Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review
Abstract Background There is no consistent operationalization of effective coverage (EC) across studies. Therefore, this scoping review synthesized evidence on the definitions and measurement approaches, outcomes reported, and the factors that are associated with variations in quality-adjusted EC es...
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2024-12-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-024-12085-7 |
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| author | Ayelign Mengesha Kassie Elizabeth Eakin Aklilu Endalamaw Anteneh Zewdie Eskinder Wolka Yibeltal Assefa |
| author_facet | Ayelign Mengesha Kassie Elizabeth Eakin Aklilu Endalamaw Anteneh Zewdie Eskinder Wolka Yibeltal Assefa |
| author_sort | Ayelign Mengesha Kassie |
| collection | DOAJ |
| description | Abstract Background There is no consistent operationalization of effective coverage (EC) across studies. Therefore, this scoping review synthesized evidence on the definitions and measurement approaches, outcomes reported, and the factors that are associated with variations in quality-adjusted EC estimates of maternal and neonatal healthcare services in low- and middle-income countries. Methods Article search was conducted using PubMed, Embase, Google Scholar, and other databases. Then, title, abstract, and full text screenings for inclusion were performed by two authors independently and disagreements were resolved through discussion. In case of duplication, the full-text published articles were retained, and the results are presented using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist as a guide. Results Overall, 36 articles were included in this scoping review. In most articles, EC has been defined from the perspectives of people in need utilizing healthcare services in well-equipped health facilities and from actual receipt of quality services. In addition, usage, instead of need, has been used as a domain in estimating EC in some instances. Effective coverage ranged from 0% for different services including for post-partum care, to 84% for antenatal care. Moreover, different socio-demographic factors including wealth index, education, and residence are found to have an association with variations in EC of maternal and neonatal healthcare services with the wealthiest, most educated, and those living in urban areas having higher estimates. From the supply side, numerous factors, particularly health facility capacity-related constraints, have been reported to be associated with low EC of those services. Conclusions The variability in the definition and measurement approaches of EC across studies emphasizes the need for standardization for better comparison in future research. We recommend that quality-adjusted EC be defined in two ways: intervention-specific service delivery EC and general service delivery EC. In addition, disparities in EC are observed among women with different socioeconomic status including educational level and wealth index. Organizational capacity constraints and other health system and societal factors also contributed to variations in EC. |
| format | Article |
| id | doaj-art-14d0cc00be7748cd9df322e77a5fe05a |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-14d0cc00be7748cd9df322e77a5fe05a2024-12-22T12:23:21ZengBMCBMC Health Services Research1472-69632024-12-0124111110.1186/s12913-024-12085-7Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping reviewAyelign Mengesha Kassie0Elizabeth Eakin1Aklilu Endalamaw2Anteneh Zewdie3Eskinder Wolka4Yibeltal Assefa5School of Public Health, Faculty of Medicine, The University of QueenslandSchool of Public Health, Faculty of Medicine, The University of QueenslandSchool of Public Health, Faculty of Medicine, The University of QueenslandInternational Institute for Primary Health CareInternational Institute for Primary Health CareSchool of Public Health, Faculty of Medicine, The University of QueenslandAbstract Background There is no consistent operationalization of effective coverage (EC) across studies. Therefore, this scoping review synthesized evidence on the definitions and measurement approaches, outcomes reported, and the factors that are associated with variations in quality-adjusted EC estimates of maternal and neonatal healthcare services in low- and middle-income countries. Methods Article search was conducted using PubMed, Embase, Google Scholar, and other databases. Then, title, abstract, and full text screenings for inclusion were performed by two authors independently and disagreements were resolved through discussion. In case of duplication, the full-text published articles were retained, and the results are presented using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews checklist as a guide. Results Overall, 36 articles were included in this scoping review. In most articles, EC has been defined from the perspectives of people in need utilizing healthcare services in well-equipped health facilities and from actual receipt of quality services. In addition, usage, instead of need, has been used as a domain in estimating EC in some instances. Effective coverage ranged from 0% for different services including for post-partum care, to 84% for antenatal care. Moreover, different socio-demographic factors including wealth index, education, and residence are found to have an association with variations in EC of maternal and neonatal healthcare services with the wealthiest, most educated, and those living in urban areas having higher estimates. From the supply side, numerous factors, particularly health facility capacity-related constraints, have been reported to be associated with low EC of those services. Conclusions The variability in the definition and measurement approaches of EC across studies emphasizes the need for standardization for better comparison in future research. We recommend that quality-adjusted EC be defined in two ways: intervention-specific service delivery EC and general service delivery EC. In addition, disparities in EC are observed among women with different socioeconomic status including educational level and wealth index. Organizational capacity constraints and other health system and societal factors also contributed to variations in EC.https://doi.org/10.1186/s12913-024-12085-7Antenatal careDelivery careEffective coverageQuality-adjusted coveragePostnatal care |
| spellingShingle | Ayelign Mengesha Kassie Elizabeth Eakin Aklilu Endalamaw Anteneh Zewdie Eskinder Wolka Yibeltal Assefa Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review BMC Health Services Research Antenatal care Delivery care Effective coverage Quality-adjusted coverage Postnatal care |
| title | Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review |
| title_full | Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review |
| title_fullStr | Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review |
| title_full_unstemmed | Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review |
| title_short | Effective coverage of maternal and neonatal healthcare services in low-and middle-income countries: a scoping review |
| title_sort | effective coverage of maternal and neonatal healthcare services in low and middle income countries a scoping review |
| topic | Antenatal care Delivery care Effective coverage Quality-adjusted coverage Postnatal care |
| url | https://doi.org/10.1186/s12913-024-12085-7 |
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