Area-based teamwork refers to the systematic interaction between primary health centers (PHCs) and hospitals at the district level. A “district hospital,” in this case, would be defined as a hospital where comprehensive emergency obstetric and newborn care (CEmONC) is consistently provided. PHCs typically provide basic primary health care services, with complicated EmONC cases referred to the district hospital. The systematic interaction between the district hospital and the peripheral units are maintained through mechanisms such as regular meetings for mutual feedback and experience sharing, coaching and supportive supervision visits, and reporting and referral of emergency cases. Experts believe that inter-facility collaboration is a critical factor for improving quality of care in facilities and MNCH outcomes. However, limited published evidence exists on this topic.
To address this gap in the literature, the Bill & Melinda Gates Foundation requested that the START Center review the literature on this topic. The START team took a three-pronged approach to identify evidence linking inter-facility collaboration with improved quality of care and MNCH outcomes. These approaches included searches for evidence in the peer-reviewed literature, the grey literature, and a database provided by Dr. Alex Rowe at the Centers for Disease Control and Prevention. Deliverables presented to the Foundation included a final report summarizing our findings and framework on area-based teamwork for MNCH, an annotated bibliography with 46 articles, and a slide deck covering the literature review findings and the framework we developed.