Zooming in and out: a holistic framework for research on maternal, late foetal and newborn survival and health.

Autor:	Singh NS; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK., Blanchard AK; Department of Community Health Sciences, University of Manitoba, R070-771 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada., Blencowe H; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK., Koon AD; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, USA., Boerma T; Department of Community Health Sciences, University of Manitoba, R070-771 McDermot Avenue, Winnipeg, MB R3E 0T6, Canada., Sharma S; CIWEC Hospital and Travel Medical Center, G.P.O. Box 12895, Kapurdhara Marg, Kathmandu 44600, Nepal., Campbell OMR; London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK.
Jazyk:	angličtina
Zdroj:	Health policy and planning [Health Policy Plan] 2022 May 12; Vol. 37 (5), pp. 565-574.
DOI:	10.1093/heapol/czab148
Abstrakt:	Research is needed to understand why some countries succeed in greater improvements in maternal, late foetal and newborn health (MNH) and reducing mortality than others. Pathways towards these health outcomes operate at many levels, making it difficult to understand which factors contribute most to these health improvements. Conceptual frameworks provide a cognitive means of rendering order to these factors and how they interrelate to positively influence MNH. We developed a conceptual framework by integrating theories and frameworks from different disciplines to encapsulate the range of factors that explain reductions in maternal, late foetal and neonatal mortality and improvements in health. We developed our framework iteratively, combining our interdisciplinary research team's knowledge, experience and review of the literature. We present a framework that includes health policy and system levers (or intentional actions that policy-makers can implement) to improve MNH; service delivery and coverage of interventions across the continuum of care; and epidemiological and behavioural risk factors. The framework also considers the role of context in influencing for whom and where health and non-health efforts have the most impact, to recognize 'the causes of the causes' at play at the individual/household, community, national and transnational levels. Our framework holistically reflects the range of interrelated factors influencing improved MNH and survival. The framework lends itself to studying how different factors work together to influence these outcomes using an array of methods. Such research should inform future efforts to improve MNH and survival in different contexts. By re-orienting research in this way, we hope to equip policy-makers and practitioners alike with the insight necessary to make the world a safer and fairer place for mothers and their babies. (© The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)
Databáze:	MEDLINE
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