Abstract:
OBJECTIVE:Conduct a global situational analysis to identify the current facilitators and barriers to improving quality of care (QoC) for pregnant women, newborns and children. STUDY DESIGN:Metareview of published and unpublished systematic reviews and meta-analyses conducted between January 2000 and March 2013 in any language. Assessment of Multiple Systematic Reviews (AMSTAR) is used to assess the methodological quality of systematic reviews. SETTINGS:Health systems of all countries. Study outcome: QoC measured using surrogate indicators--effective, efficient, accessible, acceptable/patient centred, equitable and safe. ANALYSIS:Conducted in two phases (1) qualitative synthesis of extracted data to identify and group the facilitators and barriers to improving QoC, for each of the three population groups, into the six domains of WHO's framework and explore new domains and (2) an analysis grid to map the common facilitators and barriers. RESULTS:We included 98 systematic reviews with 110 interventions to improve QoC from countries globally. The facilitators and barriers identified fitted the six domains of WHO's framework--information, patient-population engagement, leadership, regulations and standards, organisational capacity and models of care. Two new domains, 'communication' and 'satisfaction', were generated. Facilitators included active and regular interpersonal communication between users and providers; respect, confidentiality, comfort and support during care provision; engaging users in decision-making; continuity of care and effective audit and feedback mechanisms. Key barriers identified were language barriers in information and communication; power difference between users and providers; health systems not accounting for user satisfaction; variable standards of implementation of standard guidelines; shortage of resources in health facilities and lack of studies assessing the role of leadership in improving QoC. These were common across the three population groups. CONCLUSIONS:The barriers to good-quality healthcare are common for pregnant women, newborns and children; thus, interventions targeted to address them will have uniform beneficial effects. Adopting the identified facilitators would help countries strengthen their health systems and ensure high-quality care for all.
journal_name
BMJ Openjournal_title
BMJ openauthors
Nair M,Yoshida S,Lambrechts T,Boschi-Pinto C,Bose K,Mason EM,Mathai Mdoi
10.1136/bmjopen-2013-004749subject
Has Abstractpub_date
2014-05-22 00:00:00pages
e004749issue
5issn
2044-6055pii
bmjopen-2013-004749journal_volume
4pub_type
杂志文章,meta分析,评审相关文献
BMJ Open文献大全abstract:PURPOSE:Puerto Rican children experience high rates of asthma and obesity. Further, infants born in Puerto Rico are more at risk for being born prematurely compared with infants on the mainland USA. Environmental exposures from multiple sources during critical periods of child development, potentially modified by psych...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036389
更新日期:2020-07-19 00:00:00
abstract:INTRODUCTION:Policing practices are key drivers of HIV among people who inject drugs (PWID). This paper describes the protocol for the first study to prospectively examine the impact of a police education programme (PEP) to align law enforcement and HIV prevention. PEPs incorporating HIV prevention (including harm redu...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-008958
更新日期:2015-08-10 00:00:00
abstract:OBJECTIVES:While studies at the undergraduate level have begun to explore healthcare students' safety and dignity dilemmas, none have explored such dilemmas with multiple stakeholders at the postgraduate level. The current study therefore explores the patient and staff safety and dignity narratives of multiple stakehol...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025615
更新日期:2019-05-27 00:00:00
abstract:INTRODUCTION:Complex coronary artery disease (left main and three-vessel disease) carries high risks of adverse events and cost burden. However, in China, little is known about which patients are directed toward which treatment strategies and what outcomes are being achieved. METHODS AND ANALYSIS:Using the China PEACE...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2015-009743
更新日期:2016-02-15 00:00:00
abstract:OBJECTIVE:To evaluate the association between health and study-related factors measured by an Electronic Health Questionnaire (eHQ), participation in a health examination process and graduation in a university student population. DESIGN:Nationwide, retrospective, register-based cohort study with a 6-year follow-up. S...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-041551
更新日期:2020-12-16 00:00:00
abstract:OBJECTIVES:To explore healthcare professionals (HCPs) experiences and challenges in diagnosing suspected lower limb cellulitis. SETTING:UK nationwide. PARTICIPANTS:20 qualified HCPs, who had a minimum of 2 years clinical experience as an HCP in the national health service and had managed a clinical case of suspected ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034692
更新日期:2020-10-14 00:00:00
abstract:OBJECTIVE:Internationally recognised specialist breast cancer scientists, clinicians and healthcare professionals have published breast cancer research gaps that are informing research funding priorities in the UK and worldwide. We aimed to determine the breast cancer research priorities of the public to compare with t...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-036072
更新日期:2021-01-29 00:00:00
abstract:OBJECTIVE:To classify wear and non-wear time of accelerometer data for accurately quantifying physical activity in public health or population level research. DESIGN:A bi-moving-window-based approach was used to combine acceleration and skin temperature data to identify wear and non-wear time events in triaxial accele...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-007447
更新日期:2015-05-11 00:00:00
abstract:INTRODUCTION:Type 2 diabetes mellitus is a major source of morbidity and mortality in South Africa, spurred by increased urbanisation and unhealthy lifestyle factors. Local epidemiological data are required to inform health planning and policy. The purpose of this systematic review is to identify, collate and synthesis...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-021029
更新日期:2018-07-11 00:00:00
abstract:BACKGROUND AND OBJECTIVE:A comparison of sick leave in pregnancy between countries is difficult as most studies have been conducted in single countries in Scandinavia. The objective of this study was to explore patterns of and reasons for sick leave during pregnancy on a multinational level, focusing on medication use ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-014934
更新日期:2017-08-03 00:00:00
abstract:INTRODUCTION:New interventions are required to reduce unintended pregnancies among female sex workers (FSWs) in low- and middle-income countries and to improve their nutritional health. Given sex workers' high mobile phone usage, repeated exposure to short messaging service (SMS) messages could address individual and i...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-017388
更新日期:2017-08-18 00:00:00
abstract:OBJECTIVE:Post-randomisation exclusions in randomised controlled trials are common and may include participants identified as not meeting trial eligibility criteria after randomisation. We report how a decision might be reached and reported on, to include or exclude these participants. We illustrate using a motivating ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-039546
更新日期:2020-12-02 00:00:00
abstract:OBJECTIVES:To identify the diagnostic accuracy of common imaging modalities, chest X-ray (CXR) and CT, for diagnosis of COVID-19 in the general emergency population in the UK and to find the association between imaging features and outcomes in these patients. DESIGN:Retrospective analysis of electronic patient records...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-042946
更新日期:2020-11-06 00:00:00
abstract:INTRODUCTION:Cyclooxygenase 2 (COX-2) inhibitors have less upper gastrointestinal toxicity than traditional non-steroidal anti-inflammatory drugs (NSAIDs). However, both COX-2 inhibitors and traditional NSAIDs may be associated with adverse cardiovascular side effects. Data from randomised and observational studies sug...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-002295
更新日期:2013-01-29 00:00:00
abstract:OBJECTIVES:The study examined medical care utilisation by health insurance status changes. SETTING:The Korean Welfare Panel Study (KoWePs) was used. PARTICIPANTS:This study analysed 14,267 participants at baseline (2006). INTERVENTIONS:The individuals were categorised into four health insurance status groups: contin...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009538
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To report the nationwide prevalence of facial palsy (FP) of grade III or worse in the House-Brackmann (H-B) grading system in South Korea and assess the associated factors. DESIGN:Cross-sectional analysis of a nationwide health survey. SETTINGS:South Korea. METHODS:We obtained data from the 2010 to 2012 K...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012628
更新日期:2016-11-09 00:00:00
abstract:OBJECTIVES:Mortality rates in Scotland are higher, and health inequalities are greater, than in the rest of Western and Central Europe. There was a marked divergence during the 1980s and 1990s in the Scottish rates partly due to rises in alcohol-related and drug-related deaths, suicide and deaths by assault. This study...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030064
更新日期:2020-02-09 00:00:00
abstract:OBJECTIVES:Placenta or placental chorangioma could be the origin site of infantile haemangioma since they share various histochemical and genetic characteristics with placental vascular tissue. The aim of the current study was to investigate the association between chorangiomas and infantile haemangiomas in singleton a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015539
更新日期:2017-09-03 00:00:00
abstract:OBJECTIVES:Circulating 25-hydroxyvitamin D (25-OHD) is associated with improved cancer prognosis in some studies, yet it may be a surrogate marker for physical activity. We investigated the associations of leisure-time physical activity (LTPA) with circulating 25-OHD levels in cancer survivors, and determined whether a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-016064
更新日期:2017-07-10 00:00:00
abstract:INTRODUCTION:Complex population health interventions that are effective in one context may not be effective elsewhere, and may even be harmful. As such, an intervention may require adaptation to ensure it fits with a new context. To date, there is no overarching guidance to help researchers to adapt and evaluate interv...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-038965
更新日期:2020-07-20 00:00:00
abstract:OBJECTIVE:Neisseria meningitidis carriage prevalence has known variation across the lifespan, but it is unclear whether carriage varies among meningococcal capsular groups. Therefore, we aimed to characterise group-specific meningococcal carriage by age group and world region from 2007 to 2016. DESIGN:Systematic revie...
journal_title:BMJ open
pub_type: 杂志文章,meta分析
doi:10.1136/bmjopen-2018-024343
更新日期:2019-04-20 00:00:00
abstract:OBJECTIVE:There has been concern that an increase in billing for high-intensity emergency care is due to changes in coding practices facilitated by electronic health records. We sought to characterise the trends in billing for high-intensity emergency care among Medicare beneficiaries and to examine the degree to which...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-019357
更新日期:2018-01-30 00:00:00
abstract:OBJECTIVE:Since the 1990s, pregnancy hypertension rates have declined in some countries, but not all. Increasing rates of early planned delivery (before the due date) have been hypothesised as the reason for the decline. The aim of this study was to explore whether early planned delivery can partly explain the declinin...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009313
更新日期:2015-10-05 00:00:00
abstract:INTRODUCTION:Stroke is a leading cause of disability worldwide. The average hospital length of stay ranges from 3 to 28 days, and after discharge home the stroke survivors will live with physical, cognitive, even psychological disorders for the rest of their lives. It is essential to review the unmet needs of stroke su...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-029160
更新日期:2019-06-21 00:00:00
abstract:OBJECTIVE:Elevated levels of intercellular adhesion molecule-1 (ICAM-1) are demonstrated in diabetes complications. The current study aims to understand association of K469E (rs5498) in ICAM-1 gene, in type 2 diabetic (T2D) subjects with retinopathy. DESIGN:Case-control study. SETTING:Sankara Nethralaya Diabetic Reti...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001036
更新日期:2012-08-17 00:00:00
abstract:INTRODUCTION:Bariatric surgery is increasingly recognised as an effective treatment option for subjects with type 2 diabetes and obesity; however, there is no conclusive evidence on the superiority of Roux-en-Y gastric bypass or sleeve gastrectomy. The Oseberg study was designed to compare the effects of gastric bypass...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2018-024573
更新日期:2019-06-04 00:00:00
abstract:OBJECTIVE:Public opinion and support can be powerful mandates for smoke-free policy. However, the scarcity of evidence on public opinion among Malaysians necessitates further investigation. Therefore, this study aimed to determine the level of support for smoke-free policy at various public domains and its associated f...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2017-020304
更新日期:2019-02-12 00:00:00
abstract:OBJECTIVES:To investigate if centre-specific levels of perinatal interventional activity were associated with neonatal and neurodevelopmental outcome at 2 years of age in two separately analysed cohorts of infants: cohort A born at 22-25 and cohort B born at 26-27 gestational weeks, respectively. DESIGN:Geographically...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024560
更新日期:2019-03-15 00:00:00
abstract:OBJECTIVE:To assess the prevalence of cerebral stroke in the general population of Beijing and its association with systemic risk factors and ocular diseases. SETTING:The population-based Beijing Eye Study was conducted in a rural and urban region of Beijing. PARTICIPANTS:With eligibility criteria of age 50+ years an...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024646
更新日期:2020-09-10 00:00:00
abstract:INTRODUCTION:Surgery is one of the primary treatments for lung cancer. The postoperative symptom burden experienced by patients with lung cancer is substantial, seriously delaying their recovery from surgery and impairing their quality of life. Patient-reported outcome (PRO)-based symptom management is increasingly reg...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030041
更新日期:2019-08-26 00:00:00