Applying a Client-centered Approach to Maternal and Neonatal Networks of Care: Case Studies from Urban and Rural Nigeria

Fasawe, Olufunke; Adekeye, Olajumoke; Carmone, Andy E; Dahunsi, Omolara; Kalaris, Katherine; Storey, Andrew; Ubani, Osy; Wiwa, Owens

doi:10.1080/23288604.2020.1841450

Cited by 11 publications

(18 citation statements)

References 15 publications

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“…NOCs focus on the following relational aspects—the defining, differentiating aspects of this approach—to strengthen linkages, connections, and collaboration to optimize the functioning of an existing health system. 9 , 11 , 17 Empowered, multidisciplinary, and respectful teamwork based on trust and relationships within and between facilities and levels of care Network leadership and stewardship Innovative modalities to facilitate communication and collaboration (e.g., WhatsApp groups, telemedicine) among providers, providers and patients, and facilities in the network Supportive supervision and mentoring among facilities in the network Collaborative learning, sharing, and problem solving Monitoring and accountability for achieving network goals …”

Section: Definition Of An Noc For Maternal and Newborn Healthmentioning

confidence: 99%

“…and collaboration to optimize the functioning of an existing health system. 9,11,17 Empowered, multidisciplinary, and respectful teamwork based on trust and relationships within and between facilities and levels of care Network leadership and stewardship Innovative modalities to facilitate communication and collaboration (e.g., WhatsApp groups, telemedicine) among providers, providers and patients, and facilities in the network Supportive supervision and mentoring among facilities in the network Collaborative learning, sharing, and problem solving Monitoring and accountability for achieving network goals An NOC is not just a referral system but can also strengthen and support an existing referral system through a focus on improving the relational elements, described above, across facility interactions. NOCs do not operate as parallel systems but instead can enhance and improve discrete components of the existing health system to function in a more integrated manner.…”

Section: Definition Of An Noc For Maternal and Newborn Healthmentioning

confidence: 99%

“…10 This can be done, for example, by mentoring clinicians within the network. 11,12 Although substantial progress has been made in improving maternal and newborn outcomes, achieving the SDGs will require additional transformational and catalytic approaches to accelerate the reduction of maternal and newborn mortality and prevent stillbirths. The Networks of Care (NOCs) approach has the potential to harmonize existing strategies and optimize health systems functions for maternal and newborn health, thereby strengthening quality of care and ultimately improving outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Networks of Care: An Approach to Improving Maternal and Newborn Health

Kalaris

Radovich

Carmone

et al. 2022

Glob Health Sci Pract

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Section: Definition Of An Noc For Maternal and Newborn Healthmentioning

confidence: 99%

Section: Definition Of An Noc For Maternal and Newborn Healthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Networks of Care: An Approach to Improving Maternal and Newborn Health

Kalaris

Radovich

Carmone

et al. 2022

Glob Health Sci Pract

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“…The types of resources required depend on the network. Networks formed from the bottom-up are often started without financial resources [15,49], though may require resources to grow. Effective communication is needed to share the network vision and principles to stakeholders [6] and is required for the sharing and learning that is key to sustaining them [15,41].…”

Section: Plos Global Public Healthmentioning

confidence: 99%

Understanding networks in low-and middle-income countries’ health systems: A scoping review

Kalaris

Wong²,

English³

2023

PLOS Glob Public Health

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Networks are an often-employed approach to improve problems of poor service delivery and quality of care in sub-optimally functioning health systems. There are many types of health system networks reported in the literature and despite differences, there are identifiable common characteristics, uses, purposes, and stakeholders. This scoping review systematically searched the literature on networks in health systems to map the different types of networks to develop an understanding of what they are, when and what they are used for, and the purposes they intend to achieve. Peer-reviewed literature was systematically searched from six databases (Medline (Ovid), EMBASE (Ovid), Global Health (Ovid), the Cochrane Library, Web of Science Core Collection, Global Index Medicus’s Africa Index Medicus) and grey literature was purposively searched. Data from the selected literature on network definitions, characteristics, stakeholders, uses, and purposes were charted. Drawing on existing frameworks and refining with the selected literature, a five-component framework (form and structure, governance and leadership, mode of functioning, resources, and communication), broadly characterizing a network, is proposed. The framework and mapping of uses, purposes, and stakeholders is a first step towards further understanding what networks are, when and what they are used for, and the purposes they intend to achieve in health systems.

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“…In the case of Nigeria, the success of the program was largely due to the implementation of a package of community-and facility-based interventions that had individually been shown to be effective in research settings [13,14]. This program used a 'Networks of Care' approach [15] to create and reinforce parallel and horizontal linkages across all levels of the health system, including implementing community-based activities through local stakeholders and referral networks, and supporting facility-based activities such as training and mentoring, ensuring essential commodity and equipment availability, and enhancing health information management. After CHAI successfully transitioned out of the program, these results were sustained under the leadership of State and Federal Governments with key components subsequently adopted in other parts of Nigeria and this work was recognized with the 'The Horizon Prize for the Birth Day' for demonstrating a novel, safe and scalable solution for reducing maternal and perinatal mortality [16].…”

Section: Interventionmentioning

confidence: 99%

Reducing maternal and neonatal mortality through integrated and sustainability-focused programming in Zambia

Kamanga

Ngosa

Aladesanmi

et al. 2022

PLOS Glob Public Health

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Reducing maternal and neonatal mortality is a critical health priority within Zambia and globally. Although evidence-based clinical interventions can prevent a majority of these deaths, scalable and sustainable delivery of interventions across low-resource settings remains uneven, particularly across rural and marginalized communities. The Zambian Ministry of Health and the Clinton Health Access Initiative implemented an integrated sexual, reproductive, maternal, and newborn health (SRMNH) program in Northern Province aimed at dramatically reducing mortality over four years. Interventions were implemented between 2018 and 2021 across 141 government-owned health facilities covering all 12 districts of Northern Province, the poorest performing province nationwide and home to over 1.4 million people, around six pillars of an integrated health system. Data on institutional delivery and antenatal and postnatal care were collected through the national Health Management Information System (HMIS). A community-based system for capturing birth outcomes was established using existing government tools and community volunteers since HMIS did not include community-based mortality. Baseline and endline population-based mortality rates were compared for program-supported areas. From the earliest period of population-based mortality reporting in 2019 to program end in 2021, there were statistically significant decreases of 41%, 45%, and 43% in maternal, neonatal, and perinatal mortality rates respectively. Between 2017 to 2021, institutional maternal, neonatal, and perinatal mortality rates across entirety of Northern Province reduced by 12%, 40%, and 41%, respectively. Service readiness and coverage for SRMNH services improved dramatically, supporting increased numbers of patients. Significant mortality reductions were achieved over a relatively short period, reinforced through an emphasis on sustainability and strengthening existing government systems. These results were attained through a consciously cost-efficient approach backed by substantially lower levels of external investment relative to prior programs, allowing many of the interventions to be successfully adopted by government within public sector budgets.

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Applying a Client-centered Approach to Maternal and Neonatal Networks of Care: Case Studies from Urban and Rural Nigeria

Cited by 11 publications

References 15 publications

Networks of Care: An Approach to Improving Maternal and Newborn Health

Networks of Care: An Approach to Improving Maternal and Newborn Health

Understanding networks in low-and middle-income countries’ health systems: A scoping review

Reducing maternal and neonatal mortality through integrated and sustainability-focused programming in Zambia

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