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Antenatal corticosteroids for management of preterm birth: a multi-country analysis of health system bottlenecks and potential solutions

Overview of attention for article published in BMC Pregnancy and Childbirth, September 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • Good Attention Score compared to outputs of the same age (76th percentile)

Mentioned by

policy
1 policy source
twitter
3 tweeters
facebook
1 Facebook page

Citations

dimensions_citation
26 Dimensions

Readers on

mendeley
181 Mendeley
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Title
Antenatal corticosteroids for management of preterm birth: a multi-country analysis of health system bottlenecks and potential solutions
Published in
BMC Pregnancy and Childbirth, September 2015
DOI 10.1186/1471-2393-15-s2-s3
Pubmed ID
Authors

Grace Liu, Joel Segrè, A Metin Gülmezoglu, Matthews Mathai, Jeffrey M Smith, Jorge Hermida, Aline Simen-Kapeu, Pierre Barker, Mercy Jere, Edward Moses, Sarah G Moxon, Kim E Dickson, Joy E Lawn, Fernando Althabe

Abstract

Preterm birth complications are the leading cause of deaths for children under five years. Antenatal corticosteroids (ACS) are effective at reducing mortality and serious morbidity amongst infants born at <34 weeks gestation. WHO guidelines strongly recommend use of ACS for women at risk of imminent preterm birth where gestational age, imminent preterm birth, and risk of maternal infection can be assessed, and appropriate maternal/newborn care provided. However, coverage remains low in high-burden countries for reasons not previously systematically investigated. The bottleneck analysis tool was applied in 12 countries in Africa and Asia as part of the Every Newborn Action Plan process. Country workshops involved technical experts to complete the survey tool, which is designed to synthesise and grade health system "bottlenecks", factors that hinder the scale up, of maternal-newborn intervention packages. We used quantitative and qualitative methods to analyse the bottleneck data, combined with literature review, to present priority bottlenecks and actions relevant to different health system building blocks for ACS. Eleven out of twelve countries provided data in response to the ACS questionnaire. Health system building blocks most frequently reported as having significant or very major bottlenecks were health information systems (11 countries), essential medical products and technologies (9 out of 11 countries) and health service delivery (9 out of 11 countries). Bottlenecks included absence of coverage data, poor gestational age metrics, lack of national essential medicines listing, discrepancies between prescribing authority and provider cadres managing care, delays due to referral, and lack of supervision, mentoring and quality improvement systems. Analysis centred on health system building blocks in which 9 or more countries (>75%) reported very major or significant bottlenecks. Health information systems should include improved gestational age assessment and track ACS coverage, use and outcomes. Better health service delivery requires clarified policy assigning roles by level of care and cadre of provider, dependent on capability to assess gestational age and risk of preterm birth, and the implementation of guidelines with adequate supervision, mentoring and quality improvement systems, including audit and feedback. National essential medicines lists should include dexamethasone for antenatal use, and dexamethasone should be integrated into supply logistics.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 181 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Portugal 1 <1%
Nigeria 1 <1%
Switzerland 1 <1%
Unknown 178 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 31 17%
Student > Master 30 17%
Student > Ph. D. Student 17 9%
Student > Bachelor 13 7%
Student > Postgraduate 11 6%
Other 30 17%
Unknown 49 27%
Readers by discipline Count As %
Medicine and Dentistry 63 35%
Nursing and Health Professions 16 9%
Social Sciences 15 8%
Agricultural and Biological Sciences 4 2%
Psychology 4 2%
Other 22 12%
Unknown 57 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 6. 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 01 January 2016.
All research outputs
#3,421,866
of 14,572,831 outputs
Outputs from BMC Pregnancy and Childbirth
#926
of 2,709 outputs
Outputs of similar age
#56,712
of 245,858 outputs
Outputs of similar age from BMC Pregnancy and Childbirth
#1
of 1 outputs
Altmetric has tracked 14,572,831 research outputs across all sources so far. Compared to these this one has done well and is in the 76th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,709 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.1. This one has gotten more attention than average, scoring higher than 65% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 245,858 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 76% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them