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Cited by 167Health Policy Implementation ScienceGlobal Maternal and Child HealthGlobal Health and Surgery

The DOI matches its Crossref record; 142 of the 146 references it cites were found in a registry or an index.

Travelling models and the challenge of pragmatic contexts and practical norms: the case of maternal health

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Olivier de Sardan, Jean-Pierre, Diarra, Aïssa, Moha, Mahaman·2017·Health Research Policy and Systems
DOI 10.1186/s12961-017-0213-9PMC PMC5516842
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Abstract

As in other areas of international development, we are witnessing the proliferation of 'traveling models' developed by international experts and introduced in an almost identical format across numerous countries to improve some aspect of maternal health systems in low- and middle-income countries. These policies and protocols are based on 'miracle mechanisms' that have been taken out of their original context but are believed to be intrinsically effective in light of their operational devices.In reality, standardised interventions are, in Africa and elsewhere, confronted with pragmatic implementation contexts that are always varied and specific, and which lead to drifts, distortions, dismemberments and bypasses. The partogram, focused antenatal care, the prevention of mother-to-child transmission of HIV or performance-based payment all illustrate these implementation gaps, often caused by the routine behaviour of health personnel who follow practical norms (and a professional culture) that are often distinct from official norms - as is the case with midwives.Experiences in maternal and child health in Africa suggest that an alternative approach would be to start with the daily reality of social and practical norms instead of relying on models, and to promote innovations that emerge from within local health systems.

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Metadata

Authors
Olivier de Sardan, J.-P., Diarra, A., & Moha, M.
Affiliations
Laboratoire d'Études et de Recherche sur les Dynamiques Sociales et le Développement Local (NE)
ORCID
Diarra, Aïssa
Venue
Health Research Policy and Systems
Publisher
Springer Science and Business Media LLC
Published
2017-07
Volume
15
Issue
S1
Pages
60-60
ISSN
1478-4505 (ISSN-L)
DOI
10.1186/s12961-017-0213-9
PMC
PMC5516842
OpenAlex
W2736206036
Cited by
167
References
146
Citations by year
2026: 10 · 2025: 12 · 2024: 18 · 2023: 20 · 2022: 28 · 2021: 18 · 2020: 30 · 2019: 9 · 2018: 16 · 2017: 6
FWCI
2.94
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Health Research Policy and Systems (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
International Development Research Centre
Topics
  • Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Surgery
Keywords
policy transfer, maternal health, implementation gap, practical norms, professional culture, midwives, partograph, focused antenatal care, prevention of mother-to-child transmission of HIV, performance-based pay, low- and middle-income countries, Africa
MeSH terms
Maternal Health, Africa, Community Health Workers, Female, Health Services Accessibility, Humans, Maternal Health Services, Midwifery, Pregnancy, Prenatal Care

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