Spanning maternal, newborn and child health (MNCH) and health systems research boundaries: conducive and limiting health systems factors to improving MNCH outcomes in West Africa

Agyepong, Irène Akua; Kwamie, Aku; Frimpong, Edith; Defor, Selina; Ibrahim, Abdallah; Aryeetey, Genevieve Cecilia; Lokossou, Virgil; Sombié, Issiaka

doi:10.1186/s12961-017-0212-x

Cited by 31 publications

(34 citation statements)

References 48 publications

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“…The burden of PA reflects the quality of maternal-newborn health services; underlying factors for inadequate services in the sub-region has been described. (3) In Africa, the West Africa sub-region has the poorest indices for facility-based maternal care; about 50% of births still occur at home with 20% occurring with no person present and only 35% attended by a doctor or nurse/midwife. (14) Inequalities in access to health and wealth significantly contribute to giving birth with no one present and Nigeria accounts for a significant proportion of the global burden.…”

Section: The Burden Of Perinatal Asphyxiamentioning

confidence: 99%

International Perspectives: Birth-Associated Neonatal Encephalopathy: Postresuscitation Care in West African Newborns

et al. 2018

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The West African sub-region has the highest burden of neonatal mortality globally and the neonatal mortality rate indices is reducing very slowly. A high proportion of newborn deaths are preventable and improved quality of care can reduce long-term morbidity in survivors. Perinatal asphyxia is the major cause of death and disability in term babies in the sub-region. Neonatal resuscitation training programs have reduced stillbirths and early neonatal mortality but the overall effect on survival to discharge, population-based perinatal mortality and long term impairment is uncertain. Gaps in the health system and quality of post-resuscitation care for affected newborns may defeat gains from global efforts to improve care around the time of birth. The aim of this review is to discuss the current situation of post-resuscitation care of term babies with presumed birth-associated neonatal encephalopathy in West Africa. Limitations in diagnosing and treating affected babies and feasible interventions to improve acute and postdischarge care are discussed.

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Section: The Burden Of Perinatal Asphyxiamentioning

confidence: 99%

International Perspectives: Birth-Associated Neonatal Encephalopathy: Postresuscitation Care in West African Newborns

et al. 2018

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“…By contrast, syphilis tests and treatment were in low supply in ANC facilities across West African countries (Benin 10%, Burkina Faso 2%, Mauritania 4%, Senegal 12%, Sierra Leone 5% and Togo 13%). This difference in health facility readiness may reflect relatively lower burden of syphilis, poorer health infrastructures and few health system resources in West Africa [ 33 ]. The difference may also be explained by increased attention due to higher burden of HIV and the integration of syphilis interventions into existing ANC and prevention of MTCT of HIV programs in Zimbabwe and other countries in Southern Africa [ 12 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Gaps in the implementation of antenatal syphilis detection and treatment in health facilities across sub-Saharan Africa

2018

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BackgroundSyphilis in pregnancy is an under-recognized public health problem, especially in sub-Saharan Africa which accounts for over 60% of the global burden of syphilis. If left untreated, more than half of maternal syphilis cases will result in adverse pregnancy outcomes including stillbirth and fetal loss, neonatal death, prematurity or low birth weight, and neonatal infections. Achieving universal coverage of antenatal syphilis screening and treatment has been the focus of the global campaign for the elimination of mother-to-child transmission of syphilis. However, little is known about the availability of antenatal syphilis screening and treatment across sub-Saharan Africa. The objective of this study was to estimate the ‘likelihood of appropriate care’ for antenatal syphilis screening and treatment by analyzing health facility surveys and household surveys conducted from 2010 to 2015 in 12 sub-Saharan African countries.MethodsIn this secondary data analysis, we linked indicators of health facility readiness to provide antenatal syphilis detection and treatment from Service Provision Assessments (SPAs) and Service Availability and Readiness Assessments (SARAs) to indicators of ANC use from the Demographic and Health Surveys (DHS) to compute estimates of the ‘likelihood of appropriate care’.ResultsBased on data from 5,593 health facilities that reported offering antenatal care (ANC) services, the availability of syphilis detection and treatment in ANC facilities ranged from 2% to 83%. The availability of syphilis detection and treatment was substantially lower in ANC facilities in West Africa compared to the other sub-regions. Levels of ANC attendance were high (median 94.9%), but only 27% of ANC attendees initiated care at less than 4 months gestation. We estimated that about one in twelve pregnant women received ANC early (<4 months) at a facility ready to provide syphilis detection and treatment (median 8%, range 7–32%). The largest implementation bottleneck identified was low health facility readiness, followed by timeliness of the first ANC visit.ConclusionsWhile access was fairly high, the low levels of likelihood of antenatal syphilis detection and treatment identified reinforce the need to improve the availability of syphilis rapid diagnostic tests and treatment and the timeliness of antenatal care-seeking across sub-Saharan Africa.

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“…According to Agyepong et al [3], the West African countries are in dire need of increased investment in health interventions and health systems strengthening approaches that are evidence-based [2].…”

Section: Introductionmentioning

confidence: 99%

“…A number of recent studies have stressed the urgent need for increased understanding of the complexities of the evidence to policy process among policymakers in West Africa and also a need to have a guidance on evidence-based policymaking. [1,2,11]. Guidance documents with speci c focus on evidence-based policymaking or evidence-informed policymaking are essentially scarce.…”

Section: Introductionmentioning

confidence: 99%

Promoting the use of evidence in health policymaking in the ECOWAS region: the development and contextualization of an evidence-based policymaking guidance

Uneke

Sombié

Johnson

et al. 2020

Preprint

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Background The Economic Commission of the West African States (ECOWAS), through her specialised health Institution, the West African Health Organization (WAHO) is supporting Members States to improve health outcomes in West Africa. There is a global recognition that evidence-based health policies are vital towards achieving continued improvement in health outcomes. The need to have a tool that will provide systematic guide on the use of evidence in policymaking necessitated the production of the evidence-based policy-making (EBPM) Guidance. Methods Google search was performed to identify existing guidance on EBPM. Lessons were drawn from the review of identified guidance documents. Consultation, interaction and interviews were held with policymakers from the 15 West African countries during WAHO organized regional meetings in Senegal, Nigeria, and Burkina Faso. The purpose was to elicit their views on the strategies to promote the use of evidence in policymaking to be included in the EBPM Guidance. A regional Guidance Validation Meeting for West African policymakers was thereafter convened by WAHO to review findings from review of existing guidance documents and validate the EBPM Guidance. Results Out of the 250 publications screened, six publications fulfilled the study inclusion criteria and were reviewed. Among the important issues highlighted include: what evidence informed decision-making is; different types of research methods, designs and approaches, and how to judge the quality of research. The identified main target end users of the EBPM Guidance are policy/decision makers in the West African sub-region, at local, sub-national, national and regional levels. Among the key recommendations included in the EBPM Guidance include: properly defining/refining policy problem; reviewing contextual issues; initiating policy priority setting; considering political acceptability of policy; commissioning research; use of rapid response services, use of policy advisory/technical/steering committees; and use of policy briefs and policy dialogue. Conclusion The EBPM Guidance is one of the emerging tools that can enhance the understanding of evidence to policy process. The strategies to facilitate the use of evidence in policymaking outlined in the Guidance, can be adapted to local context, and incorporated validated approaches that can be used to promote evidence-to-policy-to-practice process in West Africa.

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Spanning maternal, newborn and child health (MNCH) and health systems research boundaries: conducive and limiting health systems factors to improving MNCH outcomes in West Africa

Cited by 31 publications

References 48 publications

International Perspectives: Birth-Associated Neonatal Encephalopathy: Postresuscitation Care in West African Newborns

International Perspectives: Birth-Associated Neonatal Encephalopathy: Postresuscitation Care in West African Newborns

Gaps in the implementation of antenatal syphilis detection and treatment in health facilities across sub-Saharan Africa

Promoting the use of evidence in health policymaking in the ECOWAS region: the development and contextualization of an evidence-based policymaking guidance

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