UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland.
J Glob Health. 2021 Dec 30;11:04076. doi: 10.7189/jogh.11.04076. eCollection 2021.
Antenatal care (ANC) and postnatal care (PNC) are critical opportunities for women, babies and parents/families to receive quality care and support from health services. Community-based interventions may improve the accessibility, availability, and acceptance of this vital care. For example, community mobilization strategies have been used to involve and collaborate with women, families and communities to improve maternal and newborn health.
To synthesize existing reviews of evidence on community mobilization strategies that strengthen support for appropriate and timely use of ANC and PNC.
Six databases (MEDLINE, Embase, CINAHL, PsychINFO, Cochrane Library, PROSPERO) were searched for published reviews that describe community mobilization related strategies for ANC and/or PNC. Reviews were eligible for inclusion if they described any initiatives or strategies targeting the promotion of ANC and/or PNC uptake that included an element of community mobilization in a low- or middle-income country (LMIC), published after 2000. Included reviews were critically appraised according to the Joanna Briggs Institute (JBI) Checklist for Systematic Reviews and Evidence Syntheses. This review of reviews was conducted following JBI guidelines for undertaking and reporting umbrella reviews.
In total 23 papers, representing 22 reviews were included. While all 22 reviews contained some description of community mobilization and ANC/PNC, 13 presented more in-depth details on the community mobilization processes and relevant outcomes. Seventeen reviews focused on ANC, four considered both ANC and PNC, and only one focused on PNC. Overall, 16 reviews reported at least one positive association between community mobilization activities and ANC/PNC uptake, while five reviews presented primary studies with no statistically significant change in ANC uptake and one included a primary study with a decrease in use of antenatal facilities. The community mobilization activities described by the reviews ranged from informative, passive communication to more active, participatory approaches that included engaging individuals or consulting local leaders and community members to develop priorities and action plans.
While there is considerable momentum around incorporating community mobilization activities in maternal and newborn health programs, such as improving community support for the uptake of ANC and PNC, there is limited evidence on the processes used. Furthermore, the spectrum of terminology and variation in definitions should be harmonized to guide the implementation and evaluation efforts.
产前护理（ANC）和产后护理（PNC）是妇女、婴儿和父母/家庭获得高质量医疗服务的关键机会。基于社区的干预措施可以提高这种重要护理的可及性、可用性和接受度。例如，社区动员策略已被用于让妇女、家庭和社区参与并合作，以改善母婴健康。
综合现有关于强化 ANC 和 PNC 适当及时使用支持的社区动员策略的证据综述。
在 MEDLINE、Embase、CINAHL、PsychINFO、Cochrane 图书馆、PROSPERO 六个数据库中搜索描述与 ANC 和/或 PNC 相关的社区动员策略的已发表综述。如果综述描述了任何以促进 ANC 和/或 PNC 采用为目标的举措或策略，并且包含了在中低收入国家（LMIC）进行的社区动员元素，且发表于 2000 年后，则符合纳入标准。纳入的综述根据 Joanna Briggs 研究所（JBI）系统评价和证据综合清单进行严格评价。本综述遵循 JBI 开展和报告伞状综述的指南。
共纳入 23 篇论文，代表 22 篇综述。虽然所有 22 篇综述都包含了一些关于社区动员和 ANC/PNC 的描述，但 13 篇综述更深入地介绍了社区动员过程和相关结果。17 篇综述专注于 ANC，4 篇综述同时考虑 ANC 和 PNC，只有 1 篇综述专注于 PNC。总体而言，16 篇综述报告了社区动员活动与 ANC/PNC 采用之间至少存在一个正相关，而 5 篇综述报告了初级研究中 ANC 采用率没有统计学意义的变化，1 篇综述包含了初级研究中产前保健设施使用率下降的情况。综述中描述的社区动员活动范围从信息性、被动沟通到更积极、参与式的方法，包括让个人或咨询当地领导人和社区成员参与，以制定优先事项和行动计划。
虽然在孕产妇和新生儿健康计划中纳入社区动员活动的势头强劲，例如提高社区对 ANC 和 PNC 的支持，但关于所使用的过程，证据有限。此外，术语的范围和定义的差异应加以协调，以指导实施和评估工作。
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