scholarly journals Effectiveness of community based health interventions in improving access to maternal health services in developing countries - A Systematic Review

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027822 ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Oluwasola Banke-Thomas ◽  
Adamu Maikano ◽  
Charles Anawo Ameh

IntroductionThere is substantial evidence that maternal health services across the continuum of care are effective in reducing morbidities and mortalities associated with pregnancy and childbirth. There is also consensus regarding the need to invest in the delivery of these services towards the global goal of achieving Universal Health Coverage in low/middle-income countries (LMICs). However, there is limited evidence on the costs of providing these services. This protocol describes the methods and analytical framework to be used in conducting a systematic review of costs of providing maternal health services in LMICs.MethodsAfrican Journal Online, CINAHL Plus, EconLit, Embase, Global Health Archive, Popline, PubMed and Scopus as well as grey literature databases will be searched for relevant articles which report primary cost data for maternal health service in LMICs published from January 2000 to June 2019. This search will be conducted without implementing any language restrictions. Two reviewers will independently search, screen and select articles that meet the inclusion criteria, with disagreements resolved by discussions with a third reviewer. Quality assessment of included articles will be conducted based on cost-focused criteria included in globally recommended checklists for economic evaluations. For comparability, where feasible, cost will be converted to international dollar equivalents using purchasing power parity conversion factors. Costs associated with providing each maternal health services will be systematically compared, using a subgroup analysis. Sensitivity analysis will also be conducted. Where heterogeneity is observed, a narrative synthesis will be used. Population contextual and intervention design characteristics that help achieve cost savings and improve efficiency of maternal health service provision in LMICs will be identified.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.PROSPERO registration numberCRD42018114124


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Jahirul Hushen ◽  
Arpaporn Powwattana ◽  
Chockchai Munsawaengsub ◽  
Sukhontha Siri

PurposeThis study aimed to identify the proportion and factors influencing the use of maternal health services (MHS) in rural Thawang, Rolpa, Nepal.Design/methodology/approachThis was a community-based cross-sectional study conducted among 417 mothers who had given birth in the previous two years. Bivariate and multivariate logistic regression was applied to identify associations and predictors.FindingsThe results showed that the use of maternal health services was 50.8%. Adjusting for all other factors in the final model, age group 25–30 years (AOR: 2.30; 95% CI: 1.199–4.422), spouse communication (AOR: 7.31; 95% CI: 2.574–20.791), high accessibility (AOR: 2.552, 95% CI: 1.402–4.643) and high affordability (AOR: 10.89; 95% CI: 4.66–25.445) were significant predictors.Research limitations/implicationsThis is a community-based cross-sectional study, and hence cannot establish causal relationships. The research was conducted in a limited rural area mid-Western Nepal, and this may limit the generalization of results to other settings of the country.Practical implicationsThis research supports to local level government and district health authority to develop and implement need based action to increase maternal health service in the local context.Originality/valueUnderutilization of maternal health services is the result of socioeconomic dynamics, poor access to health services and other physical developments. To increase utilization of maternal health services in rural areas, there is a need to tackle the root cause of health inequality such as reducing poverty, increasing female education, involving women in employment and increasing access to health as a priority development agenda by government authorities. This research supports local level government and district health authorities to develop and implement needs-based action to increase MHS in the local context.


2017 ◽  
Vol 12 (2) ◽  
pp. 55-61
Author(s):  
Thi Hoai Thu Nguyen ◽  
Fiona McDonald ◽  
Andrew Wilson

Background: One common governance issue faced by developing countries is the establishment and maintenance of infrastructure to support the delivery of primary health services. This qualitative study explores the perspective of maternal health workers on how infrastructure impacts the provision of maternity services in rural areas in Vietnam. Methods: Forty-one health workers and health managers at the commune, district and provincial levels of the Vietnamese public health system were interviewed. Questions focused on the impact of various organisational factors, including the impact of infrastructure on the performance of the health workforce, which provides publicly funded primary care. All interviews were recorded, transcribed and coded for thematic analysis. Findings: Participants noted that infrastructure directly affected their ability to perform certain tasks and could both directly and indirectly negatively impact their motivation. In general, participants noted a lack of investment in infrastructure for the provision of primary care services in rural areas. They identified that there were deficits in the availability of utilities and the adequacy of facilities. Conclusion: This research contributes to understanding the barriers to the provision of primary care in developing countries and in particular. The current inadequacy of facility buildings and inadequacy of clean water supply are issues for health workers in meeting the technical requirements of the standards as set out in the National Guidelines on reproductive health, and lead to safety concerns for the quality of maternal health services provided in commune health centres and District Health Centres. Abbreviations: CHC – Commune Health Centres; DHC – District Health Centre; HW – Health Worker.


2012 ◽  
Vol 20 (39) ◽  
pp. 50-61 ◽  
Author(s):  
Maurice Bucagu ◽  
Jean M. Kagubare ◽  
Paulin Basinga ◽  
Fidèle Ngabo ◽  
Barbara K Timmons ◽  
...  

2020 ◽  
Vol 18 (2) ◽  
pp. 102-104
Author(s):  
S. Bharati ◽  
N. Bajracharya ◽  
K.D. Tiwari ◽  
O. Maharjan ◽  
S. Maharjan

COVID-19, a novel corona virus has affected the life of each and every individual worldwide. Nepal being the neighborhood country of china, though, we had a late case detection. But, since the month of July this virus has spread in an alarming manner in Nepal. Nepal being one of the developing countries, we lack in equipments, manpower resources and also in treatment centers. Looking into the devastating scenario of Covid 19 in China, Italy, New York, Brazil and our neighboring countries like India, Pakistan and Bangladesh is scary. We wondered how we were going to handle this pandemic if similar circumstances happened in our country too. At the same time being OBGYN residents, we all know pregnancy is very crucial and our patients have faced much difficulties to receive the maternal health services. In this manuscript, we have shared our experience regarding preparedness for COVID-19, management of positive cases and its effect in OBGYN trainee.


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