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A systematic review and thematic synthesis of qualitative studies on maternal emergency transport in low‐ and middle‐income countries
Author(s) -
Wilson Amie,
Hillman Sarah,
Rosato Mikey,
Skelton John,
Costello Anthony,
Hussein Julia,
MacArthur Christine,
Coomarasamy Arri
Publication year - 2013
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2013.03.030
Subject(s) - cinahl , medicine , cochrane library , thematic analysis , medline , language barrier , qualitative research , poison control , nursing , medical emergency , psychological intervention , alternative medicine , political science , social science , sociology , law , pathology
Abstract Background Most maternal deaths are preventable with emergency obstetric care; therefore, ensuring access is essential. There is little focused information on emergency transport of pregnant women. Objectives The literature on emergency transport of pregnant women in low‐ and middle‐income countries (LMICs) was systematically reviewed and synthesized to explore current practices, barriers, and facilitators for transport utilization. Search strategy MEDLINE, EMBASE, BNI, Cochrane Library, CINAHL, African Index Medicus, ASSIA, QUALIDATA, RHL, and Science Citation Index (inception to April 2012) were searched without language restriction. Selection criteria : Studies using qualitative methodology and reporting on emergency transportation in LMICs were included. Data collection and analysis Thematic framework and synthesis through examination and translation of common elements were used to analyze and synthesize the data. Main results Twenty‐nine articles were included. Eight major themes were identified: time for transport; transport options; geography; local support; autonomy; culture; finance; and ergonomics. Key issues were transport availability; transport speed; terrain; meteorology; support; dependence for decision making; cultural issues; cost; and lack of safe, comfortable positioning during transport. Conclusion Themes should be appreciated within local contexts to illuminate barriers and facilitators. Potential solutions include motorcycle ambulance programs, collaboration with taxi services, community education, subsidies, and vehicle maintenance.