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Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review

Vieira, Claudia, Portela, Anayda, Miller, Tina, Coast, Ernestina, Leone, Tiziana and Marston, Cicley (2012) Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review. PLOS One, 7 (10). pp. 1-9. ISSN 1932-6203

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Abstract

Background: Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks: what has been done and what has worked? Methods and Findings: We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. Conclusions: The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these complexities. Few high quality studies that measure effectiveness of interventions exist.

Item Type: Article
Official URL: http://www.plosone.org/home.action;jsessionid=4CEF...
Additional Information: © 2012 Public Library of Science
Library of Congress subject classification: H Social Sciences > H Social Sciences (General)
Journal of Economic Literature Classification System: I - Health, Education, and Welfare > I1 - Health > I12 - Health Production: Nutrition, Mortality, Morbidity, Suicide, Substance Abuse and Addiction, Disability, and Economic Behavior
I - Health, Education, and Welfare > I3 - Welfare and Poverty > I30 - General
Sets: Departments > Social Policy
Research centres and groups > LSE Health and Social Care
Rights: http://www.lse.ac.uk/library/usingTheLibrary/academicSupport/OA/depositYourResearch.aspx
Identification Number: e47946
Funders: DFID, WHO
Date Deposited: 29 Oct 2012 15:11
URL: http://eprints.lse.ac.uk/46068/

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