Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis.
Group antenatal care models in low- and middle-income countries: a systematic evidence synthesis.
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DOI：
10.1186/s12978-018-0476-9
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发表时间：
2018-03-05
影响因子：
3.4
通讯作者：
Rima Jolivet R
中科院分区：
文献类型：
--
作者：
Sharma J;O'Connor M;Rima Jolivet R
在高收入国家，团体产前护理 (ANC) 提供了个人护理的替代方案，并且与提高孕妇和新生儿的出勤率、客户满意度和健康结果相关。在低收入和中等收入国家 (LMIC) 环境中，可以采用该模式来解决产前护理利用率低的问题并提高质量。然而，关于资源匮乏地区团体护理模式关键属性的证据仍然很少。我们对已发表的关于中低收入国家团体产前护理模式的文献进行了系统回顾，以确定可能提高此类环境中团体 ANC 的相关性、可接受性和有效性的属性。我们系统地检索了五个数据库并进行了手工检索和参考文献检索。我们还对在中低收入国家引入团体产前护理模式的研究人员和项目实施者进行了重要知情人访谈。使用预定义的证据摘要模板，我们提取了中低收入国家中引入的团体护理模型的关键属性的证据，例如会议内容和频率以及团体组成和组织。我们的系统文献综述确定了团体产前护理模式的九种独特描述。我们用 10 名重要知情人访谈的证据补充了这一信息。我们综合了这 19 个数据源的证据，以确定孕妇团体护理模式的属性，这些属性在所有数据源中都一致出现。我们考虑了这些对于提供团体产前护理至关重要的组成部分。我们还确定了需要根据实施环境进行定制的属性，以满足综合 ANC 的当地标准，例如会话数量和会话内容。我们汇编了这些属性，以编纂出一个团体产前护理的复合“通用”模型，以便在中低收入国家环境中适应和实施。通过将标准和灵活的组成部分相结合，团体产前护理是一种已在高收入国家成功引入和实施的服务提供替代方案，可用于改善中低收入国家孕妇的护理服务和体验。然而，关于该模式对中低收入国家妇女、婴儿和卫生系统的好处的任何结论都必须基于对这些环境中团体产前保健计划的强有力评估。本文的在线版本 (10.1186/s12978-018-0476-9) 包含补充材料，可供授权用户使用。
In high-income countries, group antenatal care (ANC) offers an alternative to individual care and is associated with improved attendance, client satisfaction, and health outcomes for pregnant women and newborns. In low- and middle-income country (LMIC) settings, this model could be adapted to address low antenatal care uptake and improve quality. However, evidence on key attributes of a group care model for low-resource settings remains scant. We conducted a systematic review of the published literature on models of group antenatal care in LMICs to identify attributes that may increase the relevance, acceptability and effectiveness of group ANC in such settings. We systematically searched five databases and conducted hand and reference searches. We also conducted key informant interviews with researchers and program implementers who have introduced group antenatal care models in LMICs. Using a pre-defined evidence summary template, we extracted evidence on key attributes—like session content and frequency, and group composition and organization—of group care models introduced across LMIC settings. Our systematic literature review identified nine unique descriptions of group antenatal care models. We supplemented this information with evidence from 10 key informant interviews. We synthesized evidence from these 19 data sources to identify attributes of group care models for pregnant women that appeared consistently across all of them. We considered these components that are fundamental to the delivery of group antenatal care. We also identified attributes that need to be tailored to the context in which they are implemented to meet local standards for comprehensive ANC, for example, the number of sessions and the session content. We compiled these attributes to codify a composite “generic” model of group antenatal care for adaptation and implementation in LMIC settings. With this combination of standard and flexible components, group antenatal care, a service delivery alternative that has been successfully introduced and implemented in high-income country settings, can be adapted for improving provision and experiences of care for pregnant women in LMIC. Any conclusions about the benefits of this model for women, babies, and health systems in LMICs, however, must be based on robust evaluations of group antenatal care programs in those settings. The online version of this article (10.1186/s12978-018-0476-9) contains supplementary material, which is available to authorized users.
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影响因子：
2.7
作者：
Baldwin, Karen A.
通讯作者：
Baldwin, Karen A.
影响因子：
1.4
作者：
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影响因子：
3.7
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影响因子：
168.9
作者：
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通讯作者：
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影响因子：
8.1
作者：
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通讯作者：
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