Evidence map›Paper›PMID 38803254›Full record

ArticleBMJ open2024

Eight years into the horizon of aspirational maternal and newborn health pledges: a nationwide cross-sectional exploration of the Burundian EmONC network capacity and budget deficits.

Desire Habonimana, Attakrit Leckcivilize, Catia Nicodemo, Jean Baptiste Nzorironkankuze, Ananie Ndacayisaba, Aristide Bishinga, Jeanine Ndayisenga, Eugenie Siga Diane Niane, Sylvestre Bazikamwe, Pontien Ndabashinze and 1 more

Abstract read
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

11 authors.

Desire HabonimanaCentre de Recherche Universitaire en Santé (CURSA), Department of Community Medicine, Faculty of Medicine, University of Burundi, Bujumbura, Burundi desire.habonimana@ub.edu.bi.ORCID 0000-0003-0832-5558
Attakrit LeckcivilizeCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-6172-3902
Catia NicodemoNuffield Department of Primary Care and Health Science, University of Oxford, Oxford, UK.ORCID 0000-0001-5490-9576
Jean Baptiste NzorironkankuzeMinistry of Health, Republic of Burundi, Bujumbura, Burundi.
Ananie NdacayisabaReproductive, Maternal, Child, Adolescent, and Newborn Health programme, Ministry of Health, Republic of Burundi, Bujumbura, Burundi.
Aristide BishingaMaternal and Child Health Programme, Japan International Cooperation Agency in Burundi, Bujumbura, Burundi.
Jeanine NdayisengaThe East African Community Centre of Excellence in Public Heath Training, Department of Clinical Sciences, National Institute of Public Health and Burundian Association of Neonatology, Bujumbura, Burundi.
Eugenie Siga Diane NianeReproductive, Maternal and Neonatal Health Department, World Health Organisation, Bujumbura, Burundi.
Sylvestre BazikamweDepartment of Gynaecology and Obstetrics and Burundian Association of Gynecology and Obstetrics, University of Burundi, Bujumbura, Burundi.ORCID 0000-0003-4825-2314
Pontien NdabashinzeDepartment of Paediatrics and Neonatology and Burundian Association of Neonatology, University of Burundi, Bujumbura, Burundi.
Mike EnglishCentre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-7427-0826

Funding

Wellcome Trust 207522/Z/17/ZWorld Health Organization 001
6 · The paper itself

Abstract

objectiveThe Burundian emergency obstetric and neonatal care (EmONC) programme, which was initiated in 2017 and supported by a specific policy, does not appear to reverse maternal and newborn mortality trends. Our study examined the capacity challenges facing participating EmONC facilities and developed alternative investment proposals to improve their readiness paying particular attention to EmONC professionals, physical infrastructure, and capital equipment.

designCross-sectional study.

settingBurundian EmONC facilities (n=112).

participantsWe examined EmONC policy documents, consulted 12 maternal and newborn health experts and 23 stakeholders and policymakers, surveyed all EmONC facilities (n=112), and collected cost data from the Ministry of Health and local suppliers in Burundi. We developed three context-specific EmONC resource benchmark standards by facility type; the Burundian policy norms and the expert minimum and maximum suggested thresholds; and used these alternatives to estimate EmONC resource gaps. We forecasted three corresponding budget estimates needed to address prevailing deficits taking a government perspective for a 5-year EmONC investment strategy. Additionally, we explored relationships between EmONC professionals and selected measures of service delivery using bivariate analyses and graphically.

resultsThe lowest EmONC resource benchmark revealed that 95% of basic EmONC and all comprehensive EmONC facilities lack corresponding sets of human resources and 90% of all facilities need additional physical infrastructure and capital equipment. Assessed against the highest benchmark which proposes the most progressive set of standards for the prevailing workloads, Burundi would require 162 more medical doctors, 1005 midwives and nurses, 132 delivery rooms, 191 delivery tables, 678 and 156 maternity and newborn care beds, and 395 incubators amounting to US$32.9 million additional budget for 5 years.

conclusionWe demonstrated that Burundian EmONC facilities face enormous capacity challenges equivalent to US$32.9 million funding gap for 5 years; averagely approximating to 5.96% total health budget increase annually.

Indexed as

Maternal Health ServicesBudgetsBurundiCross-Sectional StudiesEmergency Medical ServicesFemaleHumansInfantInfant MortalityInfant, NewbornMaternal MortalityPregnancyhealth policyhealth servicesmaternal medicineneonatology

Identifiers

PMID38803254
PMCPMC11256046

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.