Turner et al. BMC Public Health 2010, 10:170 http://www.biomedcentral.com/1471-2458/10/170 R E S E A R C H A R T I C L E Open Access Evidence for perinatal and child health care guidelines in crisis settings: can Cochrane help? Tari J Turner1,2*, Hayley Barnes3, Jane Reid2, Marie Garrubba2 Abstract Background: It is important that healthcare provided in crisis settings is based on the best available research evidence. We reviewed guidelines for child and perinatal health care in crisis situations to determine whether they were based on research evidence, whether Cochrane systematic reviews were available in the clinical areas addressed by these guidelines and whether summaries of these reviews were provided in Evidence Aid. Methods: Broad internet searches were undertaken to identify relevant guidelines. Guidelines were appraised using AGREE and the clinical areas that were relevant to perinatal or child health were extracted. We searched The Cochrane Database of Systematic Reviews to identify potentially relevant reviews. For each review we determined how many trials were included, and how many were conducted in resource-limited settings. Results: Six guidelines met selection criteria. None of the included guidelines were clearly based on research evidence. 198 Cochrane reviews were potentially relevant to the guidelines. These reviews predominantly addressed nutrient supplementation, breastfeeding, malaria, maternal hypertension, premature labour and prevention of HIV transmission. Most reviews included studies from developing settings. However for large portions of the guidelines, particularly health services delivery, there were no relevant reviews. Only 18 (9.1%) reviews have summaries in Evidence Aid. Conclusions: We did not identify any evidence-based guidelines for perinatal and child health care in disaster settings. We found many Cochrane reviews that could contribute to the evidence-base supporting future guidelines. However there are important issues to be addressed in terms of the relevance of the available reviews and increasing the number of reviews addressing health care delivery. Background Populations in crisis settings such as those resulting from natural disasters like earthquake, famine and flood, as well as man-made disasters like civil war, are at sub- stantial risk of trauma and illness. The risks of disease and death are particularly increased for infants, children and women giving birth. Health care providers in disas- ter settings work with limited infrastructure, equipment, supplies and training. Given the constrained resources with which they work, health care providers in these set- tings cannot afford to waste time or money on ineffec- tive or harmful treatments. Organisations working in disaster settings are develop- ing an awareness of the need for their practice to be based on evidence of effectiveness. Clinical practice * Correspondence: tari.turner@med.monash.edu.au 1Monash Institute of Health Services Research, Monash University, Locked Bag 29, Clayton 3168 Australia guidelines (CPGs) and other research-based tools are increasingly being used to support effective decision- making, and many humanitarian aid organisations have developed their own guidelines or adapted World Health Organization (WHO) guidelines. However, it has been suggested that there is a lack of evidence-based guidelines for child and perinatal health care in crisis situations [1], and WHO guidelines have been criticised for not being appropriately evidence-based [2]. The Cochrane Collaboration supports development and dissemination of high quality, systematic reviews of health research. After the devastating tsunami affecting the Pacific Rim in December 2004, The Cochrane Collaboration aimed to contribute to the relief effort by highlighting evidence relevant to people making decisions about health care in crisis situations through a website called Evidence Aid http://www.evi- denceaid.org. Evidence Aid brings together information © 2010 Turner et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.