Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational...

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Autores:
Alvis-Guzmán, Nelson
Burstein, Roy
Henry, Nathaniel J.
Collison, Michael L.
Marczak, Laurie B.
Sligar, Amber
Watson, Stefanie
Marquez, Neal
Abbasalizad-Farhangi, Mahdieh
Abbasi, Masoumeh
Tipo de recurso:
Article of journal
Fecha de publicación:
2019
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
eng
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oai:repositorio.cuc.edu.co:11323/5899
Acceso en línea:
https://hdl.handle.net/11323/5899
https://repositorio.cuc.edu.co/
Palabra clave:
Neonatal deaths
Death children
Child survival
Rights
openAccess
License
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dc.title.spa.fl_str_mv Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
title Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
spellingShingle Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
Neonatal deaths
Death children
Child survival
title_short Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
title_full Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
title_fullStr Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
title_full_unstemmed Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
title_sort Mapping 123 million neonatal, infant and child deaths between 2000 and 2017
dc.creator.fl_str_mv Alvis-Guzmán, Nelson
Burstein, Roy
Henry, Nathaniel J.
Collison, Michael L.
Marczak, Laurie B.
Sligar, Amber
Watson, Stefanie
Marquez, Neal
Abbasalizad-Farhangi, Mahdieh
Abbasi, Masoumeh
dc.contributor.author.spa.fl_str_mv Alvis-Guzmán, Nelson
Burstein, Roy
Henry, Nathaniel J.
Collison, Michael L.
Marczak, Laurie B.
Sligar, Amber
Watson, Stefanie
Marquez, Neal
Abbasalizad-Farhangi, Mahdieh
Abbasi, Masoumeh
dc.subject.spa.fl_str_mv Neonatal deaths
Death children
Child survival
topic Neonatal deaths
Death children
Child survival
description Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.
publishDate 2019
dc.date.issued.none.fl_str_mv 2019-10-16
dc.date.accessioned.none.fl_str_mv 2020-01-22T13:08:24Z
dc.date.available.none.fl_str_mv 2020-01-22T13:08:24Z
dc.type.spa.fl_str_mv Artículo de revista
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dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC - Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
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Corporación Universidad de la Costa
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dc.language.iso.none.fl_str_mv eng
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dc.relation.ispartof.spa.fl_str_mv https://doi.org/10.1038/s41586-019-1545-0
dc.relation.references.spa.fl_str_mv 1. Reidpath, D. D. & Allotey, P. Infant mortality rate as an indicator of population health. J. Epidemiol. Community Health 57, 344–346 (2003).
2. United Nations General Assembly. United Nations Millennium Declaration: Resolution adopted by the General Assembly. A/RES/55/2 (UN General Assembly, 2000).
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4. GBD 2017 Mortality Collaborators. Global, regional, and national age-sexspecific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1684–1735 (2018).
5. Golding, N. et al. Mapping under-5 and neonatal mortality in Africa, 2000–15: a baseline analysis for the Sustainable Development Goals. Lancet 390, 2171–2182 (2017).
6. Pezzulo, C. et al. Geospatial Modeling of Child Mortality across 27 Countries in sub-Saharan Africa. DHS Spatial Analysis Reports No. 13 (USAID, 2016).
7. Li, Z. et al. Changes in the spatial distribution of the under-five mortality rate: small-area analysis of 122 DHS surveys in 262 subregions of 35 countries in Africa. PLoS ONE 14, e0210645 (2019).
8. Lawn, J. E., Cousens, S. & Zupan, J. 4 million neonatal deaths: When? Where? Why? Lancet 365, 891–900 (2005).
9. World Health Organization. SDG 3: Ensure healthy lives and promote wellbeing for all at all ages. https://www.who.int/sdg/targets/en/ (2019).
10. Dwyer-Lindgren, L. et al. Estimation of district-level under-5 mortality in Zambia using birth history data, 1980–2010. Spat. SpatioTemporal Epidemiol. 11, 89–107 (2014).
11. Dwyer-Lindgren, L. et al. Small area estimation of under-5 mortality in Bangladesh, Cameroon, Chad, Mozambique, Uganda, and Zambia using spatially misaligned data. Popul. Health Metr. 16, 13 (2018).
12. Wakefield, J. et al. Estimating under-five mortality in space and time in a developing world context. Stat. Methods Med. Res. https://doi. org/10.1177/0962280218767988 (2018).
13. Burke, M., Heft-Neal, S. & Bendavid, E. Sources of variation in under-5 mortality across sub-Saharan Africa: a spatial analysis. Lancet Glob. Health 4, e936–e945 (2016).
14. Macharia, P. M. et al. Sub national variation and inequalities in under-five mortality in Kenya since 1965. BMC Public Health 19, 146 (2019).
15. Sousa, A., Hill, K. & Dal Poz, M. R. Sub-national assessment of inequality trends in neonatal and child mortality in Brazil. Int. J. Equity Health 9, 21 (2010).
16. Mohammadi, Y. et al. Measuring Iran’s success in achieving Millennium Development Goal 4: a systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015. Lancet Glob. Health 5, e537–e544 (2017).
17. Wang, Y. et al. Under-5 mortality in 2851 Chinese counties, 1996–2012: a subnational assessment of achieving MDG 4 goals in China. Lancet 387, 273–283 (2016).
18. Horton, R. Offline: in defence of precision public health. Lancet 392, 1504 (2018).
19. Takahashi, S., Metcalf, C. J. E., Ferrari, M. J., Tatem, A. J. & Lessler, J. The geography of measles vaccination in the African Great Lakes region. Nat. Commun. 8, 15585 (2017).
20. Utazi, C. E. et al. High resolution age-structured mapping of childhood vaccination coverage in low and middle income countries. Vaccine 36, 1583–1591 (2018).
21. Gething, P. W. et al. Mapping Plasmodium falciparum mortality in Africa between 1990 and 2015. N. Engl. J. Med. 375, 2435–2445 (2016).
22. Reiner, R. C. Jr et al. Variation in childhood diarrheal morbidity and mortality in Africa, 2000–2015. N. Engl. J. Med. 379, 1128–1138 (2018).
23. Osgood-Zimmerman, A. et al. Mapping child growth failure in Africa between 2000 and 2015. Nature 555, 41–47 (2018).
24. Amoah, B., Giorgi, E., Heyes, D. J., van Burren, S. & Diggle, P. J. Geostatistical modelling of the association between malaria and child growth in Africa. Int. J. Health Geogr. 17, 7 (2018).
25. Bishai, D. M. et al. Factors contributing to maternal and child mortality reductions in 146 low- and middle-income countries between 1990 and 2010. PLoS ONE 11, e0144908 (2016).
26. Marmot, M. Social determinants of health inequalities. Lancet 365, 1099–1104 (2005).
27. Victora, C. G. et al. Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. Lancet 387, 2049–2059 (2016).
28. Rose, G. Strategy of prevention: lessons from cardiovascular disease. Br. Med. J. (Clin. Res. Ed.) 282, 1847–1851 (1981).
29. Mackenbach, J. P., Lingsma, H. F., van Ravesteyn, N. T. & Kamphuis, C. B. M. The population and high-risk approaches to prevention: quantitative estimates of their contribution to population health in the Netherlands, 1970–2010. Eur. J. Public Health 23, 909–915 (2013).
30. Agarwal, S. & Taneja, S. All slums are not equal: child health conditions among the urban poor. Indian Pediatr. 42, 233–244 (2005).
31. Farag, T. H. et al. Precisely tracking childhood death. Am. J. Trop. Med. Hyg. 97, 3–5 (2017).
32. Farmer, P. E. et al. Reduced premature mortality in Rwanda: lessons from success. Br. Med. J. 346, f65 (2013).
33. Gurusamy, P. S. R. & Janagaraj, P. D. A success story: the burden of maternal, neonatal and childhood mortality in Rwanda - critical appraisal of interventions and recommendations for the future. Afr. J. Reprod. Health 22, 9–16 (2018).
34. McGovern, M. E. & Canning, D. Vaccination and all-cause child mortality from 1985 to 2011: global evidence from the Demographic and Health Surveys. Am. J. Epidemiol. 182, 791–798 (2015).
35. Cheng, J. J., Schuster-Wallace, C. J., Watt, S., Newbold, B. K. & Mente, A. An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality. Environ. Health 11, 4 (2012).
36. Steketee, R. W. & Campbell, C. C. Impact of national malaria control scale-up programmes in Africa: magnitude and attribution of effects. Malar. J. 9, 299 (2010).
37. Kiragu, K., Collins, L., Von Zinkernagel, D. & Mushavi, A. Integrating PMTCT into maternal, newborn, and child health and related services: experiences from the global plan priority countries. J. Acquir. Immune Defic. Syndr. 75, S36–S42 (2017).
38. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1736–1788 (2018).
39. Pasha, O. et al. A combined community- and facility-based approach to improve pregnancy outcomes in low-resource settings: a Global Network cluster randomized trial. BMC Med. 11, 215 (2013).
40. Horton, S. et al. Ranking 93 health interventions for low- and middle-income countries by cost-effectiveness. PLoS ONE 12, e0182951 (2017).
41. Simmons, L. E., Rubens, C. E., Darmstadt, G. L. & Gravett, M. G. Preventing preterm birth and neonatal mortality: exploring the epidemiology, causes, and interventions. Semin. Perinatol. 34, 408–415 (2010).
42. Darmstadt, G. L. et al. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet 365, 977–988 (2005).
43. Saugstad, O. D. Reducing global neonatal mortality is possible. Neonatology 99, 250–257 (2011).
44. Ntigurirwa, P. et al. A health partnership to reduce neonatal mortality in four hospitals in Rwanda. Glob. Health 13, 28 (2017).
45. Knippenberg, R. et al. Systematic scaling up of neonatal care in countries. Lancet 365, 1087–1098 (2005).
46. GBD 2015 Eastern Mediterranean Region Neonatal, Infant, and under-5 Mortality Collaborators. Neonatal, infant, and under-5 mortality and morbidity burden in the Eastern Mediterranean region: findings from the Global Burden of Disease 2015 study. Int. J. Public Health 63, 63–77 (2018).
47. Wagner, Z. et al. Armed conflict and child mortality in Africa: a geospatial analysis. Lancet 392, 857–865 (2018).
48. Mikkelsen, L. et al. A global assessment of civil registration and vital statistics systems: monitoring data quality and progress. Lancet 386, 1395–1406 (2015).
49. AbouZahr, C. et al. Civil registration and vital statistics: progress in the data revolution for counting and accountability. Lancet 386, 1373–1385 (2015).
50. Annan, K. Data can help to end malnutrition across Africa. Nature 555, 7 (2018).
51. Lindgren, F., Rue, H. & Lindström, J. An explicit link between Gaussian fields and Gaussian Markov random fields: the stochastic partial differential equation approach. R. Stat. Soc. 73, 423–498 (2011).
52. Allison, P. D. Discrete-time methods for the analysis of event histories. Sociol. Methodol. 13, 61 (1982).
53. Institute for Health Metrics and Evaluation. Global Burden of Disease Study 2017 (GBD 2017) Socio-Demographic Index (SDI) 1950–2017. http://ghdx. healthdata.org/record/ihme-data/gbd-2017-socio-demographic-index-sdi1950%E2%80%932017 (GHDx, 2019).
54. Ahmad, O. B., Lopez, A. D. & Inoue, M. The decline in child mortality: a reappraisal. Bull. World Health Organ. 78, 1175–1191 (2000).
55. Somoza, J. L. Illustrative Analysis: Infant and Child Mortality in Colombia. World Fertility Survey Scientific Report No. 10 (International Statistical Institute, 1980).
56. Rutstein, S. O. Infant and child mortality: levels, trends and demographic differentials. World Fertility Survey Scientific Report No. 43 (International Statistical Institute, 1984).
57. Burstein, R., Wang, H., Reiner, R. C. Jr & Hay, S. I. Development and validation of a new method for indirect estimation of neonatal, infant, and child mortality trends using summary birth histories. PLoS Med. 15, e1002687 (2018).
58. Graetz, N. et al. Mapping local variation in educational attainment across Africa. Nature 555, 48–53 (2018).
59. Diggle, P. & Ribeiro, P. J. Model-based Geostatistics (Springer, 2007).
60. Kristensen, K., Nielsen, A., Berg, C. W., Skaug, H. & Bell, B. M. TMB: automatic differentiation and Laplace approximation. J. Stat. Softw. 70, 1–21 (2016).
61. Patil, A. P., Gething, P. W., Piel, F. B. & Hay, S. I. Bayesian geostatistics in health cartography: the perspective of malaria. Trends Parasitol. 27, 246–253 (2011).
62. Phillips, D. E. et al. A composite metric for assessing data on mortality and causes of death: the vital statistics performance index. Popul. Health Metr. 12, 14 (2014).
63. Schmertmann, C. P. & Gonzaga, M. R. Bayesian estimation of age-specific mortality and life expectancy for small areas with defective vital records. Demography 55, 1363–1388 (2018).
64. Walker, N., Hill, K. & Zhao, F. Child mortality estimation: methods used to adjust for bias due to AIDS in estimating trends in under-five mortality. PLoS Med. 9, e1001298 (2012).
65. Silva, R. Child mortality estimation: consistency of under-five mortality rate estimates using full birth histories and summary birth histories. PLoS Med. 9, e1001296 (2012).
66. Wilson, K. & Wakefield, J. Pointless spatial modeling. Biostatistics https://doi. org/10.1093/biostatistics/kxy041 (2018).
67. Wilson, K. & Wakefield, J. Child mortality estimation incorporating summary birth history data. Preprint at https://arxiv.org/abs/1810.04140 (2018).
68. WorldPop Dataset (WorldPop, accessed 25 July 2017); http://www.worldpop. org.uk/data/get_data/
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spelling Alvis-Guzmán, NelsonBurstein, RoyHenry, Nathaniel J.Collison, Michael L.Marczak, Laurie B.Sligar, AmberWatson, StefanieMarquez, NealAbbasalizad-Farhangi, MahdiehAbbasi, Masoumeh2020-01-22T13:08:24Z2020-01-22T13:08:24Z2019-10-161476-46870028-0836https://hdl.handle.net/11323/5899Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.Alvis-Guzmán, Nelson-will be generated-orcid-0000-0001-9458-864X-600Burstein, RoyHenry, Nathaniel J.Collison, Michael L.Marczak, Laurie B.Sligar, AmberWatson, StefanieMarquez, NealAbbasalizad-Farhangi, MahdiehAbbasi, MasoumehengNaturehttps://doi.org/10.1038/s41586-019-1545-01. Reidpath, D. D. & Allotey, P. Infant mortality rate as an indicator of population health. J. Epidemiol. Community Health 57, 344–346 (2003).2. United Nations General Assembly. United Nations Millennium Declaration: Resolution adopted by the General Assembly. A/RES/55/2 (UN General Assembly, 2000).3. Centers for Disease Control and Prevention. Ten Great Public Health Achievements—Worldwide, 2001–2010. https://www.cdc.gov/mmwr/preview/ mmwrhtml/mm6024a4.htm (2011).4. GBD 2017 Mortality Collaborators. Global, regional, and national age-sexspecific mortality and life expectancy, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1684–1735 (2018).5. Golding, N. et al. Mapping under-5 and neonatal mortality in Africa, 2000–15: a baseline analysis for the Sustainable Development Goals. Lancet 390, 2171–2182 (2017).6. Pezzulo, C. et al. Geospatial Modeling of Child Mortality across 27 Countries in sub-Saharan Africa. DHS Spatial Analysis Reports No. 13 (USAID, 2016).7. Li, Z. et al. Changes in the spatial distribution of the under-five mortality rate: small-area analysis of 122 DHS surveys in 262 subregions of 35 countries in Africa. PLoS ONE 14, e0210645 (2019).8. Lawn, J. E., Cousens, S. & Zupan, J. 4 million neonatal deaths: When? Where? Why? Lancet 365, 891–900 (2005).9. World Health Organization. SDG 3: Ensure healthy lives and promote wellbeing for all at all ages. https://www.who.int/sdg/targets/en/ (2019).10. Dwyer-Lindgren, L. et al. Estimation of district-level under-5 mortality in Zambia using birth history data, 1980–2010. Spat. SpatioTemporal Epidemiol. 11, 89–107 (2014).11. Dwyer-Lindgren, L. et al. Small area estimation of under-5 mortality in Bangladesh, Cameroon, Chad, Mozambique, Uganda, and Zambia using spatially misaligned data. Popul. Health Metr. 16, 13 (2018).12. Wakefield, J. et al. Estimating under-five mortality in space and time in a developing world context. Stat. Methods Med. Res. https://doi. org/10.1177/0962280218767988 (2018).13. Burke, M., Heft-Neal, S. & Bendavid, E. Sources of variation in under-5 mortality across sub-Saharan Africa: a spatial analysis. Lancet Glob. Health 4, e936–e945 (2016).14. Macharia, P. M. et al. Sub national variation and inequalities in under-five mortality in Kenya since 1965. BMC Public Health 19, 146 (2019).15. Sousa, A., Hill, K. & Dal Poz, M. R. Sub-national assessment of inequality trends in neonatal and child mortality in Brazil. Int. J. Equity Health 9, 21 (2010).16. Mohammadi, Y. et al. Measuring Iran’s success in achieving Millennium Development Goal 4: a systematic analysis of under-5 mortality at national and subnational levels from 1990 to 2015. Lancet Glob. Health 5, e537–e544 (2017).17. Wang, Y. et al. Under-5 mortality in 2851 Chinese counties, 1996–2012: a subnational assessment of achieving MDG 4 goals in China. Lancet 387, 273–283 (2016).18. Horton, R. Offline: in defence of precision public health. Lancet 392, 1504 (2018).19. Takahashi, S., Metcalf, C. J. E., Ferrari, M. J., Tatem, A. J. & Lessler, J. The geography of measles vaccination in the African Great Lakes region. Nat. Commun. 8, 15585 (2017).20. Utazi, C. E. et al. High resolution age-structured mapping of childhood vaccination coverage in low and middle income countries. Vaccine 36, 1583–1591 (2018).21. Gething, P. W. et al. Mapping Plasmodium falciparum mortality in Africa between 1990 and 2015. N. Engl. J. Med. 375, 2435–2445 (2016).22. Reiner, R. C. Jr et al. Variation in childhood diarrheal morbidity and mortality in Africa, 2000–2015. N. Engl. J. Med. 379, 1128–1138 (2018).23. Osgood-Zimmerman, A. et al. Mapping child growth failure in Africa between 2000 and 2015. Nature 555, 41–47 (2018).24. Amoah, B., Giorgi, E., Heyes, D. J., van Burren, S. & Diggle, P. J. Geostatistical modelling of the association between malaria and child growth in Africa. Int. J. Health Geogr. 17, 7 (2018).25. Bishai, D. M. et al. Factors contributing to maternal and child mortality reductions in 146 low- and middle-income countries between 1990 and 2010. PLoS ONE 11, e0144908 (2016).26. Marmot, M. Social determinants of health inequalities. Lancet 365, 1099–1104 (2005).27. Victora, C. G. et al. Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. Lancet 387, 2049–2059 (2016).28. Rose, G. Strategy of prevention: lessons from cardiovascular disease. Br. Med. J. (Clin. Res. Ed.) 282, 1847–1851 (1981).29. Mackenbach, J. P., Lingsma, H. F., van Ravesteyn, N. T. & Kamphuis, C. B. M. The population and high-risk approaches to prevention: quantitative estimates of their contribution to population health in the Netherlands, 1970–2010. Eur. J. Public Health 23, 909–915 (2013).30. Agarwal, S. & Taneja, S. All slums are not equal: child health conditions among the urban poor. Indian Pediatr. 42, 233–244 (2005).31. Farag, T. H. et al. Precisely tracking childhood death. Am. J. Trop. Med. Hyg. 97, 3–5 (2017).32. Farmer, P. E. et al. Reduced premature mortality in Rwanda: lessons from success. Br. Med. J. 346, f65 (2013).33. Gurusamy, P. S. R. & Janagaraj, P. D. A success story: the burden of maternal, neonatal and childhood mortality in Rwanda - critical appraisal of interventions and recommendations for the future. Afr. J. Reprod. Health 22, 9–16 (2018).34. McGovern, M. E. & Canning, D. Vaccination and all-cause child mortality from 1985 to 2011: global evidence from the Demographic and Health Surveys. Am. J. Epidemiol. 182, 791–798 (2015).35. Cheng, J. J., Schuster-Wallace, C. J., Watt, S., Newbold, B. K. & Mente, A. An ecological quantification of the relationships between water, sanitation and infant, child, and maternal mortality. Environ. Health 11, 4 (2012).36. Steketee, R. W. & Campbell, C. C. Impact of national malaria control scale-up programmes in Africa: magnitude and attribution of effects. Malar. J. 9, 299 (2010).37. Kiragu, K., Collins, L., Von Zinkernagel, D. & Mushavi, A. Integrating PMTCT into maternal, newborn, and child health and related services: experiences from the global plan priority countries. J. Acquir. Immune Defic. Syndr. 75, S36–S42 (2017).38. GBD 2017 Causes of Death Collaborators. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 392, 1736–1788 (2018).39. Pasha, O. et al. A combined community- and facility-based approach to improve pregnancy outcomes in low-resource settings: a Global Network cluster randomized trial. BMC Med. 11, 215 (2013).40. Horton, S. et al. Ranking 93 health interventions for low- and middle-income countries by cost-effectiveness. PLoS ONE 12, e0182951 (2017).41. Simmons, L. E., Rubens, C. E., Darmstadt, G. L. & Gravett, M. G. 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