Evidence map›Paper›PMID 35152880›Full record

SynthesisBMC pregnancy and childbirth2022

What are the strategies for implementing primary care models in maternity? A systematic review on midwifery units.

Laura Batinelli, Ellen Thaels, Nathalie Leister, Christine McCourt, Manila Bonciani, Lucia Rocca-Ihenacho

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pregnancy and childbirth, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. 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

6 authors.

Laura BatinelliCentre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK. laura.batinelli@city.ac.uk.
Ellen ThaelsFaculty of Health & Wellbeing, School of Community Health and Midwifery, University of Central Lancashire, UCLAN, Brook Building, Victoria Street, Preston, PR17QT, UK.
Nathalie LeisterCentre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK.
Christine McCourtCentre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK.
Manila BoncianiLaboratorio Management e Sanità, Institute of Management, Scuola Superiore Sant'Anna, Piazza Martiri della Libertà, 33, CAP 56127, Pisa, Italy.
Lucia Rocca-IhenachoCentre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMidwifery Units (MUs) are associated with optimal perinatal outcomes, improved service users' and professionals' satisfaction as well as being the most cost-effective option. However, they still do not represent the mainstream option of maternity care in many countries. Understanding effective strategies to integrate this model of care into maternity services could support and inform the MU implementation process that many countries and regions still need to approach.

methodsA systematic search and screening of qualitative and quantitative research about implementation of new MUs was conducted (Prospero protocol reference: CRD42019141443) using PRISMA guidelines. Included articles were appraised using the CASP checklist. A meta-synthesis approach to analysis was used. No exclusion criteria for time or context were applied to ensure inclusion of different implementation attempts even under different historical and social circumstances. A sensitivity analysis was conducted to reflect the major contribution of higher quality studies.

resultsFrom 1037 initial citations, twelve studies were identified for inclusion in this review after a screening process. The synthesis highlighted two broad categories: implementation readiness and strategies used. The first included aspects related to cultural, organisational and professional levels of the local context whilst the latter synthesised the main actions and key points identified in the included studies when implementing MUs. A logic model was created to synthesise and visually present the findings.

conclusionsThe studies selected were from a range of settings and time periods and used varying strategies. Nonetheless, consistencies were found across different implementation processes. These findings can be used in the systematic scaling up of MUs and can help in addressing barriers at system, service and individual levels. All three levels need to be addressed when implementing this model of care.

Indexed as

HumansMaternal Health ServicesMidwiferyPrimary Health CareProfessional RoleAdoptionBirth centresImplementationInnovationMetasynthesisMidwifery centresMidwifery led careMidwifery unitsPrimary care modelsQualitative research

Identifiers

PMID35152880
PMCPMC8842978

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.