Top

Systematic Reviews

Published in:

Open Access 01-12-2018 | Protocol

Emergency transportation interventions for reducing adverse pregnancy outcomes in low- and middle-income countries: a systematic review protocol

Authors: John Ehiri, Halimatou Alaofè, Ibitola Asaolu, Joy Chebet, Ekpereonne Esu, Martin Meremikwu

Published in: Systematic Reviews | Issue 1/2018

Abstract

Background

Transportation interventions seek to decrease delay in reaching a health facility for emergency obstetric care and are, thus, believed to contribute to reductions in such adverse pregnancy and childbirth outcomes as maternal deaths, stillbirths, and neonatal mortality in low- and middle-income countries (LMICs). However, there is limited empirical evidence to support this hypothesis. The objective of the proposed review is to summarize and critically appraise evidence regarding the effect of emergency transportation interventions on outcomes of labor and delivery in LMICs.

Methods

The following databases will be searched from inception to March 31, 2018: MEDLINE/PubMed, EMBASE, Web of Science, EBSCO (PsycINFO and CINAHL), the Cochrane Pregnancy and Child Birth Group’s Specialized Register, and the Cochrane Central Register of Controlled Trials. We will search for studies in the grey literature through Google and Google Scholar. We will solicit unpublished reports from such relevant agencies as United Nations Fund for Population Activities (UNFPA), the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United States Agency for International Development (USAID), and the United Kingdom Department for International Development (DfID) among others. Data generated from the search will be managed using Endnote Version 7. We will perform quantitative data synthesis if studies are homogenous in characteristics and provide adequate outcome data for meta-analysis. Otherwise, data will be synthesized, using the narrative synthesis approach.

Discussion

Among the many barriers that women in LMICs face in accessing life-saving interventions during labor and delivery, lack of access to emergency transportation is particularly important. This review will provide a critical summary of evidence regarding the impact of transportation interventions on outcomes of pregnancy and childbirth in LMICs.

Systematic review registration

PROSPERO CRD42017080092

Available only for authorised users

WHO. Trends in maternal mortality: 1990 to 2015: estimates by WHO, UNICEF, UNFPA, World Bank, and the United Nations Population Division. Geneva: WHO; 2015.

WHO. Strategies toward ending preventable maternal mortality (EPMM). Geneva: WHO; 2015.

United Nations Inter-agency Group for Child Mortality Estimation (UN IGME). Levels & trends in child mortality: report 2017, estimates developed by the UN Inter-agency Group for Child Mortality Estimation. New York: United Nations Children’s Fund; 2017.

Liu L, Hill K, Oza S, Hogan D, Chu Y, et al. Levels and causes of mortality under age five years. In: Black R, Laxminarayan R, Temmerman M, Walker N, editors. Disease control priorities (third edition): volume 2, reproductive, maternal, newborn, and child health. Washington, DC: World Bank; 2016.

Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every newborn: progress, priorities, and potential beyond survival. Lancet. 2014;384:189–205.CrossRefPubMed

Lawn JE, Blencowe H, Waiswa P, Amouzou A, Mathers C, Hogan D, et al. Stillbirths: rate, risk factors, and acceleration towards 2030. Lancet. 2016;387:587–603.CrossRefPubMed

Lawn JE, Blencowe H, Pattinson R, Cousens S, Kumar R, Ibiebele I, et al. Stillbirths: Where? When? Why? How to make the data count? Lancet. 2011;377:1448–63.CrossRefPubMed

The Partnership for Maternal Newborn and Child Health (PMNCH). A global review of the key interventions related to reproductive, maternal, newborn and child health (RMNCH). Geneva: PMNCH; 2011.

Bhutta AZ, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384:347–70.CrossRefPubMed

10.

Souza JP, Gulmezoglu AM, Vogel J, Carroli G, Lumbiganon P, Qureshi Z, et al. Moving beyond essential interventions for reduction of maternal mortality (the WHO Multicountry Survey on Maternal and Newborn Health): a cross-sectional study. Lancet. 2013;381:1747–55.CrossRefPubMed

11.

United Nations. Millennium Development Goals report. 2015. http://www.un.org/millenniumgoals/2015_MDG_Report/pdf/MDG%202015%20rev%20(July%201).pdf. Accessed 13 Mar 2018.

12.

Black RE, Cousens S, Johnson HL, Lawn JE, Rudan I, Bassani DG, et al. Global, regional, and national causes of child mortality in 2008: a systematic analysis. Lancet. 2010;1969(87):375.

13.

Kerber KJ, de Graft-Johnson JE, Bhutta ZA, Okong P, Starrs A, Lawn JE. Continuum of care for maternal, newborn, and child health: from slogan to service delivery. Lancet. 2007;370:1358–69.CrossRefPubMed

14.

Pacagnella RC, Cecatti JG, Osis MJ, Souza JP. The role of delays in severe maternal morbidity and mortality: expanding the conceptual framework. Reprod Health Matters. 2012;20(39):155–63. doi: https://doi.org/10.1016/S0968-8080(12)39601-8.

15.

Bhopal SS, Halpin SJ, Gerein N. Emergency obstetric referral in rural Sierra Leone: what can motorbike ambulances contribute? A mixed-methods study. Matern Child Health J. 2013;17:1038–43.CrossRefPubMed

16.

World Health Organization. Riders for health. Tropical disease research (TDR) Programme. 2016. http://www.who.int/tdr/news/2016/riders-for-health/en/. Accessed 16 Mar 2018.

17.

Transaid. Linking rural communities with health services: assessing the effectiveness of the ambulance services in meeting the needs of rural communities in West Africa. 2013. http://research4cap.org/Library/Transaid-Nigeria-2013-Rural+Ambulance+Service-AFCAPgen060c-v130627.pdf. Accessed 16 Mar 2018.

18.

Silva AL, Poggioli S. Emergency transport experiences from sub-Saharan Africa: public involvement in transport innovations to improve access to healthcare. J Transport Health. 2015;2:S47. https://www.gov.uk/dfid-research-outputs/linking-rural-communities-with-health-services-assessing-the-effectiveness-of-the-ambulance-services-in-meeting-the-needs-of-rural-communities-in-west-africa-final-report.

19.

Campbell OM, Graham WJ, Lancet Maternal Survival Series steering group. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;7(368):1284–99.CrossRef

20.

Holmes W, Kennedy E. Reaching emergency obstetric care: overcoming the second delay. Reaching emergency obstetric care: overcoming the second delay. Melbourne: Burnet Institute; 2010. http://www.wchknowledgehub.com.au/sites/default/files/Policy%20Brief%20-%20MCH%20Second%20Delay.pdf. Accessed 16 Mar 2018

21.

Banda R, Fylkesnes K, Sandøy IF. Rural-urban differentials in pregnancy-related mortality in Zambia: estimates using data collected in a census. Popul Health Metr. 2015;13:32.CrossRefPubMedPubMedCentral

22.

Chauhan BG, Kumar A. Rural-urban differential in utilization of maternal healthcare services in India: a decomposition analysis. Soc Sci Spectr. 2016;21:49–62.

23.

Thaddeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38:1091–110.CrossRefPubMed

24.

Barnes-Josiah D, Myntti C, Augustin A. The three delays as a framework for examining maternal mortality in Haiti. Soc Sci Med. 1998;46:981–93.CrossRefPubMed

25.

Lawn JE, McCarthy BJ, Ross SR. The healthy newborn: a reference guide for program managers. Atlanta: CDC and CARE; 2001.

26.

Mbaruku G, van RJ KI, Bilango F, Bergström S. Perinatal audit using the 3-delays model in western Tanzania. Int J Gynecol Obstet. 2009;106:85–8.CrossRef

27.

Gabrysch S, Campbell OM. Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 2009;9:34. https://doi.org/10.1186/1471-2393-9-34.

28.

Lee AC, Lawn JE, Cousens S, Kumar V, Osrin D, Bhutta ZA, Wall SN, Nandakumar AK, Syed U, Darmstadt GL. Linking families and facilities for care at birth: what works to avert intrapartum-related deaths? Int J Gynaecol Obstet. 2009;107(Suppl 1):S65–85. S86-8CrossRefPubMedPubMedCentral

29.

PATH. Reducing birth asphyxia through the Bidan di Desa program in Cirebon, Indonesia: final report submitted by Program for Appropriate Technology in Health (PATH) to Save the Children US. Jakarta: PATH; 2006.

30.

Ganle JK, Fitzpatrick R, Otupiri E, Parker M. Addressing health system barriers to access to and use of skilled delivery services: perspectives from Ghana. Int J Health Plann Manag. 2016;31:e235–53.CrossRef

31.

Wilunda C, Oyerinde K, Putoto G, Lochoro P, Dall’Oglio G, Manenti F, et al. Availability, utilization and quality of maternal and neonatal health care services in Karamoja region, Uganda: a health facility-based survey. Reprod Health. 2015;12:30.CrossRefPubMedPubMedCentral

32.

Doctor HV, Findley SE, Afenyadu GY. Estimating maternal mortality level in rural northern Nigeria by the sisterhood method. Int J Popul Res. 2012;2012:Article ID 464657. 5 pages

33.

Essien E, Ifenne D, Sabitu K, Musa A, Alti-Mu’azu M, Adidu V. Community loan funds and transport services for obstertric emergencies in Northern Nigeria. Int J Gynaecol Obstet. 1997a;59:237–44.CrossRef

34.

Yi No Chen, Michelle M Schmitz, Florina Serbanescu, Michelle M Dynes, Godson Maro, Michael R Kramer. Geographic Access Modeling of Emergency Obstetric and Neonatal Care in Kigoma Region, Tanzania: Transportation Schemes and Programmatic Implications. Glob Health Sci Pract. 5(3):2017;430-445.

35.

Chiwuzie J, Okojie O, Okolocha C, Omorogbe S, Oronsaye A, Akpala W, et al. Emergency loan funds to improve access to obstetric care in Ekpoma, Nigeria. The Benin PMM Team. Int J Gynaecol Obstet. 1997;59:S231–6.CrossRefPubMed

36.

Olaniran N, Offiong S, Ottong J, Asuquo E, Duke F. Mobilizing the community to utilize obstetric services, Cross River State, Nigeria. The Calabar PMM Team. Int J Gynaecol Obstet. 1997;59:S181–9.CrossRefPubMed

37.

Schmid T, Kanenda O, Ahluwalia I, Kouletio M. Transportation for maternal emergencies in Tanzania: empowering communities through participatory problem solving. Am J Public Health. 2001;91:1589–90.CrossRefPubMedPubMedCentral

38.

Options. Improving access to safe deliveries using transport vouchers. 2016. http://www.options.co.uk/news/improving-access-safe-deliveries-using-transport-vouchers. Accessed 16 Mar 2018.

39.

Ir P, Horemans D, Souk N, Van Damme W. Using targeted vouchers and health equity funds to improve access to skilled birth attendants for poor women: a case study in three rural health districts in Cambodia. BMC Pregnancy Child Birth. 2010;10:1.CrossRef

40.

Van de Poel E, Flores G, Ir P, O'Donnell O, Van Doorslaer E. Can vouchers deliver? An evaluation of subsidies for maternal health care in Cambodia. Bull World Health Organ. 2014;92:331–9.CrossRefPubMedPubMedCentral

41.

Schmidt JO, Ensor T, Hossain A, Khan S. Vouchers as demand side financing instruments for health care: a review of the Bangladesh maternal voucher scheme. Health Policy. 2010;96:98–107.CrossRefPubMed

42.

uddin Mian N, Malik MZ, Iqbal S, Alvi MA, Memon Z, Chaudhry MA, Majrooh A, Awan SH. Determining the potential scalability of transport interventions for improving maternal, child, and newborn health in Pakistan. Health Res Policy Syst. 2015;13(Suppl 1):57.CrossRefPubMed

43.

Nwolise CH, Hussein J, Kanguru L, Bell J, Patel P. The effectiveness of community-based loan funds for transport during obstetric emergencies in developing countries: a systematic review. Health Policy Plan. 2015;30:946–55.CrossRefPubMed

44.

Schünemann H, Brożek J, Guyatt G, Oxman A. Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach. Available http://gdt.guidelinedevelopment.org/app/handbook/handbook.html.

45.

Higgins JPT, Altman DG, Sterne JAC (editors). Chapter 8: assessing risk of bias in included studies. In: Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.handbook.cochrane.org. Accessed: 13 Mar 2018.

46.

Schünemann H, Brożek J, Guyatt G, Oxman A. Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach. Cochrane Collaboration; 2013. Available http://gdt.guidelinedevelopment.org/app/handbook/handbook.html. Accessed 16 Mar 2018

47.

Cochrane Collaboration. Data collection forms for intervention reviews. London: Cochrane Collaboration; 2014. Available at: http://training.cochrane.org/resource/data-collection-forms-intervention-reviews.

48.

Popay J, Roberts H, Sowden A, Petticrew M, Arai L, Rodgers M, Britten N, Roen K, Duffy S. Guidance on the conduct of narrative synthesis in systematic reviews. 2006; http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.178.3100&rep=rep1&type=pdf.

49.

Kruk ME, Leslie HH, Verguet S, Mbaruku GM, Adanu RM, Langer A. Quality of basic maternal care functions in health facilities of five African countries: an analysis of national health system surveys. Lancet Glob Health. 2016;4:e845–55.CrossRefPubMed

Title: Emergency transportation interventions for reducing adverse pregnancy outcomes in low- and middle-income countries: a systematic review protocol
Authors: John Ehiri
Halimatou Alaofè
Ibitola Asaolu
Joy Chebet
Ekpereonne Esu
Martin Meremikwu
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: Systematic Reviews / Issue 1/2018
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-018-0729-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Emergency transportation interventions for reducing adverse pregnancy outcomes in low- and middle-income countries: a systematic review protocol

Abstract

Background

Methods

Discussion

Systematic review registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Discussion

Systematic review registration

Please log in to get access to this content

Other articles of this Issue 1/2018

The effectiveness of interventions to reduce peripheral blood culture contamination in acute care: a systematic review protocol

Stakeholder involvement in systematic reviews: a scoping review

Effects of hypercapnia in sepsis: protocol for a systematic review of clinical and preclinical data

Addition of platinum derivatives to neoadjuvant single-agent fluoropyrimidine chemoradiotherapy in patients with stage II/III rectal cancer: protocol for a systematic review and meta-analysis (PROSPERO CRD42017073064)

Evaluating the effect of delayed activation of rapid response teams on patient outcomes: a systematic review protocol

Evaluating the current state of Mendelian randomization studies: a protocol for a systematic review on methodological and clinical aspects using neurodegenerative disorders as outcome