Facilitators and barriers to the implementation of maternal and perinatal death surveillance and response in Ethiopia: a systematic review
Notice bibliographique
Résumé
Ethiopia was one of the pioneer countries to implement the World Health Organization’s Maternal and Perinatal Death Surveillance and Response (MPDSR) system to accelerate the reduction in maternal and perinatal mortality. However, there has been no systematic evaluation of its implementation in Ethiopia and that’s why we conducted this systematic review. A systematic review was conducted to synthesize the evidence on coverage, facilitators or barriers to MPDSR implementation in Ethiopia. We searched PubMed, Embase, Web of Science, PubMed Central, and Google Scholar using relevant key terms. In addition, Ethiopian Public Health Institute websites searched for additional data. Articles published before 2013 excluded from this review. The methodological quality of the studies assessed using the Joanna Briggs Institute’s quality appraisal tool. For quantitative studies, descriptive analysis conducted; thematic synthesis used for qualitative studies. From twenty studies included, 12 only reported maternal death reviews while eight included maternal and perinatal death reviews. During the reporting period, the coverage of maternal and perinatal deaths remained less than 22.1% and 12.1% of the expected deaths respectively. Reported facilitators were community involvement, sufficient capacity building, and supportive supervision. Reported barriers were lack of conducive learning environment, fear of blame and litigation, lack of financial resources, high staff turnover, and defensive attitudes and practices. Despite all efforts, the uptake of MPDSR has been low. Addressing identified barriers and utilizing identified facilitators essential for optimising MPDSR implementation in Ethiopia. PROSPERO Registration Number: CRD42022315199. Ethiopia was one of the pioneer countries to adopt the World Health Organization’s Maternal and Perinatal Death Surveillance and Response (MPDSR) system to accelerate the reduction in maternal and perinatal mortality. Although several studies on MPDSR implementation and/or barriers and facilitators to MPDSR in Ethiopia have been conducted, there is no comprehensive assessment of data to inform decision-making on the future of MPDSR. This review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. The review protocol was registered in PROSPERO (CRD42022315199). The PubMed (Medline), Embase (OVID), Web of Science (Core Collection), CINAHL, Cochrane Library (incl. CENTRAL), Google Scholar, PubMed Central, Academic Search Premier, Preprint Citation Index and Ethiopian Public Health Institute websites were used for searching. All identified articles exported to Covidence, and duplicates removed. Two reviewers (MY and CS) independently screened and reviewed the studies and reports against the inclusion criteria, and independently extracted information using predetermined inclusion criteria. The descriptive analysis conducted for quantitative studies while thematic synthesis done for qualitative studies and presented the main (sub-) themes in text and quotes. Over the reporting period, the coverage of maternal and perinatal deaths remained less than a quarter approximately of the expected deaths. Reported facilitators were community involvement, sufficient capacity building, and supportive supervision. Reported barriers were lack of conducive learning environment, fear of blame and litigation, lack of financial resources, high staff turnover, and defensive attitudes and practices. Therefore, addressing the identified barriers and utilizing identified facilitators paramount to optimise the MPDSR implementation in Ethiopia.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,025 | 0,081 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,002 |
| Méta-épidémiologie (sens large) | 0,007 | 0,007 |
| Bibliométrie | 0,010 | 0,010 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,002 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».