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Lassi ZS, Aftab W, Ariff S, et al. Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review. Confl Health. 2015;9:25doi: 10.1186/s13031-015-0054-5.
Lassi, Z. S., Aftab, W., Ariff, S., Kumar, R., Hussain, I., Musavi, N. B., Memon, Z., Soofi, S. B., & Bhutta, Z. A. (2015). Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review. Conflict and health, 925. https://doi.org/10.1186/s13031-015-0054-5
Lassi, Zohra S, et al. "Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review." Conflict and health vol. 9 (2015): 25. doi: https://doi.org/10.1186/s13031-015-0054-5
Lassi ZS, Aftab W, Ariff S, Kumar R, Hussain I, Musavi NB, Memon Z, Soofi SB, Bhutta ZA. Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review. Confl Health. 2015 Aug 22;9:25. doi: 10.1186/s13031-015-0054-5. eCollection 2015. PMID: 26300959; PMCID: PMC4546286.
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Confl Health. 2015 Aug 22;9:25. doi: 10.1186/s13031-015-0054-5. eCollection 2015.

Impact of service provision platforms on maternal and newborn health in conflict areas and their acceptability in Pakistan: a systematic review.

Conflict and health

Zohra S Lassi, Wafa Aftab, Shabina Ariff, Rohail Kumar, Imtiaz Hussain, Nabiha B Musavi, Zahid Memon, Sajid B Soofi, Zulfiqar A Bhutta

Affiliations

  1. Division of Women and Child Health, The Aga Khan University, Karachi, Pakistan ; Australian Research Centre for Health of Women and Babies, Robinson Research Institute, School of Paediatrics and Reproductive Health, The University of Adelaide, Adelaide, Australia.
  2. Division of Women and Child Health, The Aga Khan University, Karachi, Pakistan.
  3. Head of Research and M&E, Greenstar Social Marketing, Karachi, Pakistan.
  4. Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada ; Program for Global Paediatric Research, Hospital for Sick Children, Toronto, ON Canada.

PMID: 26300959 PMCID: PMC4546286 DOI: 10.1186/s13031-015-0054-5

Abstract

Various models and strategies have been implemented over the years in different parts of the world to improve maternal and newborn health (MNH) in conflict affected areas. These strategies are based on specific needs and acceptability of local communities. This paper has undertaken a systematic review of global and local (Pakistan) information from conflict areas on platforms of health service provision in the last 10 years and information on acceptability from local stakeholders on effective models of service delivery; and drafted key recommendations for improving coverage of health services in conflict affected areas. The literature search revealed ten studies that described MNH service delivery platforms. The results from the systematic review showed that with utilisation of community outreach services, the greatest impacts were observed in skilled birth attendance and antenatal consultation rates. Facility level services, on the other hand, showed that labour room services for an internally displaced population (IDP) improved antenatal care coverage, contraceptive prevalence rate and maternal mortality. Consultative meetings and discussions conducted in Quetta and Peshawar (capitals of conflict affected provinces) with relevant stakeholders revealed that no systematic models of MNH service delivery, especially tailored for conflict areas, are available. During conflict, even previously available services and infrastructure suffered due to various barriers specific to times of conflict and unrest. A number of barriers that hinder MNH services were discussed. Suggestions for improving MNH services in conflict areas were also laid down by participants. The review identified some important steps that can be undertaken to mitigate the effects of conflict on MNH services, which include: improve provision and access to infrastructure and equipment; development and training of healthcare providers; and advocacy at different levels for free access to healthcare services and for the introduction of the programme model in existing healthcare system. The obligation is enormous, however, for a sustainable programme, it is important to work closely with both the IDP and host community, and collaborating with the government and non-government organisations.

Keywords: Conflict area; Internally displaced population; Maternal and neonatal health; Mothers and newborn

References

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