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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
'How to know what you need to do': A cross-country comparison of maternal health guidelines in Burkina Faso, Ghana and Tanzania
Implementation Science, Volume 7, No. 1, Article 31, Year 2012
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Description
Background: Initiatives to raise the quality of care provided to mothers need to be given priority in Sub Saharan Africa (SSA). The promotion of clinical practice guidelines (CPGs) is a common strategy, but their implementation is often challenging, limiting their potential impact. Through a cross-country perspective, this study explored CPGs for maternal health in Burkina Faso, Ghana, and Tanzania. The objectives were to compare factors related to CPG use including their content compared with World Health Organization (WHO) guidelines, their format, and their development processes. Perceptions of their availability and use in practice were also explored. The overall purpose was to further the understanding of how to increase CPGs' potential to improve quality of care for mothers in SSA.Methods: The study was a multiple case study design consisting of cross-country comparisons using document review and key informant interviews. A conceptual framework to aid analysis and discussion of results was developed, including selected domains related to guidelines' implementability and use by health workers in practice in terms of usability, applicability, and adaptability.Results: The study revealed few significant differences in content between the national guidelines for maternal health and WHO recommendations. There were, however, marked variations in the format of CPGs between the three countries. Apart from the Ghanaian and one of the Tanzanian CPGs, the levels of both usability and applicability were assessed as low or medium. In all three countries, the use of CPGs by health workers in practice was perceived to be limited.Conclusion: Our cross-country study suggests that it is not poor quality of content or lack of evidence base that constitute the major barrier for CPGs to positively impact on quality improvement in maternal care in SSA. It rather emphasises the need to prioritise the format of guidelines to increase their usability and applicability and to consider these attributes together with implementation strategies as integral to their development processes. © 2012 Baker et al; licensee BioMed Central Ltd.
Available Materials
https://efashare.b-cdn.net/share/pmc/articles/PMC3372446/bin/1748-5908-7-31-S1.DOCX
https://efashare.b-cdn.net/share/pmc/articles/PMC3372446/bin/1748-5908-7-31-S2.DOCX
Authors & Co-Authors
Baker, Ulrika
Unknown Affiliation
Tomson, Göran B.
Unknown Affiliation
Somé, Mathias
Unknown Affiliation
Kouyaté, Bocar A.
Unknown Affiliation
Williams, John E.O.
Unknown Affiliation
Mpembeni, Rose N.M.
Unknown Affiliation
Massawe, Siriel Nanzia
Unknown Affiliation
Blank, Antje
Unknown Affiliation
Gustafsson, Lars L.
Unknown Affiliation
Eriksen, Jaran
Unknown Affiliation
Statistics
Citations: 36
Authors: 10
Affiliations: 8
Identifiers
Doi:
10.1186/1748-5908-7-31
e-ISSN:
17485908
Research Areas
Maternal And Child Health
Study Design
Case Study
Study Approach
Qualitative
Study Locations
Burkina Faso
Ghana
Tanzania