Stephen Kennedy, Hannah Knight

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Seeking barriers and solutions through global
crowd-sourcing

• Stephen Kennedy, Hannah Knight José Villar
• Nuffield Department Obstetrics and Gynaecology
• Oxford Maternal Perinatal Health Institute
• University of Oxford

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• To help reduce maternal morbidity and mortality
  globally, we aim to
• identify barriers to implementing effective,
  affordable interventions
• disseminate potential evidence-based solutions to
  the barriers

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• To help reduce maternal morbidity and mortality
  globally, we aim to
• identify barriers to implementing effective,
  affordable interventions
• disseminate potential evidence-based solutions to
  the barriers

• Conduct an online questionnaire amongst 10,000
  stakeholders (principally users and
  policy/decision makers) in developing countries.

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• BACKGROUND
• safe, effective and affordable interventions
  exist to reduce maternal morbidity and mortality
• not consistently used in developing countries
• views of providers at local level rarely sought,
  and not considered in planning global efforts to
  improve maternal health
• web-based survey as major departure from
  traditional approaches
• reach out to providers never previously consulted
• allow consultation on a global scale
• facilitate rapid responses and suggestions for
  implementation

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Crowdsourcing well-established method to
explore problems and identify solutions, from a
large online community (the crowd) rapidly and at
minimal cost.
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• Engage 10,000 respondents (users and
  policy/decision makers)
• MHTF organizations, FIGO, RCOG, WHO etc.
• Wide range of providers and regional
  representation

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• Engage 10,000 respondents (users and
  policy/decision makers)
• MHTF organizations, FIGO, RCOG, WHO etc.
• Wide range of providers and regional
  representation
• Disseminate effective interventions summary paper
• Most important causes maternal morbidity and
  mortality

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• Engage 10,000 respondents (users and
  policy/decision makers)
• MHTF organizations, FIGO, RCOG, WHO etc.
• Wide range of providers and regional
  representation
• Disseminate effective interventions summary paper
• Most important causes maternal morbidity and
  mortality
• Invite respondents to complete short, online
  questionnaire
• Demographic details (e.g. professional
  background)
• Perceived barriers preventing application of
  practices recommended in summary paper
• Highlight local problems and invite potential
  solutions

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• Examples of specific questions
• Are the interventions being implemented, as
  recommended, in your specific setting?
• If not, why not? (specified for each
  intervention)
• At what level do the barriers exist (clinical
  level, community level, policy environment)?
• Which interventions/actions would help you
  overcome the barriers now and in the medium/long
  term?
• Which other gaps are known to you, but not listed
  in the survey, that might improve maternal
  outcomes?
• Which interventions would help you overcome these
  other barriers?
• How can the global/regional community better
  support your efforts?

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• Classification of survey responses
• Aggregated results published on web-site
• Stratified by region, type of service,
  demographics etc.

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• Classification of survey responses
• Aggregated results published on web-site
• Stratified by region, type of service,
  demographics etc.
• Generic responses to common problems/uncertainties
  
• Known solutions directed to evidence-based best
  practice
• http//www.library.nhs.uk/womenshealth
• Uncertain solutions referred to the crowd and
  to MHTF members for generalized responses

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• Classification of survey responses
• Aggregated results published on web-site
• Stratified by region, type of service,
  demographics etc.
• Generic responses to common problems/uncertainties
  
• Known solutions directed to evidence-based best
  practice
• http//www.library.nhs.uk/womenshealth
• Uncertain solutions referred to the crowd and
  to MHTF members for generalized responses
• Follow-up online questionnaire at 1 year
• Determine usefulness of process and whether
  problems and uncertainties still exist

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• SUMMARY
• We aim to give a direct voice to the very large
  global community of stakeholders in developing
  countries who are interested in reducing maternal
  morbidity and mortality, as soon as possible, by
  
• identifying the main barriers impeding the use of
  best practices and potential solutions.
• disseminating potential, generic solutions that
  might be enacted at a local level in months, not
  decades.

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Acknowledgements