ArticlePloS one2019
Barriers to implementation of emergency obstetric and neonatal care in rural Pakistan.
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 10 papers, 5 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Community-Based Impact of Community-Based Antenatal Care Models on Prevention and Early Detection of Obstetric Complications: A Systematic Review.Annals of global health · 2026Pooled it
- Access to quality trauma care after injury in Pakistan: a systematic review and narrative synthesis.BMJ open · 2025Pooled it
- The development of proxy indicators to measure workforce well-being in emergency obstetric and neonatal care settings.Journal of global health · 2025Pooled it
- Teamwork and implementation of innovations in healthcare and human service settings: a systematic review.Implementation science : IS · 2024Pooled it
- Pooled it
- Digital Health Interventions in Emergency Obstetric and Newborn Care Services in Low- and Middle-Income Countries: Scoping Review.Journal of medical Internet research · 2025Article
- Sociodemographic Determinants of Reproductive Healthcare Service Use Among Pregnant Women in Pakistan.Healthcare (Basel, Switzerland) · 2025Article
- Improving quality of maternal and newborn care: An evaluation of enablers and barriers in implementing emergency obstetric and newborn care training in Bhutan and Lao People's Democratic Republic.PLOS global public health · 2025Article
- Context matters: examining factors influencing the implementation of evidence-based family systems care for small and sick newborns across the care continuum.Frontiers in health services · 2025Article
- Barriers experienced by community midwives to provide basic emergency obstetric and newborn care in rural Pakistan.BMC health services research · 2023Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecognizing the need for improving maternal and newborn care, the Punjab public health department (Pakistan) launched emergency obstetric neonatal care (EmONC) services under WHO guideline. Unfortunately, the program implementation is facing some serious problems. The purpose of this study was to identify barriers to implementation of EmONC in district Bahawalnagar (Pakistan).
methodsThis study used sequential exploratory design. Specifically, a qualitative study was conducted to identify barriers to EmONC. Subsequently, the relative importance of these barriers was determined in a quantitative study. Participants were health service providers involved in 24-hours basic EmONC services in the basic health units of district Bahawalnagar (Pakistan). Qualitative data were gathered by interviewing the participants using key informant guide. Quantitative data were collected in a rank order survey of the same participants. The methodological quality was assessed using mixed methods appraisal tool (MMAT) version 2011.
resultsThe results indicate that lack of teamwork, conflict management, communication, and improper power distribution are important interpersonal barriers. The significant organizational-level barriers include job insecurity, lack of organizational culture, human resource deployment issues, and lack of role clarity. Lack of target management, lack of resource availability, house job requirement, and dual practice issues were identified as major system-level barriers.
conclusionBarriers to EmONC implementation must be addressed for improving maternal and neonatal care in district Bahawalnagar.
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