ReviewBMJ global health2020
Health system redesign for maternal and newborn survival: rethinking care models to close the global equity gap.
Review in BMJ global health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
68 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Impact of travel time to health facilities on perinatal outcomes: a systematic review with narrative synthesis and meta-analysis.Journal of global health · 2026Pooled it
- Pooled it
- Process and costs for readiness to safely implement immediate kangaroo mother care: a mixed methods evaluation from the OMWaNA trial at five hospitals in Uganda.BMC health services research · 2023Trial
- The Role of Nurses in Advancing Healthcare Equity and Quality of Care : A Scoping Review.Journal of bioethical inquiry · 2026Article
- Observational
- Assessing basic Emergency Obstetric and Neonatal Care (BEmONC) service provision in community health centers: a mixed-methods study from Jember, Indonesia.BMC health services research · 2026Article
- Bypassing primary healthcare facilities for maternal and child health services in low- and middle-income countries: a scoping review.Reproductive health · 2026Article
- Global and temporal trends in neonatal and under-five mortality due to birth asphyxia/trauma and prematurity (2000-2021) with projections up to 2040.World journal of pediatrics : WJP · 2026Article
- Global Study on Newborn HOspitalization and Parental Experiences (HOPE): rationale and design of a multinational cross-sectional mixed-methods online survey.BMJ paediatrics open · 2026Observational
- The World Health Organization Safe Childbirth Checklist on Essential Birth Practices and Perinatal Mortality: A Meta-Analysis.JAMA network open · 2026Article
- Implementation pathways of a health services delivery redesign model to improve maternal and newborn outcomes in Kenya.BMJ global health · 2026Article
- Location of births by health facility type: a time trend analysis from 1995 to 2023 in 130 low- and middle-income countries.EClinicalMedicine · 2026Article
- Adapting a digital quality improvement system (Neotree) for newborn care in primary health centres and community hospitals: a mixed-methods implementation study in Malawi.Global health action · 2025Article
- Optimizing people's movement across the health system: a scoping review of referral systems within a primary health care approach.Primary health care research & development · 2025Article
- Barriers to improving preterm newborn outcomes through effective antenatal corticosteroid use in Ethiopia.BMJ global health · 2025Article
- Women's health and maternal care services: seizing missed opportunities to prevent and manage preterm birth.Reproductive health · 2025Review
- Antenatal corticosteroids for pregnant women at risk of preterm labour in low- and middle-income countries: utilisation and facility readiness.Journal of global health · 2025Article
- Article
- Improving complex health systems and lived environments for maternal and perinatal well-being in urban sub-Saharan Africa: the UrbanBirth Collective.Journal of global health · 2025Article
- Beyond facility-based births: Is Uganda delivering effective maternal and newborn care? An analysis of the 2022 demographic health survey and 2023 harmonized health facility assessment survey.PLOS global public health · 2025Article
8 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Large disparities in maternal and neonatal mortality exist between low- and high-income countries. Mothers and babies continue to die at high rates in many countries despite substantial increases in facility birth. One reason for this may be the current design of health systems in most low-income countries where, unlike in high-income countries, a substantial proportion of births occur in primary care facilities that cannot offer definitive care for complications. We argue that the current inequity in care for childbirth is a global double standard that limits progress on maternal and newborn survival. We propose that health systems need to be redesigned to shift all deliveries to hospitals or other advanced care facilities to bring care in line with global best practice. Health system redesign will require investing in high-quality hospitals with excellent midwifery and obstetric care, boosting quality of primary care clinics for antenatal, postnatal, and newborn care, decreasing access and financial barriers, and mobilizing populations to demand high-quality care. Redesign is a structural reform that is contingent on political leadership that envisions a health system designed to deliver high-quality, respectful care to all women giving birth. Getting redesign right will require focused investments, local design and adaptation, and robust evaluation.
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