Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec 28;5(4):571-580.
doi: 10.9745/GHSP-D-16-00174. Print 2017 Dec 28.

Maternal and Neonatal Directed Assessment of Technologies (MANDATE): Methods and Assumptions for a Predictive Model for Maternal, Fetal, and Neonatal Mortality Interventions

Bonnie Jones-Hepler  1 , Katelin Moran  2 , Jennifer Griffin  2 , Elizabeth M McClure  2 , Doris Rouse  2 , Carolina Barbosa  2 , Emily MacGuire  2 , Elizabeth Robbins  2 , Robert L Goldenberg  3
Affiliations

Maternal and Neonatal Directed Assessment of Technologies (MANDATE): Methods and Assumptions for a Predictive Model for Maternal, Fetal, and Neonatal Mortality Interventions

Bonnie Jones-Hepler et al. Glob Health Sci Pract. .

Abstract

Maternal, fetal, and neonatal mortality disproportionately impact low- and middle-income countries, and many current interventions that can save lives are often not available nor appropriate for these settings. Maternal and Neonatal Directed Assessment of Technologies (MANDATE) is a mathematical model designed to evaluate which interventions have the greatest potential to save maternal, fetal, and neonatal lives saved in sub-Saharan Africa and India. The MANDATE decision-support model includes interventions such as preventive interventions, diagnostics, treatments, and transfers to different care settings to compare the relative impact of different interventions on mortality outcomes. The model is calibrated and validated based on historical and current rates of disease in sub-Saharan Africa and India. In addition, each maternal, fetal, or newborn condition included in MANDATE considers disease rates specific to sub-Saharan Africa and India projected to intervention rates similar to those seen in high-income countries. Limitations include variance in quality of data to inform the estimates and generalizability of findings of the effectiveness of the interventions. The model serves as a valuable resource to compare the potential impact of multiple interventions, which could help reduce maternal, fetal, and neonatal mortality in low-resource settings. The user should be aware of assumptions in evaluating the model and interpret results accordingly.

PubMed Disclaimer

Figures

FIGURE 1.
FIGURE 1.
Conditions Modeled in MANDATE Abbreviations: IUGR, intrauterine growth restriction; IVH, intraventricular hemorrhage; NEC, necrotizing enterocolitis; RDS, respiratory distress syndrome.
FIGURE 2.
FIGURE 2.
Decision Tree Modeling Methodology *Condition positive and negative is based on an “un-prevented” incidence rate (i.e., the proportion of the population who would get a condition if no preventive interventions were available).
See this image and copyright information in PMC

Comment in

References

    1. Black RE, Cousens S, Johnson HL, et al. ; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;375(9730):1969–1987. 10.1016/S0140-6736(10)60549-1. - DOI - PubMed
    1. Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PFA. WHO analysis of causes of maternal death: a systematic review. Lancet. 2006;367(9516):1066–1074. 10.1016/S0140-6736(06)68397-9. - DOI - PubMed
    1. Lee ACC, Katz J, Blencowe H, et al. ; CHERG SGA-Preterm Birth Working Group. National and regional estimates of term and preterm babies born small for gestational age in 138 low-income and middle-income countries in 2010. Lancet Glob Health. 2013;1(1):e26–e36. 10.1016/S2214-109X(13)70006-8. - DOI - PMC - PubMed
    1. Liu L, Johnson HL, Cousens S, et al. ; Child Health Epidemiology Reference Group of WHO and UNICEF. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379(9832):2151–2161. 10.1016/S0140-6736(12)60560-1. - DOI - PubMed
    1. Ronsmans C, Graham WJ; Lancet Maternal Survival Series steering group. Maternal mortality: who, when, where, and why. Lancet. 2006;368(9542):1189–1200. 10.1016/S0140-6736(06)69380-X. - DOI - PubMed

Publication types

LinkOut - more resources