SynthesisBMJ open2018
Facilitators and barriers to the effective implementation of the individual maternal near-miss case reviews in low/middle-income countries: a systematic review of qualitative studies.
Synthesis in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Improving the quality of neonatal health care in Ethiopia: a systematic review.Frontiers in medicine · 2024Pooled it
- Pooled it
- Critical signs and symptoms for self-assessment in the immediate postnatal period: an international Systematic Scoping Review and Delphi consensus study.BMC pregnancy and childbirth · 2025Article
- Effectiveness of dissemination strategies of maternal clinical guidelines: A narrative review.African journal of primary health care & family medicine · 2024Review
- Using the WHO individual near miss case review (NMCR) cycle to improve quality of emergency obstetric care and maternal outcome in Keren hospital, Eritrea: an interrupted time series analysis.BMC pregnancy and childbirth · 2024Article
- Implementation Strategies for Maternal Near-Miss Case Reviews in LICs and LMICs: A scoping review protocol.Wellcome open research · 2024Article
- Development of a small and sick newborn clinical audit tool and its implementation guide using a human-centred design approach newborn clinical audit process and design.PLOS global public health · 2023Article
- Women with maternal near-miss in the intensive care unit in Yangzhou, China: a 5-year retrospective study.BMC pregnancy and childbirth · 2021Article
- Knowledge and barriers on correct use of modified guidelines for active management of third stage of labour: a cross sectional survey of nurse-midwives at three referral hospitals in Dar es Salaam, Tanzania.African health sciences · 2020Article
- Improving the quality of maternal and newborn care in the Pacific region: A scoping review.The Lancet regional health. Western Pacific · 2020Article
- Impact of peer-trainer leadership style on uptake of a peer led educational outreach intervention to improve tuberculosis care and outcomes in Malawi: a qualitative study.BMC health services research · 2020Article
- Women's suggestions on how to improve the quality of maternal and newborn hospital care: a qualitative study in Italy using the WHO standards as framework for the analysis.BMC pregnancy and childbirth · 2020Article
- Observational
- A qualitative exploration of Bahrain and Kuwait herbal medicine registration systems: policy implementation and readiness to change.Journal of pharmaceutical policy and practice · 2019Article
- Integrated Maternal Care Strategies in Low- and Middle-Income Countries: A Systematic Review.International journal of integrated careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe maternal near-miss cases review (NMCR), a type of clinical audit, proved to be effective in improving quality of care and decreasing maternal mortality in low/middle-income countries (LMICs). However, challenges in its implementation have been described.
objectivesSynthesising the evidence on facilitators and barriers to the effective implementation of NMCR in LMICs.
designSystematic review of qualitative studies. DATA SOURCES: MEDLINE, LILACS, Global Health Library, SCI-EXPANDED, SSCI, Cochrane library and Embase were searched in December 2017. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Qualitative studies exploring facilitators and/or barriers of implementing NMCR in LMIC were included. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data, performed thematic analysis and assessed risk of bias.
resultsOut of 25 361 papers retrieved, 9 studies from Benin, Brazil, Burkina Faso, Cote D'Ivoire, Ghana, Malawi, Morocco, Tanzania, Uganda could be included in the review. The most frequently reported barriers to NMCR implementation were the following: absence of national guidelines and local protocols; insufficient training on how to perform the audit; lack of leadership, coordination, monitoring and supervision; lack of resources and work overload; fear of blame and punishment; poor knowledge of evidenced-based medicine; hierarchical differences among staff and poor understating of the benefits of the NMCR. Major facilitators to NMCR implementation included: good leadership and coordination; training of all key staff; a good cultural environment; clear staff's perception on the benefits of conducting audit; patient empowerment and the availability of external support.
conclusionsIn planning the NMCR implementation in LMICs, policy-makers should consider actions to prevent and mitigate common challenges to successful NMCR implementation. Future studies should aim at documenting facilitators and barriers to NMCR outside the African Region.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.