Evidence map›Paper›PMID 31589635›Full record

ArticlePloS one2019

Understanding variation in health service coverage and maternal health outcomes among districts in Rwanda - A qualitative study of local health workers' perceptions.

Felix Sayinzoga, Moses Tetui, Koos van der Velden, Jeroen van Dillen, Leon Bijlmakers

Abstract read
In one paragraph

Article in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Felix SayinzogaMaternal, Child and Community Health Division, Rwanda Ministry of Health/ Rwanda Biomedical Center, Kigali, Rwanda.
Moses TetuiDepartment of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.
Koos van der VeldenDepartment of Primary and Community Care, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
Jeroen van DillenDepartment of Obstetrics and Gynaecology, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
Leon BijlmakersDepartment for Health Evidence, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID 0000-0003-2252-0579

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo obtain the perspectives of health professionals and community health workers on factors that determine health service coverage and maternal health outcomes so as to understand variations between districts.

methods16 Focus group discussions involving four different groups of participants were conducted in May 2015 in four purposively selected districts, complemented by three key informant interviews in one of the districts.

resultsThe solidarity support for poor people and the interconnectedness between local leaders and heads of health facilities were identified as enablers of health service utilization. Geographical factors, in particular location close to borders with mobile populations and migrants, and large populations with sparsely distributed health infrastructure, exacerbated by hilly topography and muddy roads were identified as barriers. Shortages of skilled health providers at the level of district hospitals were cited as contributing to poor maternal health outcomes.

conclusionThere is a need to take into account disparities between districts when allocating staff and financial resources in order to achieve universal coverage for high-quality maternal health services and better outcomes. Local innovations such as the use of SMS and WhatsApp text messages by health workers and financial protection schemes for poor patients improve solidarity and are worth to be scaled up.

Indexed as

AttitudeCommunity Health WorkersCommunity MedicineDelivery of Health CareFemaleHealthcare DisparitiesHumansInsurance CoverageMaternal HealthRwanda

Identifiers

PMID31589635
PMCPMC6779235

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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.