scholarly journals e-income countries from a provider’s perspective: a systematic review

2020 ◽  
Vol 5 (6) ◽  
pp. e002371
Author(s):  
Aduragbemi Banke-Thomas ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Francis Ifeanyi Ayomoh ◽  
Oluwasola Banke-Thomas ◽  
Ejemai Amaize Eboreime ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Services ◽  
Low Income ◽  
Caesarean Delivery ◽  
Economies Of Scale ◽  
Grey Literature ◽  
Health Economic Evaluation ◽  
Maternal Health Services ◽  
Personnel Cost

IntroductionMaternal health services are effective in reducing the morbidity and mortality associated with pregnancy and childbirth. We conducted a systematic review on costs of maternal health services in low-income and middle-income countries from the provider’s perspective.MethodsWe searched multiple peer-reviewed databases (including African Journal Online, CINAHL Plus, EconLit, Popline, PubMed, Scopus and Web of Science) and grey literature for relevant articles published from year 2000. Articles meeting our inclusion criteria were selected with quality assessment done using relevant cost-focused criteria of the Consolidated Health Economic Evaluation Reporting Standards checklist. For comparability, disaggregated costs data were inflated to 2019 US$ equivalents. Costs and cost drivers were systematically compared. Where heterogeneity was observed, narrative synthesis was used to summarise findings.ResultsTwenty-two studies were included, with most studies costing vaginal and/or caesarean delivery (11 studies), antenatal care (ANC) (9) and postabortion care (PAC) (8). Postnatal care (PNC) has been least costed (2). Studies used different methods for data collection and analysis. Quality of peer-reviewed studies was assessed average to high while all grey literature studies were assessed as low quality. Following inflation, estimated provision cost per service varied (ANC (US$7.24–US$31.42); vaginal delivery (US$14.32–US$278.22); caesarean delivery (US$72.11–US$378.940; PAC (US$97.09–US$1299.21); family planning (FP) (US$0.82–US$5.27); PNC (US$5.04)). These ranges could be explained by intercountry variations, variations in provider type (public/private), facility type (primary/secondary) and care complexity (simple/complicated). Personnel cost was mostly reported as the major driver for provision of ANC, skilled birth attendance and FP. Economies of scale in service provision were reported.ConclusionThere is a cost savings case for task-shifting and encouraging women to use lower level facilities for uncomplicated services. Going forward, consensus regarding cost component definitions and methodologies for costing maternal health services will significantly help to improve the usefulness of cost analyses in supporting policymaking towards achieving Universal Health Coverage.

scholarly journals Cost of maternal health services in low and middle-income countries: protocol for 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
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Economic Evaluations ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries

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

scholarly journals Community perceptions on demand-side incentives to promote institutional delivery in Oyam district, Uganda: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e026851
Author(s):  
William Massavon ◽  
Calistus Wilunda ◽  
Maria Nannini ◽  
Caroline Agaro ◽  
Simon Amandi ◽  
...  
Keyword(s):  
Maternal Health ◽  
Qualitative Study ◽  
Health Services ◽  
Low Income ◽  
Health Workers ◽  
Qualitative Content Analysis ◽  
Community Support ◽  
Maternal Health Services ◽  
Health Seeking ◽  
Team Members

ObjectiveTo examine the perceptions of community members and other stakeholders on the use of baby kits and transport vouchers to improve the utilisation of childbirth services.DesignA qualitative study.SettingOyam district, Uganda.ParticipantsWe conducted 10 focus group discussions with 59 women and 55 men, and 18 key informant interviews with local leaders, village health team members, health facility staff and district health management team members. We analysed the data using qualitative content analysis.ResultsFive broad themes emerged: (1) context, (2) community support for the interventions, (3) health-seeking behaviours postintervention, (4) undesirable effects of the interventions and (5) implementation issues and lessons learnt. Context regarded perceived long distances to health facilities and high transport costs. Regarding community support for the interventions, the schemes were perceived to be acceptable and helpful particularly to the most vulnerable. Transport vouchers were preferred over baby kits, although both interventions were perceived to be necessary. Health-seeking behaviours entailed perceived increased utilisation of maternal health services and ‘bypassing’, promotion of collaboration between traditional birth attendants and formal health workers, stimulation of men’s involvement in maternal health, and increased community awareness of maternal health. Undesirable effects of the interventions included increased workload for health workers, sustainability concerns and perceived encouragement to reproduce and dependency. Implementation issues included information gaps leading to confusion, mistrust and discontent, transport voucher scheme design; implementation; and payment problems, poor attitude of some health workers and poor quality of care, insecurity, and a shortage of baby kits. Community involvement was key to solving the challenges.ConclusionsThe study provides further insights into the implementation of incentive schemes to improve maternal health services utilisation. The findings are relevant for planning and implementing similar schemes in low-income countries.

Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review

2012 ◽  
Vol 20 (39) ◽  
pp. 50-61 ◽  
Author(s):  
Maurice Bucagu ◽  
Jean M. Kagubare ◽  
Paulin Basinga ◽  
Fidèle Ngabo ◽  
Barbara K Timmons ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Services ◽  
Health Systems ◽  
Maternal Health Services ◽  
Health Systems Strengthening

scholarly journals Barriers to maternal health services during the Ebola outbreak in three West African countries: a literature review

2020 ◽  
Vol 5 (9) ◽  
pp. e002974
Author(s):  
Piper Yerger ◽  
Mohamed Jalloh ◽  
Cordelia E M Coltart ◽  
Carina King
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
West Africa ◽  
Health System ◽  
Virus Disease ◽  
Grey Literature ◽  
Care Facility ◽  
Maternal Health Services ◽  
Health Crisis ◽  
Relevant Stakeholder

IntroductionThe Ebola virus disease (EVD) outbreak in West Africa, affecting Guinea, Liberia and Sierra Leone from 2014 to 2016, was a substantial public health crisis with health impacts extending past EVD itself. Access to maternal health services (MHS) was disrupted during the epidemic, with reductions in antenatal care, facility-based deliveries and postnatal care. We aimed to identify and describe barriers related to the uptake and provision of MHS during the 2014–2016 EVD outbreak in West Africa.MethodsIn June 2020, we conducted a scoping review of peer-reviewed publications and grey literature from relevant stakeholder organisations. Search terms were generated to identify literature that explained underlying access barriers to MHS. Published literature in scientific journals was first searched and extracted from PubMed and Web of Science databases for the period between 1 January 2014 and 27 June 2020. We hand-searched relevant stakeholder websites. A ‘snowball’ approach was used to identify relevant sources uncaptured in the systematic search. The identified literature was examined to synthesise themes using an existing framework.ResultsNineteen papers were included, with 26 barriers to MHS uptake and provision identified. Three themes emerged: (1) fear and mistrust, (2) health system and service constraints, and (3) poor communication. Our analysis of the literature indicates that fear, experienced by both service users and providers, was the most recurring barrier to MHS. Constrained health systems negatively impacted MHS on the supply side. Poor communication and inadequately coordinated training efforts disallowed competent provision of MHS.ConclusionsBarriers to accessing MHS during the EVD outbreak in West Africa were influenced by complex but inter-related factors at the individual, interpersonal, health system and international level. Future responses to EVD outbreaks need to address underlying reasons for fear and mistrust between patients and providers, and ensure MHS are adequately equipped both routinely and during crises.

scholarly journals Kasus-Kasus Maternal di Berita Online Menyangkut Hak Asasi yang Patut Menjadi Pelajaran dalam Pendidikan Bidan di Indonesia

2019 ◽  
pp. 140-152
Author(s):  
Mahindria Vici Virahayu ◽  
D. Dasuki ◽  
O. Emilia ◽  
M. Hasanbasri ◽  
M. Hakimi
Keyword(s):  
Human Rights ◽  
Maternal Health ◽  
Health Services ◽  
Low Income ◽  
Community Involvement ◽  
Health Workers ◽  
Professional Associations ◽  
Maternal Health Services ◽  
Online News ◽  
Scientific Publications

Abstrak Gerakan menghormati hak asasi manusia dalam pelayanan kesehatan maternal di berbagai negara mendorong petugas kesehatan bertindak lebih manusiawi. Perempuan selama ini diam karena tidak ingin memutus hubungan harmonis dengan bidan serta jarangnya isu ini diangkat dalam pertemuan profesi dan publikasi ilmiah menyebabkan perhatian yang rendah terhadap hak asasi manusia dalam pelayanan kesehatan maternal. Penelitian ini bertujuan untuk mengidentifikasi kegagalan dalam pemenuhan hak kesehatan ibu hamil dan bersalin serta mengeksplorasi alasan-alasan yang menyebabkan hal tersebut terjadi. Metode penelitian dilakukan dengan melakukan penelusuran berita online kompas.com, tribunnews.com, dan detiknews.com tahun 2016-2018 dengan kata kunci “malpraktik” dan “bidan”, tentang persoalan hak asasi manusia dalam pelayanan bidan. Kami mengikuti kasus dalam lebih dari satu media online, disertai perkembangan berita tentang kasus tersebut. Hasil penelitian menunjukkan bahwa dominasi bidan dalam pelayanan kesehatan maternal di Indonesia, berdampak pada pengabaian hak asasi perempuan dan keselamatan. Kejadian ini pada kelompok orang dengan pendapatan rendah dan kelompok yang mampu. Didapatkan praktik bidan di luar kewenangan, kemungkinan motivasi mendapatkan keuntungan, dominasi bidan, posisi sosial perempuan yang rendah dalam pelayanan kesehatan maternal, dan keterlibatan masyarakat yang rendah untuk mendukung perempuan yang mengalami ketidakadilan dalam layanan kesehatan. Kepercayaan dan ketergantungan perempuan pada bidan, berdampak pengabaian hak asasi dan keselamatan ibu, tindakan di luar kewenangan, untuk pencarian keuntungan dalam praktik pribadi. Organisasi profesi dan pendidik bidan harus memasukkan penerapan hak asasi manusia dalam praktik kebidanan melalui kasus-kasus dari berita online dalam pertemuan berkala asosiasi profesi, serta kurikulum pendidikan, untuk mencegah dampak buruk pengabaian hak asasi ibu di masa depan. Kata kunci: pengabaian hak asasi dalam layanan bidan, kasus malpraktik bidan, penguatan pendidikan bidan Abstract The movement to respect human rights in maternal health services in various countries encourages health workers to act more humanely. Low attention to human rights issue in maternal health services due to the silent of the victims-because women do not want to break the harmonious relationship with midwives, and this issue is rarely raised in professional meetings and scientific publications. This study aims to identify failures in fulfilling the health rights of pregnant women and childbirth and explore the reasons for this. The research method is done by searching online news kompas.com, tribunnews.com, and detiknews.com in 2016-2018 with the keywords “malpractice” and “midwife”, about human rights issues in midwifery services. We followed the case in more than one online media, accompanied by the case progress report. The results of the study show that the dominance of midwives in maternal health services in Indonesia has an impact on neglecting women’s human rights and safety. This event is in the group of people with low income and groups who are able. The practice of midwive’s out of authority, possible motivations for profit, dominance of midwives, low social position of women in maternal health services, and low community involvement in supporting women who experience inequality in maternal health services. Trust and dependence of women on midwives, impact on neglecting human rights and maternal safety, actions that are beyond authority, for seeking profit in private practice. Midwife professional organizations and educators must incorporate the application of human rights in midwifery practice through cases from online news in periodic meetings of professional associations, as well as educational curricula, to prevent the adverse effects of neglecting maternal rights in the future. Keywords: neglect of human rights in midwife services, midwife malpractice case, strengthening midwifery education

scholarly journals Cost of Utilising Maternal Health Services in Low- and Middle-Income Countries: A Systematic Review

2020 ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Francis Ifeanyi Ayomoh ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Oluwasola Banke-Thomas ◽  
Ejemai Amaize Eboreime ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Cost Drivers ◽  
Middle Income Countries ◽  
Low And Middle Income

Background: Cost is a major barrier to maternal health service utilisation for many women in low- and middle-income countries (LMICs). However, comparable evidence of the available cost data in these countries is limited. We conducted a systematic review and comparative analysis of costs of utilising maternal health services in these settings. Methods: We searched peer-reviewed and grey literature databases for articles reporting cost of utilising maternal health services in LMICs published post-2000. All retrieved records were screened and articles meeting the inclusion criteria selected. Quality assessment was performed using the relevant cost-specific criteria of the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklist. To guarantee comparability, disaggregated costs data were inflated to 2019 US dollar equivalents. Total adjusted costs and cost drivers associated with utilising each service were systematically compared. Where heterogeneity in methods or non-disaggregated costs was observed, narrative synthesis was used to summarise findings. Results: Thirty-six studies met our inclusion criteria. Many of the studies costed multiple services. However, the most frequently costed services were utilisation of normal vaginal delivery (22 studies), caesarean delivery (13), and antenatal care (ANC) (10). The least costed services were post-natal care (PNC) and post-abortion care (PAC) (5 each). Studies used varied methods for data collection and analysis and their quality ranged from low to high with most assessed as average or high. Generally, across all included studies, cost of utilisation progressively increased from ANC and PNC to delivery and PAC, and from public to private providers. Medicines and diagnostics were main cost drivers for ANC and PNC while cost drivers were variable for delivery. Women experienced financial burden of utilising maternal health services and also had to pay some unofficial costs to access care, even where formal exemptions existed. Conclusion: Consensus regarding approach for costing maternal health services will help to improve their relevance for supporting policy-making towards achieving universal health coverage. If indeed the post-2015 mission of the global community is to "leave no one behind," then we need to ensure that women and their families are not facing unnecessary and unaffordable costs that could potentially tip them into poverty.

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