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Reproductive Health
Published in: Reproductive Health 2/2014

Open Access 01-09-2014 | Review

Evidence from district level inputs to improve quality of care for maternal and newborn health: interventions and findings

Authors: Rehana A Salam, Zohra S Lassi, Jai K Das, Zulfiqar A Bhutta

Published in: Reproductive Health | Special Issue 2/2014

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Abstract

District level healthcare serves as a nexus between community and district level facilities. Inputs at the district level can be broadly divided into governance and accountability mechanisms; leadership and supervision; financial platforms; and information systems. This paper aims to evaluate the effectivness of district level inputs for imporving maternal and newborn health. We considered all available systematic reviews published before May 2013 on the pre-defined district level interventions and included 47 systematic reviews.
Evidence suggests that supervision positively influenced provider’s practice, knowledge and client/provider satisfaction. Involving local opinion leaders to promote evidence-based practice improved compliance to the desired practice. Audit and feedback mechanisms and tele-medicine were found to be associated with improved immunization rates and mammogram uptake. User-directed financial schemes including maternal vouchers, user fee exemption and community based health insurance showed significant impact on maternal health service utilization with voucher schemes showing the most significant positive impact across all range of outcomes including antenatal care, skilled birth attendant, institutional delivery, complicated delivery and postnatal care. We found insufficient evidence to support or refute the use of electronic health record systems and telemedicine technology to improve maternal and newborn health specific outcomes.
There is dearth of evidence on the effectiveness of district level inputs to improve maternal newborn health outcomes. Future studies should evaluate the impact of supervision and monitoring; electronic health record and tele-communication interventions in low-middle-income countries.
Appendix
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Metadata
Title
Evidence from district level inputs to improve quality of care for maternal and newborn health: interventions and findings
Authors
Rehana A Salam
Zohra S Lassi
Jai K Das
Zulfiqar A Bhutta
Publication date
01-09-2014
Publisher
BioMed Central
Published in
Reproductive Health / Issue Special Issue 2/2014
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/1742-4755-11-S2-S3

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