 2010;25:533–9.http://www.ncbi.nlm.nih.gov/pubmed/21181688 (accessed 17 May 2018)Field-based trauma careIraqCase–controlTrauma patient mortality rateHealthcare provider, programme managers, policy-makersThe validity of the main outcome variable
Triage
Althabe F, Belizán JM, McClure EM, et al. A population-based, multifaceted strategy to implement antenatal corticosteroid treatment vs standard care for the reduction of neonatal mortality due to preterm birth in low-income and middle-income countries: the ACT cluster-randomised trial. Lancet (London, England) 2015;385:629–39. doi:10.1016/S0140-6736(14)61651-2Community and facility triage for high-risk preterm labour with administration of antenatal steroidsArgentina, Guatemala, India, Kenya, Pakistan and ZambiaCluster RCTNeonatal mortalityHealthcare providers, programme managers, policy-makersMisclassification of subgroups
Implementation (implementation science) domain
Goldenberg RL, Saleem S, Ali S, et al. Maternal near miss in low-resource areas. Int J Gynecol Obstet 2017;138:347–55. doi:10.1002/ijgo.12219Implementation of near miss identification and careDemocratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and ZambiaImplementation scienceMaternal mortalityHealthcare providers, programme managers, policy-makersObservational data
Kesinger MR, Nagy LR, Sequeira DJ, et al. A standardised trauma care protocol decreased in-hospital mortality of patients with severe traumatic brain injury at a teaching hospital in a middle-income country. Injury 2014;45:1350–4. doi:10.1016/j.injury.2014.04.037Standardised trauma care protocol (STP)ColombiaPre and post STPIn-hospital mortality of TBIHealthcare providers, programme managers, policy-makersOnly one hospital
Robison JA, Ahmad ZP, Nosek CA, et al. Decreased paediatric hospital mortality after an intervention to improve emergency care in Lilongwe, Malawi. Paediatrics Published Online First: 2012. doi:10.1542/peds.2012–0026Reallocation of staff, institute triage system and stabilise patient before transfer to wardMalawiPre/post interventionInpatient paediatric mortalityHealthcare providers, programme managers, policy-makersNon-randomised
Health systems domain
Goudar SS, Carlo WA, McClure EM, et al. The Maternal and Newborn Health Registry Study of the Global Network for Women’s and Children’s Health Research. Int J Gynecol Obstet 2012;118:190–3. doi:10.1016/j.ijgo.2012.04.022Registry of every pregnancy and delivery to reduce maternal/neonatal mortality and morbiditiesArgentina, Guatemala, India, Kenya, Pakistan and ZambiaObservationalMaternal and neonatal mortality and morbiditiesHealthcare providers, programme managers, policy-makersObservational data
Henry JA, Reingold AL. Prehospital trauma systems reduce mortality in developing countries. J Trauma Acute Care Surg 2012;73:261–8. doi:10.1097/TA.0b013e31824bde1ePrehospital trauma systemsLMICsSystematic review/meta-analysisMortality risk of TBIHealthcare providers, programme managers, policy-makersSystematic review
Husum HMD, Gilbert MMDP, Wisborg TMDD, et al. Rural prehospital trauma systems improve trauma outcome in low-income countries: a prospective study from North Iraq and Cambodia. J Trauma-Injury Infect Crit Care 2003;54:1188–96.Prehospital trauma systemIraq and CambodiaProspective studyTrauma mortalityHealthcare providers, programme managers, policy-makersNon-randomised

  • LMICs, low-income and middle-income countries; RCT, randomised controlled trial; TBI, traumatic brain injury.