‘First 1000 days’ health interventions in low- and middle-income countries: alignment of South African policies with high-quality evidence

Figures & data

Figure 1. Criteria to determine alignment.

Figure 2. Methodology and results of the search strategy.

Table 1. Categories used to rank evidence.

Score	Categories
Evidence of impact on morbidity or mortality^a
1	Strong evidence of benefit in efficacy and effectiveness settings and recommended for inclusion in health systems.
2	Moderate level of evidence of impact but recommended for inclusion in health systems.
3	Low level of evidence but recommended for further evaluation in health systems on additional criteria and plausibility.
Evidence and potential for delivery and inclusion in primary care programmes
1	Strong evidence of benefit in efficacy and effectiveness settings and recommended.
2	Plausible and promising evidence of impact but needs evaluation in health systems at scale.
3	Promising interventions that need further assessment in primary care settings.
Evidence on determinants of child health and behaviour change (eg. fiscal, regulatory)
1	Strong evidence of benefit in efficacy and effectiveness settings and recommended.
2	Plausible and promising evidence of impact but need more at scale.
3	Low or no evidence of scale with uncertainty if applicability.

^aCategories are based on a ranking scale developed by Bhutta Z et al. [17] and modified for this review.

Table 2. Table of interventions according to the stages of pregnancy.

Stage	Intervention	Reference
Pre-pregnancy	Promotion of birth spacing of between 18 and 59 months	[30]
Antenatal	Promotion of a minimum of > or = 4 ANC visits	[33]
	Multiple micronutrient, balanced protein energy and folic acid supplementation	[19,36,37,38]
	Detection and treatment of maternal syphilis	[40]
	Prevention of hypertensive disorders (calcium supplementation/anti-platelets)	[41,42,43]
	Interpersonal psychotherapy to prevent and treat antenatal depression	[44]
	Prevention of mother-to-child transmission (PMTCT)	[46]
Childbirth	Antibiotic therapy for PROM or pPROM	[49,50]
	Corticosteroid administration at presentation of preterm labour	[18,53]
	Magnesium sulphate (IV/IM) versus phenytoin as part of managing eclampsia	[54]
	Supply of clean birth kits for deliveries	[55]
	Presence of birth attendants during delivery	[63,64,65]
Neonate	Promotion of KMC/skin-to-skin contact	[66,67]
	Vitamin A supplementation in term neonates within first 28 days of life	[68,71]
Postnatal	Antidepressants to prevent postnatal depression	[69]
	ARVs to treat HIV/AIDS in children <3 years	[70]
Across the first 1000 days categories	Community-level service delivery interventions	[73,74,75]
	Handwashing with soap or improved water quality to prevent diarrhoea	[78,79]

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