Skip to main content

Table 4 Interventions for increasing provision of postpartum care in sub-Saharan Africa

From: Interventions to increase facility births and provision of postpartum care in sub-Saharan Africa: a scoping review

Authors, year, Country

Community level intervention

Health system level intervention

Intervention effect

Target

Package

Mode

Actors

Frequency

Target

Package

Mode

Actors

Frequency

Pallangyo et al., 2017, Tanzania [36]

     

Health providers

Training on facilitation skills, supervision, national postpartum care guidelines, priority setting for improving postpartum care

Participatory workshop

Peer trained health providers

[Not reported]

Health providers testified about the increased number of mothers now attending postpartum care: ‘’The number of mothers who are coming for postpartum has gone high…’’. Mothers were reported to sensitize their husbands about postpartum care at health facility: ‘’I have observed great awareness among community members, because even men are accompanying their wives to the [postpartum care] clinic.’’

Djellouli et al., 2017, Burkina Faso, Kenya, Malawi, Mozambique [33]

CHWs & postpartum women

For CHWs: training on postpartum care, promotion of breastfeeding, and FP counseling;

For women: postpartum care, referrals of postpartum complications, FP counseling, promotion of breastfeeding

Individual & group sessions for promotion, [Not reported for the others]

CHWs for care, referrals, promotion; [Not reported for training]

[Not reported]

Health providers & postpartum women

For providers: training on postpartum & FP care;

For women: postpartum care, FP services, promotion of breastfeeding

Clinical mentorship and quality of care reviews (for the training in Malawi), [Not reported for the others]

Health providers for care & promotion; [Not reported for training]

[Not reported]

The bridging function of CHWs between community and health facility increased uptake of postpartum care:

CHWs’ sense of responsibility and motivation was due to community’s trust in them, their sense of belonging to the health facility (training, supervision, and incentives), the visible signs of their connection to the formal sector (uniforms, institution’s bicycles).

The visibility of the ‘bridge’ between CHWs and the health facility reinforced community trust and established connectivity. In Burkina Faso, positive talks by women about the ‘bridge’ increased provision of postpartum care.

Health providers’ motivation to provide postpartum care was not related to the training received, but to an existing pay-for-performance system

Massavon et al., 2017, Uganda [26]

Pregnant women

Awareness raising about the voucher program

Radio and stakeholders meetings

Community volunteers, health providers

[Not reported]

Pregnant women

Transport voucher for delivery

Distribution during ANC

[Not reported]

[Not reported]

1% [N not reported] to 49% [N not reported] in the intervention group versus 13% [N not reported] to 12% [N not reported] in the comparison group that is a difference in differences of 49% higher is the intervention group

Massavon et al., 2017, Uganda [26]

Pregnant women

Awareness raising about the baby kit

Radio and stakeholders meetings

Community volunteers, health providers

[Not reported]

Pregnant women

Baby kits (plastic basin, soap, polythene bag, ½ kg of sugar, a piece of cotton cloth for wrapping the baby)

Distribution during ANC

[Not reported]

[Not reported]

3% [N not reported] to 26% [N not reported] in the intervention group versus 8% [N not reported] to 33% [N not reported] in the control group that is a difference in differences of 2% lower in the intervention group

Obare et al., 2013, Kenya [22]

Pregnant & postpartum women

Voucher for maternal health expenses

Identification of women through a poverty grading tool

Distributors from a voucher management agency

Once

Pregnant and postpartum women

Provision of standard quality services

Routine services

Health providers

Routinely

73% (N = 649) in the intervention group versus 61% (N = 274) in the comparison group; OR: 1.3 (95% CI: 0.9 – 1.8)

Wilunda et al., 2016, Ethiopia [34]

CHWs, village leaders, community

Strengthening sensitization capacity; promotion of free maternal services

Radio broadcasts for promotion, [Not reported for the others]

[Not reported]

[Not reported]

Local health system managers, hospital, health centers, pregnant women

Improving infrastructures, information system, meeting coordination, monitoring; removal of user fees, equipment of maternity wards, training and supervision of CHWs, free ambulance services, care provision

Standard checklists for supervision, routine services for care, [Not reported for the others]

Doctors with Africa, hospital staff (training), health providers (care)

Routinely for care, [Not reported for the others]

34% [N not reported] during the intervention compared to 30% [N not reported] before the intervention; AOR: 1.02 (0.60–1.73)

  1. AOR adjusted odd ratio, OR odd ratio