Barriers to implementing guideline recommendations to improve childbirth care: a rapid review of evidence

• Published in: Revista Panamericana de Salud Pública
• Main Authors: Cintia de Freitas Oliveira, Aline Ângela Victoria Ribeiro, Cézar D. Luquine Jr., Maritsa Carla de Bortoli, Tereza Setsuko Toma, Evelina Maria Gracia Chapman, Jorge Otávio Maia Barreto
• Format: Article in Journal/Newspaper
• Language: English; Spanish; Portuguese
• Published: Pan American Health Organization 2021
• Subjects: evidence-informed policy; implementation science; practice guidelines as topic; parturition; brazil; Medicine; R; Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic
• Online Access: https://doi.org/10.26633/RPSP.2021.7; https://doaj.org/article/b29946cea88b4396a4ef9e97db854017

Objective. To identify potential barriers to the implementation of the National Childbirth Guidelines in Brazil based on the best available global evidence. Method. A rapid review of evidence was performed in six databases in March/April 2019. Secondary studies published in English, Spanish, or Portuguese with a focus on barriers of any nature relating to the implementation of the Guidelines were retrieved. Results. Twenty-three documents (21 reviews and two practice guides) were included in the review. The barriers identified were grouped into 52 meaning categories and then reorganized into nine thematic clusters: delivery and childbirth care model, human resource management, knowledge and beliefs, gender relations, health care service management, attitudes and behaviors, communication, socioeconomic conditions, and political interests. Conclusions. The results show that combined approaches may be required to address different barriers to the implementation of the Guidelines. For successful implementation, it is essential to engage health care leaders, professionals, and users in the effort to change the delivery and childbirth care model. Also necessary is the development of intersectoral initiatives to improve the socioeconomic conditions of women and families and to curtail gender inequalities.