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Zahroh, Rana Islamiah
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Hazfiarini, Alya
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Eddy, Katherine E.
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Vogel, Joshua P.
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Tunçalp, Özge
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Minckas, Nicole
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Althabe, Fernando
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Oladapo, Olufemi T.
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Bohren, Meghan A.
dc.date.available
2023-11-15T15:50:45Z
dc.date.issued
2022-08
dc.identifier.citation
Zahroh, Rana Islamiah; Hazfiarini, Alya; Eddy, Katherine E.; Vogel, Joshua P.; Tunçalp, Özge; et al.; Factors influencing appropriate use of interventions for management of women experiencing preterm birth: A mixed-methods systematic review and narrative synthesis; Public Library of Science; Plos Medicine; 19; 8; 8-2022; 1-39
dc.identifier.issn
1549-1277
dc.identifier.uri
http://hdl.handle.net/11336/218196
dc.description.abstract
Background Preterm birth-related complications are the leading cause of death in newborns and children under 5. Health outcomes of preterm newborns can be improved with appropriate use of antenatal corticosteroids (ACSs) to promote fetal lung maturity, tocolytics to delay birth, magnesium sulphate for fetal neuroprotection, and antibiotics for preterm prelabour rupture of membranes. However, there are wide disparities in the rate and consistency in the use of these interventions across settings, which may underlie the differential health outcomes among preterm newborns. We aimed to assess factors (barriers and facilitators) affecting the appropriate use of ACS, tocolytics, magnesium sulphate, and antibiotics to improve preterm birth management. Methods and findings We conducted a mixed-methods systematic review including primary qualitative, quantitative, and mixed-methods studies. We searched MEDLINE, EMBASE, CINAHL, Global Health, and grey literature from inception to 16 May 2022. Eligible studies explored perspectives of women, partners, or community members who experienced preterm birth or were at risk of preterm birth and/or received any of the 4 interventions, health workers providing maternity and newborn care, and other stakeholders involved in maternal care (e.g., facility managers, policymakers). We used an iterative narrative synthesis approach to analysis, assessed methodological limitations using the Mixed Methods Appraisal Tool, and assessed confidence in each qualitative review finding using the GRADE-CERQual approach. Behaviour change models (Theoretical Domains Framework; Capability, Opportunity, and Motivation (COM-B)) were used to map barriers and facilitators affecting appropriate use of these interventions. We included 46 studies from 32 countries, describing factors affecting use of ACS (32/46 studies), tocolytics (13/46 studies), magnesium sulphate (9/46 studies), and antibiotics (5/46 studies). We identified a range of barriers influencing appropriate use of the 4 interventions globally, which include the following: inaccurate gestational age assessment, inconsistent guidelines, varied knowledge, perceived risks and benefits, perceived uncertainties and constraints in administration, confusion around prescribing and administering authority, and inadequate stock, human resources, and labour and newborn care. Women reported hesitancy in accepting interventions, as they typically learned about them during emergencies. Most included studies were from highincome countries (37/46 studies), which may affect the transferability of these findings to low- or middle-income settings. Conclusions In this study, we identified critical factors affecting implementation of 4 interventions to improve preterm birth management globally. Policymakers and implementers can consider these barriers and facilitators when formulating policies and planning implementation or scale-up of these interventions. Study findings can inform clinical preterm birth guidelines and implementation to ensure that barriers are addressed, and enablers are reinforced to ensure these interventions are widely available and appropriately used globally.
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application/pdf
dc.language.iso
eng
dc.publisher
Public Library of Science
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.subject
Preterm birth
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Magnesium
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Sulfates
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Medical risk factors
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Antibiotics
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Women's health
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Preterm labor
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Qualitative studies
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Otras Ciencias de la Salud
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Ciencias de la Salud
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CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
Factors influencing appropriate use of interventions for management of women experiencing preterm birth: A mixed-methods systematic review and narrative synthesis
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info:eu-repo/semantics/article
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info:ar-repo/semantics/artículo
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info:eu-repo/semantics/publishedVersion
dc.date.updated
2023-11-14T14:24:08Z
dc.journal.volume
19
dc.journal.number
8
dc.journal.pagination
1-39
dc.journal.pais
Estados Unidos
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Fil: Zahroh, Rana Islamiah. Melbourne School Of Population And Global Health; Australia
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Fil: Hazfiarini, Alya. Melbourne School Of Population And Global Health; Australia
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Fil: Eddy, Katherine E.. Burnet Institute; Australia
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Fil: Vogel, Joshua P.. Burnet Institute; Australia
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Fil: Tunçalp, Özge. Organizacion Mundial de la Salud; Argentina
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Fil: Minckas, Nicole. Organizacion Mundial de la Salud; Argentina
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Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; Argentina. Organizacion Mundial de la Salud; Argentina
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Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; Argentina
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Fil: Bohren, Meghan A.. Melbourne School Of Population And Global Health; Australia
dc.journal.title
Plos Medicine
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dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/http://dx.doi.org/10.1371/journal.pmed.1004074
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