Measurement approaches in continuum of care for maternal health: a critical interpretive synthesis of evidence from LMICs and its implications for the South African context

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dc.contributor.authorMothupi, Mamothena Carol
dc.contributor.authorKnight, Lucia
dc.contributor.authorTabana, Hanani
dc.date.accessioned2019-10-15T07:16:35Z
dc.date.available2019-10-15T07:16:35Z
dc.date.issued2018
dc.description.abstractBackground: Global strategies recommend a continuum of care for maternal health to improve outcomes and access to care in low and middle income countries (LMICs). South Africa has already set priority interventions along the continuum of care for maternal health, and mandated their implementation at the district health level. However, the approach for monitoring access to this continuum of care has not yet been defined. This review assessed measurement approaches in continuum of care for maternal health among LMICs and their implications for the South African context. Methods: We conducted a critical interpretive synthesis of quantitative and qualitative research sourced from Academic Search Complete (EBSCO), MEDLINE (Pubmed), Cambridge Journals Online, Credo Reference and Science Direct. We selected 20 out of 118 articles into the analysis, following a rigorous quality appraisal and relevance assessment. The outcomes of the synthesis were new constructs for the measurement of continuum of care for maternal health, derived from the existing knowledge gaps. Results: We learned that coverage was the main approach for measuring and monitoring the continuum of care for maternal health in LMICs. The measure of effective coverage was also used to integrate quality into coverage of care. Like coverage, there was no uniform definition of effective coverage, and we observed gaps in the measurement of multiple dimensions of quality. From the evidence, we derived a new construct called adequacy that incorporated timeliness of care, coverage, and the complex nature of quality. We described the implications of adequacy to the measurement of the continuum of care for maternal health in South Africa. Conclusions: Critical interpretive synthesis allowed new understandings of measurement of the continuum of care for maternal health in South Africa. The new construct of adequacy can be the basis of a new measure of access to the continuum of care for maternal health. Although adequacy conceptualizes a more holistic approach, more research is needed to derive its indicators and metrics using South African data sources.en_US
dc.identifier.citationMothupi, M., Knight, L., & Tabana, H. (2018). Measurement approaches in continuum of care for maternal health: a critical interpretive synthesis of evidence from LMICs and its implications for the South African context. BMC Health Services Research, 18(1). doi: 10.1186/s12913-018-3278-4en_US
dc.identifier.issn1472-6963
dc.identifier.urihttps://doi.org/10.1186/s12913-018-3278-4
dc.identifier.urihttp://hdl.handle.net/10566/5040
dc.language.isoenen_US
dc.publisherSpringer Natureen_US
dc.subjectContinuum of careen_US
dc.subjectMaternal healthen_US
dc.subjectCritical interpretive synthesisen_US
dc.subjectMaternal health servicesen_US
dc.subjectLow and middle income countriesen_US
dc.titleMeasurement approaches in continuum of care for maternal health: a critical interpretive synthesis of evidence from LMICs and its implications for the South African contexten_US
dc.typeArticleen_US

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