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Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

Elmusharaf K, Byrne E, O'Donovan D - BMC Public Health (2015)

Bottom Line: The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems.We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services.These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

View Article: PubMed Central - PubMed

Affiliation: Reproductive & Child Health Research Unit (RCRU), University of Medical Sciences & Technology, Khartoum, Sudan. Khalifa_elmusharaf@yahoo.com.

ABSTRACT

Background: Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective.

Discussion: Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

No MeSH data available.


Conceptual framework for strategies to overcome demand-side barriers to maternal healthcare access and their challenges
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Fig1: Conceptual framework for strategies to overcome demand-side barriers to maternal healthcare access and their challenges

Mentions: The aim of this review article is to identify the existing common strategies that have been implemented to overcome demand-side barriers to maternal healthcare access, as well as debating their limitations and challenges. The finding of this review will help to inform the global conversations around universal health coverage and universal health access and to help develop appropriate and sustainable strategies at community level to enhance demand for maternal care. Based on the articles reviewed we can group the main demand-side approaches to improving maternal health service access into: (i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement (Fig. 1). The main challenges in assessing the effectiveness or efficacy of these interventions or strategies is the lack of quality evidence on their outcome and impact [21–23], as well as the lack of a system-wide interventions or interventions not integrated into existing systems for likely sustainability [24]. However, what is also noted, though not highlighted as much as the above, is the lack of knowledge about the context in which these strategies are to be implementedFig. 1


Strategies to increase demand for maternal health services in resource-limited settings: challenges to be addressed.

Elmusharaf K, Byrne E, O'Donovan D - BMC Public Health (2015)

Conceptual framework for strategies to overcome demand-side barriers to maternal healthcare access and their challenges
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4562346&req=5

Fig1: Conceptual framework for strategies to overcome demand-side barriers to maternal healthcare access and their challenges
Mentions: The aim of this review article is to identify the existing common strategies that have been implemented to overcome demand-side barriers to maternal healthcare access, as well as debating their limitations and challenges. The finding of this review will help to inform the global conversations around universal health coverage and universal health access and to help develop appropriate and sustainable strategies at community level to enhance demand for maternal care. Based on the articles reviewed we can group the main demand-side approaches to improving maternal health service access into: (i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement (Fig. 1). The main challenges in assessing the effectiveness or efficacy of these interventions or strategies is the lack of quality evidence on their outcome and impact [21–23], as well as the lack of a system-wide interventions or interventions not integrated into existing systems for likely sustainability [24]. However, what is also noted, though not highlighted as much as the above, is the lack of knowledge about the context in which these strategies are to be implementedFig. 1

Bottom Line: The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems.We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services.These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

View Article: PubMed Central - PubMed

Affiliation: Reproductive & Child Health Research Unit (RCRU), University of Medical Sciences & Technology, Khartoum, Sudan. Khalifa_elmusharaf@yahoo.com.

ABSTRACT

Background: Universal health access will not be achieved unless women are cared for in their own communities and are empowered to take decisions about their own health in a supportive environment. This will only be achieved by community-based demand side interventions for maternal health access. In this review article, we highlight three common strategies to increase demand-side barriers to maternal healthcare access and identify the main challenges that still need to be addressed for these strategies to be effective.

Discussion: Common demand side strategies can be grouped into three categories:(i) Financial incentives/subsidies; (ii) Enhancing patient transfer, and; (iii) Community involvement. The main challenges in assessing the effectiveness or efficacy of these interventions or strategies are the lack of quality evidence on their outcome and impact and interventions not integrated into existing health or community systems. However, what is highlighted in this review and overlooked in most of the published literature on this topic is the lack of knowledge about the context in which these strategies are to be implemented. We suggest three challenges that need to be addressed to create a supportive environment in which these demand-side strategies can effectively improve access to maternal health services. These include: addressing decision-making norms, engaging in intergenerational dialogue, and designing contextually appropriate communication strategies.

No MeSH data available.