Implementation outcomes of policy and programme innovations to prevent obstetric haemorrhage in low- and middle-income countries: a systematic review
| العنوان: | Implementation outcomes of policy and programme innovations to prevent obstetric haemorrhage in low- and middle-income countries: a systematic review |
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| المؤلفون: | Anya Snyder, Godwin O Akaba, Chioma Ogechi Egekeze, Dena Goffman, Dorice Vieira, Evan M. Bloch, Emmanuel Peprah, Magdalena Lyimo, Nessa Ryan, Brenda S. D'Mello, Obiageli E Nnodu |
| المصدر: | Health Policy and Planning. 35:1208-1227 |
| بيانات النشر: | Oxford University Press (OUP), 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Quality management, media_common.quotation_subject, Psychological intervention, Developing country, Stakeholder engagement, 03 medical and health sciences, 0302 clinical medicine, Nursing, Pregnancy, Intervention (counseling), Preventive Health Services, Humans, Medicine, 030212 general & internal medicine, Developing Countries, Poverty, media_common, 030219 obstetrics & reproductive medicine, business.industry, Health Policy, Postpartum Hemorrhage, Service (economics), Scale (social sciences), Africa, Female, Implementation research, business |
| الوصف: | Globally, obstetric haemorrhage (OH) remains the leading cause of maternal mortality. Much of the associated mortality is ascribed to challenges surrounding deployment of innovations rather than lack of availability. In low- and middle-income countries (LMICs), where the burden is highest, there is a growing interest in implementation research as a means to bridge the ‘know–do’ gap between proven interventions and their reliable implementation at scale. In this systematic review, we identified and synthesized qualitative and quantitative data across the implementation outcomes of OH prevention innovations in LMICs using a taxonomy developed by Proctor et al. We also identified service outcomes for the included innovations, as well as implementation strategies and implementation facilitators and barriers. Eligible studies were empirical, focused on the implementation of OH prevention programmes or policies and occurred in an LMIC. Eight databases were searched. Two authors independently assessed studies for selection and extracted data; the first author resolved discrepancies. Narrative synthesis was used to analyse and interpret the findings. Studies were predominantly focused in Africa and on primary prevention. Interventions included prophylactic use of uterotonics (n = 7), clinical provider skills training (n = 4) and provision of clinical guidelines (n = 1); some (n = 3) were also part of a multi-component quality improvement bundle. Various barriers were reported, including challenges among intervention beneficiaries, providers and within the health system; however, studies reported the development and testing of practical implementation solutions. These included training and monitoring of implementers, community and stakeholder engagement and guidance by external mentors. Some studies linked successful delivery to implementation outcomes, most commonly adoption and acceptability, but also feasibility, penetration and sustainability. Findings suggest that innovations to prevent OH can be acceptable, appropriate and feasible in LMIC settings; however, more research is needed to better evaluate these and other under-reported implementation outcomes. |
| تدمد: | 1460-2237 0268-1080 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c9fffd7b9fcda8ef58f41ea04a985f21Test https://doi.org/10.1093/heapol/czaa074Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....c9fffd7b9fcda8ef58f41ea04a985f21 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14602237 02681080 |
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