Table 2 Implementation factors linked to systematic review outcomes
Studies from systematic review that report overall improvement in care seeking outcomes | Findings from synthesis of factors influencing implementation | ||
|---|---|---|---|
Author, year | Country, setting | Facilitating factors critical to successful outcomes | Barriers to successful outcomes |
Fauveau et al., 1991 [6] | BANGLADESH, rural Matlab | Collaborative working between trained midwives, nurse-midwives, CHW’s and TBAs - Integration of TBAs into a ‘referral chain’ working with skilled personnel | - Continued adherence to traditionalism and traditional practices - Men as main decision-makers in the family may be unwilling to seek external assistance |
Frankenberg et al., 2009 [4] | INDONESIA | - Collaborative relationships with TBAs identified as a duty of trained midwives posted in villages | - Greater degree of traditionalism in some villages where trained midwife posted |
Gabrysch et al., 2009 [19] | PERU, Ayacucho rural Santillana district | - Adopting a participatory approach including TBAs and family members to design culturally appropriate childbirth services - TBAs accommodated as birth companions to help with pushing and giving drinks and to provide a culturally appropriate facility birth - TBAs involved in capacity building workshops with other health workers | - Providers continuing to ascribe high levels of home births as due to ‘cultural preference’ or ‘ignorance’ rather than offering culturally accessible services |
Mullany et al., 2010 [7] | MYANMAR, Shan, Mon, Karen, and Karenni regions | - Integration of TBA into a 3 tiered network of community based providers - Training of HWs and TBAs to strengthen their working relationship - TBAs used to create links between community members and senior health workers - TBAs used to provide improved ANC - Supervision of TBA role a responsibility of MHWs | Â |
Purdin et al., 2009 [13] | PAKISTAN, Hangu district, Afghan refugee camp | - TBAs provided with reproductive health (RH) training along with other community members - TBAs active in awareness raising, including RH | Â |
Ronsmans et al., 2001 [5] | INDONESIA, three districts in South Kalimantan | - Village midwives encouraged to strengthen their relationships with TBAs - TBAs identified as one of several ‘key decision-makers’ - TBAs involved in accessing information, education and communication (IEC) materials for community use |  |