Evaluations of effective coverage of maternal and child health services: A systematic review.

Ferede Gebremedhin, A; Dawson, A; Hayen, A

Evaluations of effective coverage of maternal and child health services: A systematic review.

Ferede Gebremedhin, A Dawson, A

Hayen, A

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Publisher:: Oxford University Press
Publication Type:: Journal Article
Citation:: Health Policy and Planning, 2022, 37, (7), pp. 895-914
Issue Date:: 2022-08-03

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Field	Value	Language
dc.contributor.author	Ferede Gebremedhin, A
dc.contributor.author	Dawson, A https://orcid.org/0000-0003-0926-2202
dc.contributor.author	Hayen, A https://orcid.org/0000-0003-4046-8030
dc.date.accessioned	2022-10-07T03:59:04Z
dc.date.available	2022-04-21
dc.date.available	2022-10-07T03:59:04Z
dc.date.issued	2022-08-03
dc.identifier.citation	Health Policy and Planning, 2022, 37, (7), pp. 895-914
dc.identifier.issn	0268-1080
dc.identifier.issn	1460-2237
dc.identifier.uri	http://hdl.handle.net/10453/162387
dc.description.abstract	Conventionally used coverage measures do not reflect the quality of care. Effective coverage (EC) assesses the extent to which health care services deliver potential health gains to the population by integrating concepts of utilization, need and quality. We aimed to conduct a systematic review of studies evaluating EC of maternal and child health services, quality measurement strategies and disparities across wealth quantiles. A systematic search was performed in six electronic databases [MEDLINE, EMBASE, Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, Web of Science and Maternity and Infant Care] and grey literature. We also undertook a hand search of references. We developed search terms having no restrictions based on publication period, country or language. We included studies which reported EC estimates based on the World Health Organization framework of measuring EC. Twenty-seven studies, all from low- and middle-income settings (49 countries), met the criteria and were included in the narrative synthesis of the results. Maternal and child health intervention(s) and programme(s) were assessed either at an individual level or as an aggregated measure of health system performance or both. The EC ranged from 0% for post-partum care to 95% for breastfeeding. When crude coverage measures were adjusted to account for the quality of care, the EC values turned lower. The gap between crude coverage and EC was as high as 86%, and it signified a low quality of care. The assessment of the quality of care addressed structural, process and outcome domains individually or combined. The wealthiest 20% had higher EC of services than the poorest 20%, an inequitable distribution of coverage. More efforts are needed to improve the quality of maternal and child health services and to eliminate the disparities. Moreover, considering multiple dimensions of quality and the use of standard measurements are recommended to monitor coverage effectively.
dc.format	Print
dc.language	eng
dc.publisher	Oxford University Press
dc.relation.ispartof	Health Policy and Planning
dc.relation.isbasedon	10.1093/heapol/czac034
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1117 Public Health and Health Services, 1605 Policy and Administration, 1606 Political Science
dc.subject.classification	Health Policy & Services
dc.subject.mesh	Child
dc.subject.mesh	Child Health Services
dc.subject.mesh	Family
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Poverty
dc.subject.mesh	Pregnancy
dc.subject.mesh	World Health Organization
dc.subject.mesh	Child
dc.subject.mesh	Child Health Services
dc.subject.mesh	Family
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Infant
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Poverty
dc.subject.mesh	Pregnancy
dc.subject.mesh	World Health Organization
dc.subject.mesh	Humans
dc.subject.mesh	Family
dc.subject.mesh	Pregnancy
dc.subject.mesh	Poverty
dc.subject.mesh	Child
dc.subject.mesh	Infant
dc.subject.mesh	Child Health Services
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	World Health Organization
dc.subject.mesh	Female
dc.title	Evaluations of effective coverage of maternal and child health services: A systematic review.
dc.type	Journal Article
utslib.citation.volume	37
utslib.location.activity	England
utslib.for	1117 Public Health and Health Services
utslib.for	1605 Policy and Administration
utslib.for	1606 Political Science
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	open_access	*
pubs.consider-herdc	false
dc.date.updated	2022-10-07T03:58:52Z
pubs.issue	7
pubs.publication-status	Published
pubs.volume	37
utslib.citation.issue	7

Abstract:

Conventionally used coverage measures do not reflect the quality of care. Effective coverage (EC) assesses the extent to which health care services deliver potential health gains to the population by integrating concepts of utilization, need and quality. We aimed to conduct a systematic review of studies evaluating EC of maternal and child health services, quality measurement strategies and disparities across wealth quantiles. A systematic search was performed in six electronic databases [MEDLINE, EMBASE, Cumulative Index of Nursing and Allied Health (CINAHL), Scopus, Web of Science and Maternity and Infant Care] and grey literature. We also undertook a hand search of references. We developed search terms having no restrictions based on publication period, country or language. We included studies which reported EC estimates based on the World Health Organization framework of measuring EC. Twenty-seven studies, all from low- and middle-income settings (49 countries), met the criteria and were included in the narrative synthesis of the results. Maternal and child health intervention(s) and programme(s) were assessed either at an individual level or as an aggregated measure of health system performance or both. The EC ranged from 0% for post-partum care to 95% for breastfeeding. When crude coverage measures were adjusted to account for the quality of care, the EC values turned lower. The gap between crude coverage and EC was as high as 86%, and it signified a low quality of care. The assessment of the quality of care addressed structural, process and outcome domains individually or combined. The wealthiest 20% had higher EC of services than the poorest 20%, an inequitable distribution of coverage. More efforts are needed to improve the quality of maternal and child health services and to eliminate the disparities. Moreover, considering multiple dimensions of quality and the use of standard measurements are recommended to monitor coverage effectively.

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http://hdl.handle.net/10453/162387