Rural transport interventions to improve maternal health outcomes

Raje, Fiona ORCID: https://orcid.org/0000-0002-3267-5526 (2018) Rural transport interventions to improve maternal health outcomes. Institute of Development Studies, Brighton.

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Abstract

Rural transport interventions have been shown to improve maternal health outcomes. This rapid review synthesises findings from academic, practitioner, policy and non-governmental organisation (NGO) sources that discuss maternal mortality and transport. The report focusses on evidence on interventions from low- and middle-income countries (LMICs), in Africa and Asia, in particular. While there is descriptive discussion of ideas for transport provision and interventions, there is considerably less reflection on measurable outcomes and reliable evaluation within the literature. As a result, there is limited reliable data on what works, how and why. Key findings from this review include:  Timely treatment is vital to lowering maternal mortality rates  There is limited empirical evidence to show effectiveness in reducing adverse outcomes associated with labour and delivery  A number of transport interventions are available (e.g. motorcycle, bicycle and vehicular ambulances); Communications that complement the transport provision are also important.  Finance schemes (e.g. community-led savings schemes, vouchers) can help facilitate access to maternal healthcare  Public health change can decrease delays associated with accessing timely maternal healthcare  Interventions need to be sensitive to local conditions and circumstances  All interventions cannot be assumed to be successful in facilitating improved healthcare access  There is a need for increased monitoring and evaluation of transport interventions  Non-existence of a transport operational management system can be a major challenge  Procurement of new vehicles and motorbikes is perceived as a solution to challenges faced in managing transport resources in health delivery services  While the importance of improved transport and roads to reducing maternal and child mortality rates is recognised, the failure of transportation services is also an important finding  Since healthcare decision-making is a complex process drawing on multiple factors and perspectives, interventions do not always translate into improved outcomes