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      Improving maternal, newborn and women's reproductive health in crisis settings

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          This is the protocol for a review and there is no abstract. The objectives are as follows:

          To identify, synthesise and evaluate the effects of health system and other interventions aimed at improving maternal, newborn and women's reproductive health in crisis settings.

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          Most cited references47

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          Too far to walk: maternal mortality in context.

          S Thaddeus, D Maine (1994)
          The Prevention of Maternal Mortality Program is a collaborative effort of Columbia University's Center for Population and Family Health and multidisciplinary teams of researchers from Ghana, Nigeria and Sierra Leone. Program goals include dissemination of information to those concerned with preventing maternal deaths. This review, which presents findings from a broad body of research, is part of that activity. While there are numerous factors that contribute to maternal mortality, we focus on those that affect the interval between the onset of obstetric complication and its outcome. If prompt, adequate treatment is provided, the outcome will usually be satisfactory; therefore, the outcome is most adversely affected by delayed treatment. We examine research on the factors that: (1) delay the decision to seek care; (2) delay arrival at a health facility; and (3) delay the provision of adequate care. The literature clearly indicates that while distance and cost are major obstacles in the decision to seek care, the relationships are not simple. There is evidence that people often consider the quality of care more important than cost. These three factors--distance, cost and quality--alone do not give a full understanding of decision-making process. Their salience as obstacles is ultimately defined by illness-related factors, such as severity. Differential use of health services is also shaped by such variables as gender and socioeconomic status. Patients who make a timely decision to seek care can still experience delay, because the accessibility of health services is an acute problem in the developing world. In rural areas, a woman with an obstetric emergency may find the closest facility equipped only for basic treatments and education, and she may have no way to reach a regional center where resources exist. Finally, arriving at the facility may not lead to the immediate commencement of treatment. Shortages of qualified staff, essential drugs and supplies, coupled with administrative delays and clinical mismanagement, become documentable contributors to maternal deaths. Findings from the literature review are discussed in light of their implications for programs. Options for health programs are offered and examples of efforts to reduce maternal deaths are presented, with an emphasis on strategies to mobilize and adapt existing resources.
          Article 0 comments Cited 422 times – based on 0 reviews     Review now
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            Interrupted time series designs in health technology assessment: lessons from two systematic reviews of behavior change strategies.

            Craig R Ramsay, Lloyd Matowe, Roberto Grilli … (2003)
            In an interrupted time series (ITS) design, data are collected at multiple instances over time before and after an intervention to detect whether the intervention has an effect significantly greater than the underlying secular trend. We critically reviewed the methodological quality of ITS designs using studies included in two systematic reviews (a review of mass media interventions and a review of guideline dissemination and implementation strategies). Quality criteria were developed, and data were abstracted from each study. If the primary study analyzed the ITS design inappropriately, we reanalyzed the results by using time series regression. Twenty mass media studies and thirty-eight guideline studies were included. A total of 66% of ITS studies did not rule out the threat that another event could have occurred at the point of intervention. Thirty-three studies were reanalyzed, of which eight had significant preintervention trends. All of the studies were considered "effective" in the original report, but approximately half of the reanalyzed studies showed no statistically significant differences. We demonstrated that ITS designs are often analyzed inappropriately, underpowered, and poorly reported in implementation research. We have illustrated a framework for appraising ITS designs, and more widespread adoption of this framework would strengthen reviews that use ITS designs.
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              Maternal complications and perinatal mortality: findings of the World Health Organization Multicountry Survey on Maternal and Newborn Health.

              J. P. Vogel, J. Souza, R Mori … (2014)
              We aimed to determine the prevalence and risks of late fetal deaths (LFDs) and early neonatal deaths (ENDs) in women with medical and obstetric complications.
              Article 0 comments Cited 114 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cochrane Database Syst Rev
                Journal ID (iso-abbrev): Cochrane Database Syst Rev
                Journal ID (publisher-id): cd
                Title: The Cochrane Database of Systematic Reviews
                Publisher: John Wiley & Sons, Ltd (Chichester, UK )
                ISSN (Electronic): 1469-493X
                Publication date (Electronic): 08 August 2015
                Issue: 8
                Pages: 1-26
                Affiliations
                [1 ]Department of Conditions of Violence and Peace (CVP), Peace Research Institute Oslo (PRIO) Oslo, Norway
                [2 ]Institute of Health and Society, University of Oslo Oslo, Norway
                [3 ]Cameroon Bioethics Initiative Yaounde, Cameroon
                [4 ]Department of Obstetrics & Gynaecology, Ebonyi State University Abakaliki, Nigeria
                [5 ]Division of Programme Support and Management, United Nations High Commissioner for Refugees Geneva, Switzerland
                [6 ]School of Nursing and Midwifery, National University of Ireland Galway Galway, Ireland
                Author notes

                Contact address: Primus Che Chi, Department of Conditions of Violence and Peace (CVP), Peace Research Institute Oslo (PRIO), Hausmanns gate 7, Oslo, NO-0186, Norway. chiprimus@ 123456gmail.com .

                Editorial group: Cochrane Effective Practice and Organisation of Care Group.

                Publication status and date: New, published in Issue 8, 2015.

                Article
                DOI: 10.1002/14651858.CD011829
                PMC ID: 4561524
                SO-VID: 9ab627b1-9807-49f3-ab8c-0d9329110c3d
                Copyright © Copyright © 2015 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
                History
                Categories
                Subject: Intervention Protocol

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