van der Werf Laura, Evers Silvia, Prieto-Pinto Laura, Samacá-Samacá Daniel, Paulus Aggie
Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, NL.
Centre for Economic Evaluation and Machine Learning, Netherlands Institute of Mental Health and Addiction, Trimbos Institute, Utrecht, NL.
Int J Integr Care. 2022 Jun 22;22(2):26. doi: 10.5334/ijic.6254. eCollection 2022 Apr-Jun.
Ineffective organisation of care leads to increased morbidity and mortality in neonates and their mothers. We aimed to identify and describe strategies used in low- and middle-income countries that attempt to deliver coherent, coordinated, and continuous services (i.e., integrated care) and how the various strategies affect the organisation of care.
We conducted a systematic literature review to identify, appraise, and synthesise relevant evidence about strategies for integrating maternal care in low- and middle-income countries, searching multiple electronic databases.
Fourteen studies met our inclusion criteria. We identified five types of integration strategies: 1) organisational, 2) service/professional, 3) functional, 4) organisational combined with normative strategies, and 5) clinical combined with functional integration strategies. The most frequent types of strategies were organisational, and service/professional integration strategies. We did not identify any publications describing systemic integration strategies implemented in low- and middle-income countries.
Most types of strategies described in theory have been implemented and studied in low- and middle-income countries. Our findings suggest that different types of strategies may lead to comparable organisational outcomes. For example, organisational integration strategies and professional or service integration strategies may similarly influence inter-organisational collaboration. Inter-organisational collaboration may play a particularly important role in the context of maternal care integration.
护理组织不力会导致新生儿及其母亲的发病率和死亡率上升。我们旨在识别和描述低收入和中等收入国家为提供连贯、协调和持续服务（即综合护理）所采用的策略，以及各种策略如何影响护理组织。
我们进行了一项系统的文献综述，以识别、评估和综合有关低收入和中等收入国家孕产妇护理整合策略的相关证据，检索了多个电子数据库。
14项研究符合我们的纳入标准。我们确定了五种整合策略类型：1）组织层面的，2）服务/专业层面的，3）功能层面的，4）组织层面与规范策略相结合的，5）临床层面与功能整合策略相结合的。最常见的策略类型是组织层面的和服务/专业层面的整合策略。我们未发现任何描述在低收入和中等收入国家实施的系统整合策略的出版物。
理论上描述的大多数策略类型已在低收入和中等收入国家得到实施和研究。我们的研究结果表明，不同类型的策略可能会带来类似的组织成果。例如，组织整合策略和专业或服务整合策略可能同样会影响组织间的协作。组织间协作在孕产妇护理整合背景下可能发挥特别重要的作用。
