| Title |
Maternal and neonatal service usage and determinants in fragile and conflict-affected situations: a systematic review of Asia and the Middle-East
|
|---|---|
| Published in |
BMC Women's Health, March 2017
|
| DOI | 10.1186/s12905-017-0379-x |
| Pubmed ID | |
| Authors |
Saji S. Gopalan, Ashis Das, Natasha Howard |
| Abstract |
Fragile and conflict-affected situations (FCS) in Asia and the Middle-East contribute significantly to global maternal and neonatal deaths. This systematic review explored maternal and neonatal health (MNH) services usage and determinants in FCS in Asia and the Middle-East to inform policy on health service provision in these challenging settings. This systematic review was conducted using a standardised protocol. Pubmed, Embase, Web of Science, and selected development agency websites were searched for studies meeting inclusion criteria. Studies were assessed for methodological quality using an adapted evaluation tool. Qualitative and quantitative data were synthesized and pooled odds ratios generated for meta-analysis of service-usage determinants. Of 18 eligible peer-reviewed studies, eight were from Nepal, four from Afghanistan, and two each from Iraq, Yemen, and the Palestinian Territories. Fragile situations provide limited evidence on emergency obstetric care, postnatal care, and newborn services. Usage of MNH services was low in all FCS, irrespective of economic growth level. Demand-side determinants of service-usage were transportation, female education, autonomy, health awareness, and ability-to-pay. Supply-side determinants included service availability and quality, existence of community health-workers, costs, and informal payments in health facilities. Evidence is particularly sparse on MNH in acute crises, and remains limited in fragile situations generally. Findings emphasize that poor MNH status in FCS is a leading contributor to the burden of maternal and neonatal ill-health in Asia and the Middle-East. Essential services for skilled birth attendance and emergency obstetric, newborn, and postnatal care require improvement in FCS. FCS require additional resources and policy attention to address the barriers to appropriate MNH care. Authors discuss the 'targeted policy approach for vulnerable groups' as a means of addressing MNH service usage inequities. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Singapore | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Scientists | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 219 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 219 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 42 | 19% |
| Researcher | 26 | 12% |
| Student > Ph. D. Student | 20 | 9% |
| Student > Bachelor | 18 | 8% |
| Student > Doctoral Student | 11 | 5% |
| Other | 32 | 15% |
| Unknown | 70 | 32% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 53 | 24% |
| Nursing and Health Professions | 30 | 14% |
| Social Sciences | 19 | 9% |
| Economics, Econometrics and Finance | 7 | 3% |
| Psychology | 6 | 3% |
| Other | 25 | 11% |
| Unknown | 79 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 March 2017.
All research outputs
#15,450,375
of 22,959,818 outputs
Outputs from BMC Women's Health
#1,279
of 1,840 outputs
Outputs of similar age
#194,541
of 308,059 outputs
Outputs of similar age from BMC Women's Health
#15
of 20 outputs
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