Enhancing quality midwifery care in humanitarian and fragile settings: a systematic review of interventions, support systems and enabling environments

作者：Caroline Homer, Sabera Turkmani, Alyce N. Wilson, Joshua Peter Vogel, Mehr Gul Shah, Helga Fogstad, Étienne V Langlois · 发表于：BMJ Global Health · 年份：2022 · DOI：10.1136/bmjgh-2021-006872 · 被引用次数：47 · 研究领域：Global Maternal and Child Health、Maternal Mental Health During Pregnancy and Postpartum、Maternal and Perinatal Health Interventions

INTRODUCTION: Women and children bear a substantial burden of the impact of conflict and instability. The number of people living in humanitarian and fragile settings (HFS) has increased significantly over the last decade. The provision of essential maternal and newborn healthcare by midwives is crucial everywhere, especially in HFS. There is limited knowledge about the interventions, support systems and enabling environments that enhance midwifery care in these settings. The aim of this paper is to identify the factors affecting an enabling environment for midwives in HFS and to explore the availability and effectiveness of support systems for midwives. METHODS: A structured systematic review was undertaken to identify peer-reviewed primary research articles published between 1995 and 2020. RESULTS: In total, 24 papers were included from Afghanistan, Bangladesh, Nigeria, Democratic Republic of Congo, South Sudan and Sudan, Ethiopia, Pakistan, Uganda and Liberia. There were two broad themes: (1) the facilitators of, and barriers to, an enabling environment, and (2) the importance of effective support systems for midwives. Facilitators were: community involvement and engagement and an adequate salary, incentives or benefits. Barriers included: security and safety concerns, culture and gender norms and a lack of infrastructure and supplies. Support systems were: education, professional development, supportive supervision, mentorship and workforce planning. CONCLUSION: More effo...