Reviews (n=18) | Description of included interventions | Type of studies included (no) | Targeted health care providers | Outcome reported | Pooled data (Y/N) | Results | |
---|---|---|---|---|---|---|---|
 |  |  |  | Other outcomes | MNCH specific outcomes |  |  |
Bhutta 2010[51] | In-service training to health personnel only, defined as SBAs (nurses, midwives, doctors or health personnel with midwifery skills) for better maternal outcomes. | Before after:08, Quais:02, Cross-sectional: 2 | Skilled birth attendants (doctors, nurses and midwives) as well as to other service providers (lab tech) in LMIC | Â | Cesarean section | No | 1.78 (0.34-9.32) |
 |  |  |  |  | Maternal mortality |  | 0.57 (0.36-0.91) |
 |  |  |  |  | Obstetric complications |  | 1.72 (0.72-4.10) |
 |  |  |  |  | Institutional delivery |  | 2.92 (2.09-4.06) |
 |  |  |  |  | Referrals |  | 0.57 (0.25-1.31) |
 |  |  |  |  | Mean antenatal visits |  | 0.90 (0.47-1.33) |
Giguere 2012[72] | The distribution of published or printed recommendations for clinical care and evidence to inform practice, including clinical practice guidelines, journals and monographs. | 14 RCTs 31 ITS | All health care professionals | PEM vs. no intervention | Â | Yes | Â |
 |  |  |  | Practice outcomes: (categorical) |  |  | Median absolute risk difference 0.02 (range 0, 0.11) i.e. 2% absolute improvement |
 |  |  |  | Profession practice outcomes: (continuous) |  |  | median improvement in standardised mean difference 0.13 (range -0.16, 0.36) |
Forsetlund 2009[53] | We included the following types of educational meetings: conferences, lectures, workshops, seminars, symposia, and courses. | Trials: 81 | Qualified health professionals or health professionals in postgraduate training mostly in HIC | Any intervention with educational meeting vs. no intervention: | Â | Yes | 6% (1.8-15.9) |
 |  |  |  | Compliance |  |  |  |
 |  |  |  | Only educational meeting vs. no intervention: |  |  |  |
 |  |  |  | Compliance |  |  | 6% (2.9-15.3) |
 |  |  |  | Achievement of treatment goal |  |  | 3 (0.1-4) |
Hulscher 2005[54] | Within the professional oriented interventions we distinguished between conceptually different interventions: information transfer, learning through social influence, feedback and reminders. | RCT: 37 Quasi: 18 | Family physicians, general internists, gynaecologists, obstetricians, pediatricians and sometimesother professionals like nurse practitioners and radiologists in HIC | Preventive services: | Â | Â | Â |
 |  |  |  | Group education vs. no intervention |  |  | Range: -4% - 31% |
 |  |  |  | Multifaceted interventions versus group education |  |  | Range: -31% - 28% |
Hyde 2000[55] | Critical appraisal is the process of assessing and interpreting evidence by systematically considering its validity, results and relevance to an individual’s work. | RCT:01 NRCT: 08 CBA: 07 | Doctors, midwives, managers and researchers | Knowledge |  | Yes | 0.10 (0.06-0.14) |
 |  |  |  | Skills |  |  | 14/16 comparisons showed positive effect |
 |  |  |  | Attitude |  |  | 4/4 comparisons showed positive impact |
Lassi 2010[39] | Intervention packages that included additional training of outreach workers namely, female health workers/visitors, community midwives, community/village health workers, facilitators or TBAs in maternal care during pregnancy, delivery and in the postpartum period; and routine newborn care. | 18 cluster-randomized/quasi-randomized trials | Outreach workers namely, female health workers/visitors, community midwives, community/village health workers, facilitators or TBAs in LMIC | Â | Maternal mortality | Yes | 0.77 (0.59-1.02) |
 |  |  |  |  | Maternal morbidity |  | 0.75 (0.61-0.92) |
 |  |  |  |  | Neonatal mortality |  | 0.76 (0.68-0.84) |
 |  |  |  |  | Perinatal mortality |  | 0.80 (0.71-0.91) |
 |  |  |  |  | Referral |  | 1.4 (1.19-1.65) |
 |  |  |  |  | Early breast feeding |  | 1.94 (1.56-2.42) |
Légaré 2010[56] | Interventions may include but are not limited to the distribution of printed educational material, educational meetings, audit and feedback, reminders, and patient-mediated interventions | RCT’s:05 | Healthcare professionals, residents, fellows, and other pre licensurehealthcare professional | Adoption of shared decision making: |  | No |  |
 |  |  |  | Both patient mediated interventions |  |  | 1.06 (0.62-1.5) |
 |  |  |  | Multifaceted intervention vs usual care |  |  | 2.11 (1.3-2.9) |
Lugtenberg 2008[57] | CPGs were defined as ‘‘systematically developed statements to assist practitioner decisions about appropriate healthcare for specific clinical circumstances.’’ | cRCT: 10, before after: 10, ITS: 1 | Physicians | Process outcomes |  | No | 17/19 studies showed significant improvements |
 |  |  |  | Patient outcomes |  |  | 6/9 studies showed significant but small improvements |
Norman 1998[58] | The conscientious explicit and judicious use of current evidence in making decisions about the care of individual patients | RCT: 03 CT:06 Cohort: 01 | Medical students, residents | Undergraduate knowledge | Â | No | Mean gain 17.0%; [SD] 4.0%). |
 |  |  |  | Residents knowledge |  |  | Mean gain 1.3%; SD 1.7%). |
O’Brien 2007[59] | Educational outreach visits, defined as use of a trained person from outside the practice setting who meets with healthcare professionals in their practice settings to provide information with the intent of changing their performance. | RCT: 69 | Healthcare professionals | Compliance |  | Yes | 5.6% (3.0-9.0%) |
 |  |  |  | Prescribing |  |  | 4.8% (3.0-6.5%) |
 |  |  |  | Professional Performance |  |  | 6.0% (3.6-(16.0) |
Opiyo 2010[60] | Following in-service training courses aimed at changing provider behavior in the care of the seriously ill newborn or child: Neonatal and pediatric life support courses e.g. NLS, NRP, PALS, PLS, and others. Life support elements. Other in-service newborn and child health training courses aimed at the recognition and management of the seriously ill child | RCT: 02 | Doctors (general practitioners and specialists), nurses, pharmacists and dieticians/nutritionists, in outpatient or hospital-based settings in LMIC | Â | Performance of adequate initial resuscitation steps | No | 2.45 (1.75-3.42) |
 |  |  |  |  | Frequency of inappropriate and potentially harmful practices |  | 0.40 (0.13-0.66) |
Oxman 1995[61] | Participation of health care providers in conferences, lectures, workshops or traineeships outside their practice settings. | Trials: 17 | General healthcare providers | Change in health outcome and performance | Â | No | Narrative |
Reeves 2008[62] | An IPE intervention occurs when members of more than one health and/or social care profession learn interactively together, for the explicit purpose of improving inter-professional collaboration and/or the health/well being of patients/clients. | RCT: 04 CBA: 02 | Health and social care professionals | Patient satisfaction | Â | No | 4/6 reported positive outcomes |
 |  |  |  | Collaborative team behavior |  |  |  |
 |  |  |  | Reduction in clinical error |  |  |  |
Sibley 2012[73] | Trained birth attendants training | RCT: 6 | Trained birth attendants | Â | Trained birth attendants versus untrained birth attendants: | No | Adjusted OR (95% CI) |
 |  |  |  |  | Still births |  | 0.69 (0.57 to 0.83) |
 |  |  |  |  | Perinatal death |  | 0.70 (0.59 to 0.83) |
 |  |  |  |  | Maternal mortality |  | 0.74 (0.45 to 1.22) |
 |  |  |  |  | Referral |  | 1.50 (1.18 to 1.90) |
 |  |  |  |  | Neonatal deaths |  | 0.71 (0.61 to 0.82) |
 |  |  |  |  | Obstructed labor |  | 1.26 (1.03 to 1.54) |
 |  |  |  |  | Hemorrhage |  | 0.61 (0.47 to 0.79) |
 |  |  |  |  | Puerperal Sepsis |  | 0.17 (0.13 to 0.23) |
Smits 2002[63] | Educational intervention was problem based learning | RCT’s: 06 | Post graduate continuing education in HIC | Participant’s knowledge, performance, satisfaction |  | No | Narrative |
 |  |  |  | Patients health |  |  |  |
 |  |  |  | Follow-up |  |  |  |
Thomas 1999[64] | Effect of clinical guideline on behavior of nurses, midwives or PAM's, on patient outcomes | RCT: 13 CBA: 2 ITS: 03 | Nursing, midwifery, health visiting, podiatry, speech and language therapy, physiotherapy and occupational therapy, pharmacy and radiography | General effectiveness | Â | No | Narrative |
Wensing 1998[65] | Information transfer through group education, reading material and patient education | RCT: 39 CBA: 22 | Physicians in HIC | Effectiveness against the reported outcome measures | Â | No | Narrative |
Worral 1997[66] | Interventions to improve medical practice like dissemination strategies such as conferences or mailing | 13 trials | Physicians in HIC | Conditions studies | Â | No | 5/13 studies showed statistically significant results |