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

BMC Public Health

Debate

Diarmuid O’Donovan¹  Khalifa Elmusharaf²  Elaine Byrne³ 

[1] National University of Ireland, Galway, Ireland;Reproductive & Child Health Research Unit (RCRU), University of Medical Sciences & Technology, Khartoum, Sudan;Royal College of Surgeons in Ireland, Manama, Bahrain;National University of Ireland, Galway, Ireland;Royal College of Surgeons in Ireland, Dublin, Ireland;

关键词: Antenatal Care;    Maternal Health;    Maternal Death;    Institutional Delivery;    Maternal Health Service;   

DOI  :  10.1186/s12889-015-2222-3

 received in 2015-03-23, accepted in 2015-09-04,  发布年份 2015

来源: Springer

【 摘 要 】

BackgroundUniversal 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.DiscussionCommon 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.SummaryWe 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.

【 授权许可】

CC BY   
© Elmusharaf et al. 2015