Developing Measures of Care Coordination for Maternal and Newborn Health Services in Developing Countries: The Gambia as a Test Case Public Deposited

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  • March 20, 2019
Creator
  • Oyerinde, Koyejo
    • Affiliation: Gillings School of Global Public Health, Department of Health Policy and Management
Abstract
  • Annually, 350,000 women die of pregnancy complications and about a million babies die during delivery in low and middle-income countries (LMICs). The healthcare system in The Gambia and in most LMICs requires a process of assigning patients to appropriate levels of care. By monitoring care coordination, lapses in the continuum of care can be addressed to improve health outcomes. Specific aims: 1. To identify the principal components of care coordination for maternal and newborn health services 2. To develop measures of coordination of care 3. To evaluate the perceptions of feasibility of routine monitoring of care coordination Literature review revealed that care coordination has not featured prominently in the discourse of maternal and newborn health service delivery in LMICs. Rate of transfer, and time to care were common measures in literature. Study methods: (1) a single panel, 2-round Nominal Group Technique (NGT) for concept development and (2) key informant interviews (KIIs) to assess the feasibility of routine monitoring of care coordination in The Gambia. Audio recordings of interviews were transcribed into text and exported into WEFT QDA for data processing and content analysis. The consensus among NGT panelists and key informants was that care coordination was essential in LMICs health systems and its monitoring is desirable. Key informants agreed that improvements in infrastructure and capacity development for health personnel were needed to support routine monitoring of care coordination. Most informants thought that data should initially be collected in regular surveys rather than through the HMIS and that a pilot study was needed. A guiding coalition of local maternal and child health experts and civil society will lead the modification of policies and the development of new tools and processes, and communicate the benefits of the new policy to the general public. Effective care coordination is essential in a multi-tiered health system. It should be monitored and weaknesses should be addressed to improve maternal and child health survival in LMICs.
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  • In Copyright
Advisor
  • Thirumurthy, Harsha
  • Weiner, Bryan
  • Maggwa, Baker
  • Skinner, Asheley
  • Petersen, Herbert
Degree
  • Doctor of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2016
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