Postpartum care content and delivery throughout the African continent: An integrative review

Gresh, Ashley; Cohen, Michael L.; Anderson, Jean; Glass, Nancy

doi:10.1016/j.midw.2021.102976

Cited by 8 publications

(17 citation statements)

References 44 publications

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“…The tendency to focus on individual clinical interventions (and corresponding measures) for the woman or the newborn might be related to the fragmented organization of PNC in the health system [102,103]. In almost all countries, PNC is still strictly divided into women and newborn services, often from different health providers, with services sometimes further subdivided into different specialties such as nutrition, family planning and neonatal screening [102,104,105].…”

Section: Discussionmentioning

confidence: 99%

Measures to assess quality of postnatal care: A scoping review

Galle

Moran²,

Bonet³

et al. 2023

PLOS Glob Public Health

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High quality postnatal care is key for the health and wellbeing of women after childbirth and their newborns. In 2022, the World Health Organization (WHO) published global recommendations on maternal and newborn care for a positive postnatal care experience in a new WHO PNC guideline. Evidence regarding appropriate measures to monitor implementation of postnatal care (PNC) according to the WHO PNC guideline is lacking. This scoping review aims to document the measures used to assess the quality of postnatal care and their validity. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Five electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened and appraised identified articles. All data on PNC measures were extracted and mapped to the 2022 WHO PNC recommendations according to three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. We identified 62 studies providing measures aligning with the WHO PNC recommendations. For most PNC recommendations there were measures available and the highest number of recommendations were found for breastfeeding and the assessment of the newborn. No measures were found for recommendations related to sedentary behavior, criteria to be assessed before discharge, retention of staff in rural areas and use of digital communication. Measure validity assessment was described in 24 studies (39%), but methods were not standardized. Our review highlights a gap in existing PNC measures for several recommendations in the WHO PNC guideline. Assessment of the validity of PNC measures was limited. Consensus on how the quality of PNC should be measured is needed, involving a selection of priority measures and the development of new measures as appropriate.

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Section: Discussionmentioning

confidence: 99%

Measures to assess quality of postnatal care: A scoping review

Galle

Moran²,

Bonet³

et al. 2023

PLOS Glob Public Health

View full text Add to dashboard Cite

show abstract

“…Only a minority of resources provided measures for a broader understanding of quality of care including both provision and experience of care(34). The tendency to focus on individual interventions (and corresponding measures) for the woman or the newborn might be related to the fragmented organization of PNC in the health system(98,99). In almost all countries, PNC is still strictly divided into women and newborn services, often from different health providers, with services sometimes further subdivided into different specialties such as nutrition, family planning and neonatal screening (98,100,101).…”

Section: Discussionmentioning

confidence: 99%

Measures to assess quality of postnatal care: a scoping review

Galle

Moran

Bonet

et al. 2022

Preprint

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High quality postnatal care is key for the health and wellbeing of women after childbirth and their newborns. In 2022, the World Health Organization (WHO) published global recommendations on maternal and newborn care for a positive postnatal care experience. Evidence regarding appropriate measures to monitor implementation of postnatal care (PNC) according to the WHO recommendations is lacking. This scoping review aims to document the measures used to assess the quality of postnatal care and their validity. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Five electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened and appraised identified articles. All data on PNC measures were extracted and mapped to the postnatal care guideline according to three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. We identified 62 resources providing measures aligning with the WHO PNC recommendations. For most PNC recommendations there were measures available and the highest number of recommendations were found for breastfeeding and the assessment of the newborn. No measures were found for recommendations related to sedentary behavior, criteria to be assessed before discharge, retention of staff in rural areas and use of digital communication. Measure validity assessment was described in 24 articles (39%), but methods were not standardized. Our study highlights a gap in existing PNC measures for several recommendations in the WHO PNC guideline. Assessment of the validity of measurement of PNC indicators was limited. Consensus on how the quality of PNC should be measured is needed, involving a selection of priority measures and the development of new measures as appropriate.

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“…Step 1: De ne the problem and assemble a team To de ne the problem, we completed an integrative review (50) to describe and evaluate current postpartum care content and service-delivery models used throughout the African continent. Guided by the WHO's Maternal Morbidity Working Group's conceptual framework for healthcare interventions to address maternal morbidity, we also identi ed multiple gaps in care.…”

Section: Methodsmentioning

confidence: 99%

“…Guided by the WHO's Maternal Morbidity Working Group's conceptual framework for healthcare interventions to address maternal morbidity, we also identi ed multiple gaps in care. We showed that NCDs, intimate partner violence (IPV) screening, mental health, and a rights-based approach to care are rarely included (50). Group care and integrated maternal and child health services models were identi ed as ways to improve maternal and child health outcomes (50).…”

Section: Methodsmentioning

confidence: 99%

“…Free listing, successfully used in public health research (56), is a method for rapidly gathering information on a topic by listing as many ideas as possible related postpartum and well-child care. This approach allows for examining intracultural variations of postpartum and well-child care and provides opportunities to build consensus about healthcare services priorities (50).…”

Section: Physicalmentioning

confidence: 99%

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Adapting group-based postpartum and well-child care using a human-centered design approach in Malawi

Gresh

Batchelder

Glass

et al. 2023

Preprint

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Background. Responsive and resilient strategies to reduce the high rates of maternal and infant mortality and clinician shortages are needed in low- and middle-income countries (LMICs). Malawi has some of highest maternal and infant mortality rates globally. Group-based healthcare is one such strategy to improve maternal and child health outcomes. Group-based care has been applied to the perinatal period, but less attention has been paid its potential benefits in postpartum care. The postpartum period is a period of opportunity for innovative approaches to engage mothers and children in care and contribute to the reduction of maternal and infant mortality and morbidity. We present the adaption of an evidence-based group-based perinatal care model to the postpartum period using human centered design with key stakeholders in Malawi. Methods. To adapt the perinatal group-based care model for the Malawian context, the team completed four steps of a five-step framework guiding the use of human centered design: 1) define the problem and assemble a team; 2) gather information through evidence and inspiration; 3) synthesize; and 4) intervention design: guiding principles and ideation. Steps 2-4 relied on qualitative methods, in-depth interviews, and incubator sessions with key stakeholders to produce a prototype of the group-based postpartum care model. Results Once the stakeholders had defined the problem of limited postpartum care in the context and assembled local and global team members, we completed 20 interviews and 6 incubator sessions with stakeholders. All stakeholders reported a desire to participate in and offer group care in the postpartum period in their community. Health promotion priorities identified were hygiene (e.g., perineal care), breastfeeding, family planning, nutrition, and mental health. The recommended group-based care implementation schedule includes 6 sessions that corresponds with the child vaccination schedule over the 12-month postpartum period. A prototype for the curriculum and implementation structure for group postpartum and well-child care was created based on the findings. Conclusions A human centered design approach to adapt an evidence-based group-based care approach to an LMIC, Malawi is feasible and acceptable to key stakeholders and resulted in a prototype curriculum with practical strategies for implementation in the health care setting.

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Postpartum care content and delivery throughout the African continent: An integrative review

Cited by 8 publications

References 44 publications

Measures to assess quality of postnatal care: A scoping review

Measures to assess quality of postnatal care: A scoping review

Measures to assess quality of postnatal care: a scoping review

Adapting group-based postpartum and well-child care using a human-centered design approach in Malawi

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