高收入国家孕产妇、新生儿、儿童和青少年健康的有效覆盖测量与级联：系统评价
Effective coverage measurements and cascade for maternal, newborn, child and adolescent health in high-income countries: systematic review.
作者信息
Zanette Marianna, Konstantinou Georgia, Exley Josephine, Jackson Debra, Lazzerini Marzia
机构信息
Institute for Maternal and Child Health IRCCS Burlo Garofolo, World Health Organization (WHO) Collaborating Centre (CC) for Maternal and Child Health, Trieste, Italy.
London School of Hygiene & Tropical Medicine, London, UK.
出版信息
J Glob Health. 2025 Jun 20;15:04178. doi: 10.7189/jogh.15.04178.
BACKGROUND
The concept of 'effective coverage' (EC) aims to combine the concept of coverage with the quality of care delivered and, ultimately, the health benefits received by the population in need. To date, systematic reviews of EC of maternal, newborn, child and adolescent health (MNCAH) have focused on low- and middle-income countries (LMICs). No review has examined whether and how the concept has been applied in high-income countries (HICs). To address this gap, this systematic review investigated the application of EC measures in MNCAH care in HICs.
METHODS
This was a systematic review that followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) reporting guidelines. The search strategy was developed from previous EC reviews conducted in LMICs and further adapted to the HIC setting. Additional search terms were identified through discussion with experts from the Life Stage Quality of Care Metrics Technical Working Group subgroup on EC. We searched three databases, PubMed, Embase, and Web of Science, over 10 years. We conducted additional searches in Google Scholar and by consulting members of the Life Stage Quality of Care Metrics Technical Working Group. We did not pose any language or type of article limits.
RESULTS
The database search identified 18 976 studies for screening. Of these, 672 abstracts were screened, and none of the full texts considered met our inclusion criteria (e.g. human immunodeficiency virus/hepatitis c virus continuum of care cascade, intervention type, qualitative search-interviews/questionnaire type studies). Thirty-two articles were retrieved through the additional search strategies, and none were included because of LMIC-focused research. Therefore, examples of EC of MNCAH care applied in HICs were not identified.
CONCLUSIONS
Further investigation should be conducted into the application of the EC concept for assessing MNCAH care in HICs. This research will help us understand how this concept can be used to support health system effectiveness, efficiency, and equity in HICs.
REGISTRATION
The study protocol was registered at the Open Science Framework: https://doi.org/10.17605/OSF.IO/FMCG8.
背景
“有效覆盖”（EC）的概念旨在将覆盖范围的概念与所提供的医疗服务质量以及最终有需要人群所获得的健康益处相结合。迄今为止，对孕产妇、新生儿、儿童和青少年健康（MNCAH）有效覆盖的系统评价主要集中在低收入和中等收入国家（LMICs）。尚无评价考察该概念在高收入国家（HICs）是否以及如何应用。为填补这一空白，本系统评价调查了有效覆盖措施在高收入国家MNCAH护理中的应用情况。
方法
这是一项遵循系统评价和Meta分析的首选报告项目（PRISMA）报告指南的系统评价。检索策略基于先前在低收入和中等收入国家进行的有效覆盖评价制定，并进一步适用于高收入国家的情况。通过与生命阶段医疗质量指标技术工作组有效覆盖子组的专家讨论确定了额外的检索词。我们在10年期间检索了三个数据库，即PubMed、Embase和Web of Science。我们还在谷歌学术上进行了额外检索，并咨询了生命阶段医疗质量指标技术工作组的成员。我们没有设置任何语言或文章类型限制。
结果
数据库检索识别出18976项研究以供筛选。其中，筛选了672篇摘要，没有一篇纳入的全文符合我们的纳入标准（例如，艾滋病毒/丙型肝炎病毒连续护理级联、干预类型、定性搜索访谈/问卷调查类型研究）。通过额外的检索策略检索到32篇文章，由于这些研究主要聚焦于低收入和中等收入国家，均未被纳入。因此，未找到高收入国家应用MNCAH护理有效覆盖的实例。
结论
应进一步调查有效覆盖概念在评估高收入国家MNCAH护理方面的应用。这项研究将帮助我们了解如何利用这一概念支持高收入国家卫生系统的有效性、效率和公平性。
注册情况
该研究方案已在开放科学框架注册：https://doi.org/10.17605/OSF.IO/FMCG8
Zotero 插件