ArticleJournal of global health2015
Barriers and facilitators to the quality use of essential medicines for maternal health in low-resource countries: An Ishikawa framework.
Article in Journal of global health, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- The Current Status in Obstetrics in North Korea and Strategies for Establishing a Better Healthcare System.Frontiers in public health · 2021Pooled it
- Tracking health commodity inventory and notifying stock levels via mobile devices: a mixed methods systematic review.The Cochrane database of systematic reviews · 2020Pooled it
- Supply chain management of health commodities and essential drug procurement systems at Sankhuwasabha and Kavrepalanchowk districts of federal Nepal.Journal of public health research · 2026Article
- Procurement process and shortages of essential medicines in public health facilities: A qualitative study from Nepal.PLOS global public health · 2024Article
- Novel Hydrolytic Degradable Crosslinked Interpenetrating Polymeric Networks (IPNs): An Efficient Hybrid System to Manage the Controlled Release and Degradation of Misoprostol.Gels (Basel, Switzerland) · 2023Article
- Primary Health Care System Strengthening Project in Sri Lanka: Status and Challenges with Human Resources, Information Systems, Drugs and Laboratory Services.Healthcare (Basel, Switzerland) · 2022Article
- Article
- Stability of Oxytocin Preparations in Malawi and Rwanda: Stabilizing Effect of Chlorobutanol.The American journal of tropical medicine and hygiene · 2020Article
- Quality, availability and storage conditions of oxytocin and misoprostol in Malawi.BMC pregnancy and childbirth · 2020Article
- Stability of misoprostol tablets collected in Malawi and Rwanda: Importance of intact primary packaging.PloS one · 2020Article
- Barriers and facilitators with medication use during the transition from hospital to home: a qualitative study among patients.BMC health services research · 2019Article
- Article
- Clinical practice patterns on the use of magnesium sulphate for treatment of pre-eclampsia and eclampsia: a multi-country survey.BJOG : an international journal of obstetrics and gynaecology · 2017Article
- Article
- Situational analysis of facilitators and barriers to availability and utilization of magnesium sulfate for eclampsia and severe preeclampsia in the public health system in Brazil.BMC pregnancy and childbirth · 2016Article
- Article
Corrections and comments
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAn estimated 800 women die every day due to complications related to pregnancy or childbirth. Complications such as postpartum haemorrhage (PPH) and pre-eclampsia and eclampsia can be prevented by the appropriate use of essential medicines. The objective of this study was to identify the common barriers and facilitators to the availability and use of oxytocin, ergometrine, and magnesium sulfate (MgSO4) - essential medicines indicated for the prevention and treatment of PPH and pre-eclampsia and eclampsia.
methodsWe analyzed seven UNFPA/WHO reports published in 2008-2010. These reports summarized country-wide rapid assessments of access to and use of essential medicines for maternal health in Mongolia, Nepal, Laos, the Democratic People's Republic of Korea (DPRK), the Philippines, Vanuatu, and the Solomon Islands. We used a "fishbone" (Ishikawa) diagram as the analytic framework to identify facilitators and barriers at four health-system levels: government/regulatory, pharmaceutical supply, health facility, and health professional.
resultsCommon facilitators to the quality use of essential medicines for maternal health were observed at the government/regulatory and health professional level. A majority of countries had these medicines listed in their essential medicines lists. Awareness of the medicines was generally high among health professionals. Common barriers were identified at all health-system levels. First, standard treatment guidelines were not available, updated, or standardized. Second, there was an inadequate capacity to forecast and procure medicines. Third, a required MgSO4 antidote was often not available and the storage conditions for oxytocin were deficient.
conclusionsThe "fishbone" Ishikawa diagram is a useful tool for describing the findings of rapid assessments of quality use of essential medicines for maternal health across countries. The facilitators and barriers identified should guide the development of tailored intervention programs to improve and expand the use of these life-saving medicines.
Identifiers
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Registered trials
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