Cargando…

Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap

Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income co...

Descripción completa

Detalles Bibliográficos
Autores principales: Roder-DeWan, Sanam, Nimako, Kojo, Twum-Danso, Nana A Y, Amatya, Archana, Langer, Ana, Kruk, Margaret
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559116/
https://www.ncbi.nlm.nih.gov/pubmed/33055093
http://dx.doi.org/10.1136/bmjgh-2020-002539
_version_ 1783594787680550912
author Roder-DeWan, Sanam
Nimako, Kojo
Twum-Danso, Nana A Y
Amatya, Archana
Langer, Ana
Kruk, Margaret
author_facet Roder-DeWan, Sanam
Nimako, Kojo
Twum-Danso, Nana A Y
Amatya, Archana
Langer, Ana
Kruk, Margaret
author_sort Roder-DeWan, Sanam
collection PubMed
description Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income countries where, unlike in high-income countries, a substantial proportion of births occur in primary care facilities that cannot offer definitive care for complications. We argue that the current inequity in care for childbirth is a global double standard that limits progress on maternal and newborn survival. We propose that health systems need to be redesigned to shift all deliveries to hospitals or other advanced care facilities to bring care in line with global best practice. Health system redesign will require investing in high-quality hospitals with excellent midwifery and obstetric care, boosting quality of primary care clinics for antenatal, postnatal, and newborn care, decreasing access and financial barriers, and mobilizing populations to demand high-quality care. Redesign is a structural reform that is contingent on political leadership that envisions a health system designed to deliver high-quality, respectful care to all women giving birth. Getting redesign right will require focused investments, local design and adaptation, and robust evaluation.
format Online
Article
Text
id pubmed-7559116
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-75591162020-10-19 Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap Roder-DeWan, Sanam Nimako, Kojo Twum-Danso, Nana A Y Amatya, Archana Langer, Ana Kruk, Margaret BMJ Glob Health Analysis Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income countries where, unlike in high-income countries, a substantial proportion of births occur in primary care facilities that cannot offer definitive care for complications. We argue that the current inequity in care for childbirth is a global double standard that limits progress on maternal and newborn survival. We propose that health systems need to be redesigned to shift all deliveries to hospitals or other advanced care facilities to bring care in line with global best practice. Health system redesign will require investing in high-quality hospitals with excellent midwifery and obstetric care, boosting quality of primary care clinics for antenatal, postnatal, and newborn care, decreasing access and financial barriers, and mobilizing populations to demand high-quality care. Redesign is a structural reform that is contingent on political leadership that envisions a health system designed to deliver high-quality, respectful care to all women giving birth. Getting redesign right will require focused investments, local design and adaptation, and robust evaluation. BMJ Publishing Group 2020-10-14 /pmc/articles/PMC7559116/ /pubmed/33055093 http://dx.doi.org/10.1136/bmjgh-2020-002539 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Analysis
Roder-DeWan, Sanam
Nimako, Kojo
Twum-Danso, Nana A Y
Amatya, Archana
Langer, Ana
Kruk, Margaret
Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
title Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
title_full Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
title_fullStr Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
title_full_unstemmed Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
title_short Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
title_sort health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559116/
https://www.ncbi.nlm.nih.gov/pubmed/33055093
http://dx.doi.org/10.1136/bmjgh-2020-002539
work_keys_str_mv AT roderdewansanam healthsystemredesignformaternalandnewbornsurvivalrethinkingcaremodelstoclosetheglobalequitygap
AT nimakokojo healthsystemredesignformaternalandnewbornsurvivalrethinkingcaremodelstoclosetheglobalequitygap
AT twumdansonanaay healthsystemredesignformaternalandnewbornsurvivalrethinkingcaremodelstoclosetheglobalequitygap
AT amatyaarchana healthsystemredesignformaternalandnewbornsurvivalrethinkingcaremodelstoclosetheglobalequitygap
AT langerana healthsystemredesignformaternalandnewbornsurvivalrethinkingcaremodelstoclosetheglobalequitygap
AT krukmargaret healthsystemredesignformaternalandnewbornsurvivalrethinkingcaremodelstoclosetheglobalequitygap