TY - JOUR
T1 - Postpartum care content and delivery throughout the African continent
T2 - An integrative review
AU - Gresh, Ashley
AU - Cohen, Megan
AU - Anderson, Jean
AU - Glass, Nancy
N1 - Funding Information:
Ashley Gresh was supported by the National Institute Of Nursing Research of the National Institutes of Health under Award Number F31NR019205. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2021
PY - 2021/6
Y1 - 2021/6
N2 - Objective: The objective of this review was to describe and evaluate the content of postpartum care and models of delivery throughout the African continent. Design: Integrative review was used to allow for the combination of studies using diverse research methodologies. Data sources: A comprehensive search strategy using the phrases ‘postpartum period’, ‘healthcare delivery’, and ‘Africa,’ including all spelling variants and countries within the continent, was used in the following databases: PubMed, Cumulative Index of Nursing and Allied Health Literature Plus, and Embase for studies published through September 2019. Review method: The integrative review process included five stages: problem identification, literature search, data evaluation, data analysis and presentation. Twelve studies from eight African countries were identified in the search and met the inclusion criteria for the review. The Mixed Methods Appraisal Tool was used to evaluate the quality of the studies included in the review. The theoretical framework developed by the World Health Organization Maternal Morbidity Working Group for healthcare interventions to address maternal morbidity was used for data analysis and to synthesize the results for presentation. Results: Definitions of the postpartum period varied among studies with service delivery ranging from six weeks to one year postpartum. There was no standard package of postpartum care across studies. Based on the World Health Organization theoretical framework, five primary topics were covered in postpartum care interventions: preventive care and counseling, health systems innovation, a life course approach, family planning, and health literacy and education. In contrast, five gaps in content of postpartum care services and service delivery included: integration of screening and treatment of noncommunicable diseases with maternal healthcare, intimate partner violence screening, social protection, a rights-based approach, and social vulnerability. No study addressed all aspects of the World Health Organization framework to address maternal morbidity. Conclusions: The results from this review indicate the need to address gaps in postpartum care services throughout the African continent in order to reduce maternal morbidity. Re- conceptualizing the paradigm of maternal health to take a life course approach and focusing future research on developing and building interventions to target postpartum care and healthcare delivery of postpartum care are necessary and important in efforts to reduce maternal morbidity and improve health outcomes for mother and child.
AB - Objective: The objective of this review was to describe and evaluate the content of postpartum care and models of delivery throughout the African continent. Design: Integrative review was used to allow for the combination of studies using diverse research methodologies. Data sources: A comprehensive search strategy using the phrases ‘postpartum period’, ‘healthcare delivery’, and ‘Africa,’ including all spelling variants and countries within the continent, was used in the following databases: PubMed, Cumulative Index of Nursing and Allied Health Literature Plus, and Embase for studies published through September 2019. Review method: The integrative review process included five stages: problem identification, literature search, data evaluation, data analysis and presentation. Twelve studies from eight African countries were identified in the search and met the inclusion criteria for the review. The Mixed Methods Appraisal Tool was used to evaluate the quality of the studies included in the review. The theoretical framework developed by the World Health Organization Maternal Morbidity Working Group for healthcare interventions to address maternal morbidity was used for data analysis and to synthesize the results for presentation. Results: Definitions of the postpartum period varied among studies with service delivery ranging from six weeks to one year postpartum. There was no standard package of postpartum care across studies. Based on the World Health Organization theoretical framework, five primary topics were covered in postpartum care interventions: preventive care and counseling, health systems innovation, a life course approach, family planning, and health literacy and education. In contrast, five gaps in content of postpartum care services and service delivery included: integration of screening and treatment of noncommunicable diseases with maternal healthcare, intimate partner violence screening, social protection, a rights-based approach, and social vulnerability. No study addressed all aspects of the World Health Organization framework to address maternal morbidity. Conclusions: The results from this review indicate the need to address gaps in postpartum care services throughout the African continent in order to reduce maternal morbidity. Re- conceptualizing the paradigm of maternal health to take a life course approach and focusing future research on developing and building interventions to target postpartum care and healthcare delivery of postpartum care are necessary and important in efforts to reduce maternal morbidity and improve health outcomes for mother and child.
KW - Africa
KW - Healthcare delivery
KW - Maternal health
KW - Postpartum period
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U2 - 10.1016/j.midw.2021.102976
DO - 10.1016/j.midw.2021.102976
M3 - Review article
C2 - 33740519
AN - SCOPUS:85102508995
SN - 0266-6138
VL - 97
JO - Midwifery
JF - Midwifery
M1 - 102976
ER -