Title:
Sustaining Maternal Health Quality Improvement Interventions at the community level in Sub Saharan Africa A literature review
Authors:
Nagalakshmi Venkatraman
Publisher:
KIT (Royal Tropical Institute) Vrije Universiteit Amsterdam
Year:
August 2024
Language:
En
Subject:
mHealth in Low-Resource Settings
Keywords:
Maternal health, Sustainability, Quality Improvement Interventions (QII), SSA, Community.
Abstract:
Background: According to the World Health Organization (WHO), the Maternal Mortality Rate (MMR) in sub-Saharan Africa (SSA) was 536 deaths per 100,000 live births in 2020, highlighting poor maternal outcomes. The Sustainable Development Goals (SDGs) aim to reduce the global MMR to less than 70 per 100,000 live births by 2030 (SDG 3: Good Health and Well-being, target 3.1). Improving maternal care requires evaluating and then sustaining quality care provided by skilled healthcare workers at the community level. Quality Improvement interventions have shown positive impact, however sustaining these interventions remains a challenge for many local healthcare systems. Objective: This study aims to identify determinants impacting the sustainability of maternal health quality improvement (QI) interventions at the community level in SSA and to understand stakeholder perspectives and roles in sustaining these interventions. Methodology: This research is a literature review of eight selected articles, evaluated using the RE-AIM implementation science framework. Findings: Factors were analysed at three stakeholder levels: governmental agencies/representatives, community/district health workers, and community representatives and beneficiaries. Facilitators included institutionalizing interventions as national policy, and effective training and involvement of Community Health Workers (CHWs). Community leader involvement and engagement were crucial for intervention success, local ownership and subsequent sustainability. A bottom-up decision-making process, integrating community knowledge and preferences, significantly contributed to success. Barriers included insufficient funding, inadequate facilities and resources, negative CHW attitudes, staffing issues, and dilution of intervention plans after scaling up. Conclusion and Recommendations: Factors affecting the sustainability of maternal health QI interventions were identified at three stakeholder levels. Recommendations were provided to ensure program sustainability in SSA.
Institute:
KIT (Royal Tropical Institute)
Country:
Amsterdam, The Netherlands
Training:
Master of Science in International Health
Category:
Master of Science in International Health
Right:
@2024,Nagalakshmi Venkatraman
Document type:
Thesis/dissertation
File:
3YXWC1Xtid_20241104133302152.pdf