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The provision of midwife-led care in low-and middle-income countries: An integrative review
- Source :
- Midwifery. 84:102659
- Publication Year :
- 2020
- Publisher :
- Elsevier BV, 2020.
-
Abstract
- Background The provision of midwife-led care, the model of care in which midwives are the lead professionals for women and newborn infants across the continuum, has been shown to be effective in improving outcomes for women and newborn infants, but predominantly based on research in high-income countries. Objective To explore how midwife-led care is provided in low- and middle-income countries. The specific question was to examine how, where and by whom has midwife-led care been provided in low-and-middle-income countries? Design: An integrative literature review was undertaken and included studies using a range of methods. Data sources A systematic search was conducted in Pubmed, EMBASE (Ovid), Web of Science, Scopus, Google Scholar, The Cochrane Library and hand-searching of relevant journals and website of International Organizations and relevant grey-literature. Review methods After applying inclusion criteria, systematic sifting and quality assessment processes, data were extracted from relevant studies. The software program NVivo was used to initially extract the findings and results of the studies. Coded data from primary data sources were iteratively compared, using patterns and themes as per the conceptual framework of the WHO on skilled health personnel providing care for childbearing women and newborn infants, including an analysis of the competent provider, standards of practice and the enabling environment. Findings Of a total of 3324 articles retrieved, 31 studies were included. There were 18 qualitative, nine quantitative and four mixed method studies with different levels of quality from five of six global regions published between 1997 and 2017. In these studies, midwife-led care was not found to be a standardised model in low- and middle-income countries (LMIC) and there was limited evidence on the effectiveness of midwife-led care in these countries. Care provided across the continuum was however described in most studies. Standards of practice in education, regulation and training varied widely as did the enabling environment in which midwife-led care took place. Conclusion and implication for practice and research Midwife-led care is provided across low- and middle-income countries but lack of enabling factors limits the quality of care that midwives can provide. Further research about this model of care is needed to understand the ingredients of successful implementation, their effectiveness and sustainability.
- Subjects :
- Practice Patterns, Nurses'
030219 obstetrics & reproductive medicine
030504 nursing
media_common.quotation_subject
MEDLINE
Scopus
Obstetrics and Gynecology
Developing country
Cochrane Library
Midwifery
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Nursing
Maternity and Midwifery
Humans
Quality (business)
0305 other medical science
Psychology
Developing Countries
Inclusion (education)
Qualitative Research
Cohort study
Qualitative research
media_common
Subjects
Details
- ISSN :
- 02666138
- Volume :
- 84
- Database :
- OpenAIRE
- Journal :
- Midwifery
- Accession number :
- edsair.doi.dedup.....99544583c3d6e8b2a1b3999ea844c098
- Full Text :
- https://doi.org/10.1016/j.midw.2020.102659