Quality of Care in Maternal and Child Health. BMC Reproductive Health. 2014 (Series)
Abstract / Summary:
Summary: 'This series of papers focuses on a quality of care framework for maternal health, and systematically reviews the evidence of interventions aimed at improving care at the community-, district- and factility-levels. While the systematic reviews highlight the effectiveness of specific quality improvement efforts on maternal and newborn health, it also illlustrates the dearth of evidence on community-, district- and facility-level interventions, particulary for issues specific to quality of maternal health care and maternal newborn health outcomes. Further evidence is now needed to evaluate the best possible combination of the strategies. Governments, stakeholders and donors need to work together to form these policies and develop models of health care to suit the needs of their own population.'
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Overview of the findings:
'At the community-level, home visitation, community mobilization, women's support groups and the training of community health workers (CHW) and traditional birth attendants (TBA) have shown significant and positive impacts on MNH outcomes...'
'At the district-level, user directed financial incentives have shown to improve quality of care indicators, with conditional cash transfers and maternal voucher schemes having the most significant positive impacts across a range of MNH outcomes...'
'At the facility-level, evidence suggests that standardized or individualized social support programs and continuity of specialized midwifery care throughout pregnancy, labor and postnatal period have the potential to improve a range of perinatal, maternal, and labor specific indicators. To maintain performance and motivation among the healthcare workers, stress management trainings, multidisciplinary meetings and feedback sessions can reduce work related stress and improve performance. There was limited and inconclusive evidence for the impacts of physical environment, exit interviews and organizational culture modification on any MNH process or outcome measures.'
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