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Table 6 Essential interventions and effective practices included in the modelling, and estimated time requirement for delivery of each

From: The ‘Dream Team’ for sexual, reproductive, maternal, newborn and adolescent health: an adjusted service target model to estimate the ideal mix of health care professionals to cover population need

Intervention Time requirement per woman/girl/newborn (minutes) Level(s) of care at which intervention delivered
Primary Secondary Tertiary
Pre-pregnancy
 Family planning advicea 20  
 Delivery of condoms, vaginal barrier, vaginal tablet, other 15   
 Delivery of contraceptive pills, injectables 20   
 Delivery of contraceptive implants 40   
 Delivery of intrauterine devices (IUDs) 35   
 Female and male sterilisation 70    
 Prevention of HIV in all women of reproductive agea 45   
 Prevention of other sexually transmitted infections (STIs) in all women of reproductive agea 14   
 Syphilis managementa 15
 Gonorrhoea managementa 15
 Chlamydia managementa 15
 Trichomoniasis managementa 15
 HIV managementa 240
 Folic acid fortification/supplementation 10   
Pregnancy
 Iron and folic acid supplementation, zinc supplementation, advice to increase dietary energy and protein intake/microsupplementation/interventions to increase frequency and ease of defecation 15   
 Tetanus toxoid vaccination 5   
 Prevention of malaria with insecticide treated nets (ITNs) and antimalarial medication 5   
 Management of malaria with ITNs and antimalarial medication 4
 Screening for HIV for prevention of mother-to-child transmission 30
 Treatment of HIV for prevention of mother-to-child transmission 280
 Prevention of STIs as part of antenatal care 6   
 Gonorrhoea managementa 10
 Chlamydia managementa 10
 Trichomoniasis managementa 10
 Screening for syphilisa 15
 Treatment of syphilis 10
 Antibiotics for treating bacterial vaginosis 10
 Antibiotics for treating asymptomatic bacteriuria 10
 Treatment for symptomatic urinary tract infections 10
 Any topical treatment for vaginal candidiasis 10
 Calcium supplementation to prevent hypertension 8
 Interventions for cessation of smokinga 16   
 Antihypertensive drugs to treat high blood pressure (including low-dose aspirin to prevent pre-eclampsia)a 50
 Magnesium sulphate for eclampsia (nurse or midwife) 180
 Magnesium sulphate for eclampsia (ob/gyn) 60  
 Antibiotics for prevention of preterm premature rupture of membranes 30
 Corticosteroids to prevent respiratory distress (nurse or midwife) 40
 Corticosteroids to prevent respiratory distress (generalist doctor) 30
 Safe abortion (vacuum aspiration or dilation & curettage) 30  
 Post-abortion care (auxiliary) 90  
 Post-abortion care (nurse or midwife) 90
 Post-abortion care (ob/gyn) 30
 Reduce malpresentation at term with external cephalic versiona 107  
 Induction of labour to manage pre-labour rupture of membranes at term 86  
 Digital perineal massage 0
 Interventions intended to promote breastfeeding 30
 Anti-D administration in pregnancy for preventing rhesus alloimmunisation 1   
 Antiplatelet agents for preventing pre-eclampsia and its complications 30   
 Interventions for preventing and treating pelvic and back pain in pregnancy 15   
 Psychological and psychosocial interventions for preventing postpartum depression 30   
Labour and birth
 Normal labour and delivery management and social support during childbirth (nurse or midwife) 360
 Normal labour and delivery management and social support during childbirth (ob/gyn) 30
 Any perineal technique during the second stage of labour 0
 Immersion in any bathtub or pool during labour 0
 Upright positions assumed by women in first stage of labour 0
 Acupuncture or acupressure for pain management in labour 0
 Massage, reflexology and other manual methods for pain management in labour 0
 Relaxation techniques 0
 Restrictive episiotomy 0
 Any inhaled analgesia during labour 0
 Active management of third stage labour (to deliver placenta) to prevent postpartum haemorrhage (including uterine massage, uterotonics and controlled cord traction) 10
 Oxytocin given prophylactically for third stage of labour 0
 Prophylactic use of ergot alkaloids in third stage of labour 0
 Rapid versus stepwise negative pressure application for vacuum extraction 0
 Screen for HIV during childbirth if not already testeda 11
 Manage HIV during childbirth if not already testeda 120
 Caesarean section for maternal/foetal indication (including prophylactic antibiotic for C-section) - auxiliarya 210  
 Caesarean section for maternal/foetal indication (including prophylactic antibiotic for C-section) - nurse or midwifea 90  
 Caesarean section for maternal/foetal indication (including prophylactic antibiotic for C-section) – ob/gyna 90  
 Induction of labour for prolonged pregnancy (midwife or nurse) 40  
 Induction of labour for prolonged pregnancy (ob/gyn) 20  
 Management of postpartum haemorrhage (PPH) (manual removal of placenta and/or surgical procedures and/or oxytocics)-auxiliary 120  
 Management of PPH (manual removal of placenta and/or surgical procedures and/or oxytocics)-nurse or midwife 60  
 Management of PPH (manual removal of placenta and/or surgical procedures and/or oxytocics)-ob/gyn 90  
 Interventions intended to promote breastfeeding 30
 Alternative institutional birth environment 0
 Midwife-led continuity models of care 0
 Labour assessment programmes aimed at delaying admission to the labour ward 0
Postnatal: mother
 Postnatal preventive care 80
 Detect and treat postpartum sepsis (auxiliary) 150
 Detect and treat postpartum sepsis (nurse or midwife) 60
 Continuous versus interrupted sutures for episiotomy/ second degree tears 0
 Psychological and psychosocial interventions for preventing postpartum depression 30
 Single administration of paracetamol for early postpartum pain 5
 Any type of approved analgesia for after-birth pains (vaginal birth) 0
 Antibiotic regimens for endometritis after delivery 15
 Analgesic rectal suppositories for relief of perineal pain 0
Postnatal: newborn
 Neonatal resuscitation with bag and maska 20
 Kangaroo Mother Care 30
 Skin-to-skin contact between mother and baby 5
 Immediate thermal care 5
 Extra support for feeding small and preterm babiesa 90
 Management of newborns with jaundice 150
 Initiate prophylactic antiretroviral therapy (ART) for babies exposed to HIVa 30
 Presumptive antibiotic therapy for newborns at risk of bacterial infectionsa 40
 Surfactant to prevent respiratory distress syndrome in preterm babiesa 60
 Continuous positive airway pressure (CPAP) to manage babies with respiratory distress syndromea 120
 Interventions intended to promote breastfeeding 60
 Exclusive breastfeeding for at least 6 months 0
  1. aNot included in OneHealth so the time estimate was an expert opinion