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British Medical Bulletin 67:73-83 (2003)
© 2003 Oxford University Press
Promoting standards for quality of maternal health care
HRP—UNDP/UNFPA/WHO/World Bank Special Programme on Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
Correspondence to: A Metin Gülmezoglu, HRP—UNDP/UNFPA/WHO/World Bank Special Programme on Research, Development and Research Training in Human Reproduction, Department of Reproductive Health and Research, World Health Organization, Avenue Appia 20, Geneva 27, CH-1211 Switzerland. E-mail: gulmezoglum{at}who.int
Evidence-based health care with its emphasis on the need for searching, retrieving, summarizing and utilizing the best available evidence in decision-making has become essential in setting standards. Accordingly, maternity care standards should be based on best available evidence identified through systematic reviews of the literature. Promotion of standards relies on access to information, active strategies to facilitate professional behaviour change and efforts to sustain the change. Access to information is essential but insufficient to improve standards on its own. Changing professional behaviour is not accomplished easily. Active strategies based on the nature of the health care problem and an evaluation of the barriers that are likely to operate against change are required to influence professional behaviour. Once implemented, the standards should be regularly monitored and revised as new evidence becomes available.