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Table 2 Survey completers’ priority ranked questions (n = 28), research priority scores, average expert agreement and mean criterion scores

From: Neonatal survival in complex humanitarian emergencies: setting an evidence-based research agenda

Rank

Question

Research type*

Research Priority Score (RPS)

Average Expert Agreement (AEA)

Answerability

Feasibility

Relevance

Equity

1

What strategies are effective in increasing demand for, and use of skilled attendance?

DEL

0.846

0.643

0.837

0.824

0.870

0.852

2

What is the feasibility, effectiveness and cost of approaches to increase coverage of clean delivery practices in facilities and in homes?

DEL

0.841

0.616

0.820

0.774

0.863

0.908

3

What is the additional burden of neonatal mortality in different emergency situations (e.g. conflict, acute vs. protracted, natural disaster)?

DES

0.833

0.667

0.836

0.755

0.883

0.858

4

Can simplified pregnancy surveillance at community level be used to measure neonatal mortality?

DES

0.830

0.616

0.799

0.857

0.797

0.867

5

Can simplified verbal autopsy tools be adapted for use in emergency settings to capture the main causes of neonatal mortality?

DES

0.828

0.661

0.827

0.789

0.825

0.872

6

Develop and validate strategies to identify preterm babies at community level by CHWs and family members

DEV

0.826

0.610

0.823

0.768

0.859

0.855

7

Which risk factors for neonatal sepsis can be identified in emergency settings and these mothers and babies given extra support? E.g. low birth weight, short gestational age, unhygienic delivery, skin and umbilical cord care, hypothermia, poor feeding practices.

DES

0.818

0.634

0.797

0.765

0.841

0.868

8

Can pregnancy surveillance at community level contribute to increased uptake of facility-based delivery?

DEL

0.816

0.610

0.866

0.815

0.790

0.793

9

What is the feasibility, effectiveness and cost of different approaches to increase coverage of syphilis screening in pregnancy, treatment and partner treatment?

DEL

0.814

0.568

0.827

0.801

0.812

0.814

10

What is the feasibility, effectiveness and cost of different approaches to promote handwashing of caregivers?

DEL

0.812

0.610

0.862

0.835

0.743

0.807

11

What is the incidence of neonatal sepsis in emergency settings?

DES

0.803

0.619

0.788

0.764

0.802

0.861

12

What is the relative proportion of death in the neonatal period to other causes of child mortality in emergency settings?

DES

0.794

0.610

0.783

0.784

0.755

0.853

13

What is the feasibility, effectiveness and cost of approaches to increase and/or maintain tetanus toxoid coverage?

DEL

0.791

0.557

0.828

0.773

0.679

0.885

14

Can use of perinatal audit reduce the incidence of adverse outcomes related in acute intrapartum events?

DEL

0.785

0.500

0.805

0.795

0.801

0.740

15

What is the feasibility, effectiveness and cost of different approaches to promote hygienic cord and skin care?

DEV

0.783

0.548

0.808

0.782

0.782

0.762

16

Evaluate ways to provide thermal care and feeding for the very preterm baby at or close to home

DEV

0.780

0.512

0.798

0.766

0.744

0.812

17

What is the feasibility, effectiveness and cost of a scheme of routine home visits for initiation of supportive practices, detection of illness and newborn survival?

DEL

0.771

0.539

0.799

0.747

0.743

0.795

18

What is the feasibility, costs and effectiveness of setting up newborn care corners in mobile clinics, first referral units and district hospitals?

DEL

0.769

0.536

0.790

0.725

0.823

0.739

19

Can simpler clinical algorithms (recognition and management) be developed and validated for babies who require resuscitation at birth, and does this increase met need for resuscitation at birth?

DEL

0.767

0.539

0.669

0.785

0.809

0.806

20

Safety, feasibility and effectiveness and cost of managing severe neonatal infections at or close to home (e.g. requiring injectable antibiotics)

DEV

0.763

0.530

0.807

0.590

0.836

0.820

21

What is the incidence, causes and outcomes of umbilical and skin infections among newborns in emergency settings?

DES

0.762

0.521

0.789

0.703

0.701

0.855

22

What is the feasibility and effectiveness of approaches to improve aseptic practices in labour rooms, maternity, paediatric wards and nurseries?

DEL

0.753

0.533

0.747

0.754

0.779

0.731

23

What is the feasibility, effectiveness and cost of approaches to increase coverage of antibiotics for prolonged rupture of membranes?

DEL

0.752

0.494

0.779

0.716

0.738

0.776

24

What is the relative proportion of neonatal infections that are pneumonia, sepsis, meningitis and are there reliable clinical markers/combination of markers to distinguish these conditions?

DES

0.739

0.521

0.686

0.720

0.734

0.815

25

What is the feasibility and effectiveness of approaches to improve quality of care in hospitals?

DEL

0.739

0.479

0.706

0.729

0.752

0.768

26

Can introduction of Doppler increase the use of partograph to monitor labor?

DEL

0.724

0.461

0.829

0.736

0.655

0.675

27

What is the attribute of clean delivery kit distribution in decision making process for home or facility based delivery?

DEL

0.713

0.429

0.729

0.695

0.677

0.751

28

What is the additional burden of stillbirth in different emergency situations (e.g. conflict, acute vs protracted, natural disaster)?

DES

0.706

0.515

0.725

0.604

0.785

0.709

29

Can low-cost, robust, simple fetal heart monitors be developed and tested that are more user-friendly than the Pinard? Does use of such a device improve fetal heart rate monitoring and reduce intrapartum stillbirth and asphyxia-related outcomes?

DEV

0.700

0.443

0.718

0.689

0.770

0.622

30

Can UTI screening in pregnancy be reduced in cost and made more feasible so can be used in lower levels of care?

DEV

0.698

0.438

0.726

0.653

0.663

0.751

31

Can simpler, cheaper technology be developed to improve supportive care of neonates who require oxygen (such as robust pulse oximeter, oxygen condensers, low cost CPAP etc.) and does this reduce deaths, improve outcomes?

DEV

0.696

0.458

0.734

0.617

0.760

0.675

32

How can diagnostic facilities in health facilities for identification of neonatal sepsis be improved?

DEL

0.696

0.461

0.662

0.682

0.758

0.684

33

What is the feasibility, effectiveness and cost of different approaches to promote prompt care seeking for illness from an appropriate provider?

DEL

0.691

0.426

0.699

0.614

0.705

0.744

34

Identification of new interventions to prevent transmission of infections during childbirth, e.g. chlorhexidine vaginal douche, immune modulators like zinc to mothers.

DEV

0.679

0.440

0.678

0.674

0.692

0.672

35

Evaluate different methods of behavior change that overcome harmful practices and promote positive cultural and social norms

DEL

0.679

0.411

0.751

0.585

0.681

0.699

  1. *Research type: DES = description; DEL = delivery; DEV = development.