Maternal and newborn health implementation research: programme outcomes, pathways of change and partnerships for equitable health systems in Uganda

George, Asha; Tetui, Moses; Pariyo, George; Peterson, Stefan

doi:10.1080/16549716.2017.1359924

Cited by 2 publications

(2 citation statements)

References 41 publications

(50 reference statements)

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“…Combined approaches have shown some positive results. George et al document an initiative in Uganda that utilised mentoring with a combination of external specialist teams and local mentors that resulted in more productivity, increased problem identification and solving, improved management of patients and health worker skills 46. They, however, noted challenges with documentation practices and use of self-assessment tools.…”

Section: Supportive Supervision Structures and Processes In Licsmentioning

confidence: 99%

Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?

Avortri

Nabukalu²,

Nabyonga‐Orem

2019

BMJ Glob Health

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Supportive supervision is perceived as an intervention that strengthens the health system, enables health workers to offer quality services and improve performance. Unfortunately, numerous studies show that supervisory mechanisms in many low-income countries (LICs) are suboptimal. Further, the understanding of the concept and its implementation is still shrouded in misinterpretations and inconsistencies. This analysis contributes to a deeper understanding of the concept of supportive supervision and how reorganisation of the approach can contribute to improved performance. The effectiveness of supportive supervision is mixed, with some studies noting that evidence on its role, especially in LICs is inconclusive. Quality of care is a core component of universal health coverage which, accentuates the need for supportive supervision. In the context of LICs, it is imperative for supportive supervision to be implemented as an on-going approach. Factors that affect supportive supervision encompass cultural, social, organizational and context dimensions but the capacity of majority of LIC to address these is limited. To this end, we underscore the need to review the supportive supervision approach to improve its effectiveness, and ensure that facility-based supervision embodies as many of the envisioned qualities as possible. We thus make a case for a stronger focus on internal supportive supervision where internal refers to health facility/unit/ward level. Inherent in the approach is what we refer to as ‘supervisee initiated supportive supervision’. The success of this approach must be anchored on a strong system for monitoring, data and information management at the health facility level.

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Section: Supportive Supervision Structures and Processes In Licsmentioning

confidence: 99%

Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?

Avortri

Nabukalu²,

Nabyonga‐Orem

2019

BMJ Glob Health

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“…The majority of studies [ 42 ] had multifaceted interventions involving more than one approach to improving access to care ( Table 2 ). Of the 63 articles, we identified 28 that had at least one intervention in the category of community engagement, 27 with an intervention in the education/training category, 18 in financial category, 39 in the transportation category, and 16 in the facility infrastructure category.…”

Section: Resultsmentioning

confidence: 99%

Access to care solutions in healthcare for obstetric care in Africa: A systematic review

et al. 2021

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Background Emergency Medical Services (EMS) systems exist to reduce death and disability from life-threatening medical emergencies. Less than 9% of the African population is serviced by an emergency medical services transportation system, and nearly two-thirds of African countries do not have any known EMS system in place. One of the leading reasons for EMS utilization in Africa is for obstetric emergencies. The purpose of this systematic review is to provide a qualitative description and summation of previously described interventions to improve access to care for patients with maternal obstetric emergencies in Africa with the intent of identifying interventions that can innovatively be translated to a broader emergency context. Methods The protocol was registered in the PROSPERO database (International Prospective Register of Systematic Reviews) under the number CRD42018105371. We searched the following electronic databases for all abstracts up to 10/19/2020 in accordance to PRISMA guidelines: PubMed/MEDLINE, Embase, CINAHL, Scopus and African Index Medicus. Articles were included if they were focused on a specific mode of transportation or an access-to-care solution for hospital or outpatient clinic care in Africa for maternal or traumatic emergency conditions. Exclusion criteria included in-hospital solutions intended to address a lack of access. Reference and citation analyses were performed, and a data quality assessment was conducted. Data analysis was performed using a qualitative metasynthesis approach. Findings A total of 6,457 references were imported for screening and 1,757 duplicates were removed. Of the 4,700 studies that were screened against title and abstract, 4,485 studies were excluded. Finally, 215 studies were assessed for full-text eligibility and 152 studies were excluded. A final count of 63 studies were included in the systematic review. In the 63 studies that were included, there was representation from 20 countries in Africa. The three most common interventions included specific transportation solutions (n = 39), community engagement (n = 28) and education or training initiatives (n = 27). Over half of the studies included more than one category of intervention. Interpretation Emergency care systems across Africa are understudied and interventions to improve access to care for obstetric emergencies provides important insight into existing solutions for other types of emergency conditions. Physical access to means of transportation, efforts to increase layperson knowledge and recognition of emergent conditions, and community engagement hold the most promise for future efforts at improving emergency access to care.

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Maternal and newborn health implementation research: programme outcomes, pathways of change and partnerships for equitable health systems in Uganda

Cited by 2 publications

References 41 publications

Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?

Supportive supervision to improve service delivery in low-income countries: is there a conceptual problem or a strategy problem?

Access to care solutions in healthcare for obstetric care in Africa: A systematic review

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