Frontiers in health services最新文献

{"title":"Patient and family-centered care practices during inter-facility transfer of critically ill children: an exploratory mixed methods study.","authors":"Claire Stucky, Aaron M Scherer, Irene Pantekidis, Caroline Elser, Aditya Badheka, Shilpa C Balikai, Madhuradhar Chegondi, Mitchell A Luangrath, Nehal R Parikh, Priyadarshini R Pennathur, Heather Schacht Reisinger, Christina L Cifra","doi":"10.3389/frhs.2026.1835422","DOIUrl":"10.3389/frhs.2026.1835422","url":null,"abstract":"<p><strong>Introduction: </strong>The inter-facility transfer of a critically ill child to the pediatric intensive care unit (PICU) is a highly stressful time for families. This exploratory study aimed to identify care practices important to patients/families during urgent transfers of children from frontline settings to a higher level of care.</p><p><strong>Methods: </strong>We conducted a mixed methods study using surveys and interviews of parents/guardians of children transferred to a single PICU from external institutions. Participants were surveyed about their perceived importance of transfer-related care practices, specifically those addressing families' understanding of transfer, communication, family presence, and patient/family needs. A subset of parents were interviewed to characterize their transfer experience and identify improvement opportunities.</p><p><strong>Results: </strong>Of 23 patient-parent dyads who consented, 13 parents completed the initial survey, 11 completed the follow-up survey, and four participated in interviews. From the surveys, three care practices were identified as most important to responding families: 1) providing parents/guardians with verbal information about their child's condition, 2) providing patients the ability to request their parents/guardians during transfer, and 3) immediately contacting families with significant patient status changes. Interviews revealed that communication with healthcare teams is a substantial factor affecting families' experience of a smooth vs. stressful inter-facility transfer.</p><p><strong>Conclusions: </strong>In this exploratory study, care practices ensuring that timely information about a child's clinical condition is relayed to their parents/guardians were most important to families of critically ill children undergoing inter-facility transfer to the PICU. Communication between families and healthcare teams plays a significant role in families' experiences of transfer.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1835422"},"PeriodicalIF":2.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting continuous glucose monitoring for people with serious mental illness and type 2 diabetes: a co-design study for a structured intervention.","authors":"Jennifer V E Brown, Olivia Matthias, Jessica Hendon, Ramzi A Ajjan, Najma Siddiqi, Ian Kellar, Peter A Coventry","doi":"10.3389/frhs.2026.1807689","DOIUrl":"10.3389/frhs.2026.1807689","url":null,"abstract":"<p><strong>Introduction: </strong>Individuals with serious mental illness (SMI), such as schizophrenia or bipolar disorder, are at a two- to threefold increased risk of developing type 2 diabetes and face significant health inequalities, including reduced life expectancy. Diabetes self-management in this population is challenging, and existing interventions are poorly suited to their needs. Continuous glucose monitoring (CGM) offers potential benefits but remains underused. This study aimed to co-design a logic model and programme theory for a structured CGM intervention tailored to adults with SMI and type 2 diabetes, as a resource to support the planned future co-production of the content and the implementation of the full intervention.</p><p><strong>Methods: </strong>Using experience-based co-design, this study engaged service users, carers, and healthcare professionals (HCPs) in workshops and discussions to identify challenges and facilitators for CGM use. Participants co-developed an outline of candidate intervention components, which were summarised in a logic model and programme theory. The process included synthesising existing evidence, exploring personas, and mapping CGM user journeys. The draft intervention outline was iteratively refined across multiple sessions.</p><p><strong>Results: </strong>Ten participants (four HCPs, four service users, and two carers) contributed to the co-design process. Barriers identified included limited technical support, accessibility challenges, and a lack of integrated physical and mental healthcare. Key components for a structured CGM intervention include personalised CGM training, flexible delivery methods, ongoing support, and peer networks. The proposed intervention was conceptualised in three phases: set-up, early days, and living with CGM. Participants prioritised flexibility and tailored intervention adjustments, emphasising the importance of addressing both physical and mental health needs concurrently.</p><p><strong>Discussion: </strong>This study demonstrates the feasibility of co-designing interventions with individuals often considered \"hard to reach.\" Our study highlights that people with SMI can take an interest in their physical health and see the potential for CGM to improve diabetes management, provided they receive appropriate and flexible support. Future work will develop and refine the intervention and evaluate its clinical and cost-effectiveness in diverse populations, aiming to address significant unmet needs in diabetes care for this vulnerable group.</p><p><strong>Study registration: </strong>https://osf.io/4ae3g/ (2 February 2024).</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1807689"},"PeriodicalIF":2.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning from the world's oldest continuous culture - the circle of leadership: a new way to support the healthcare workforce.","authors":"Leila Karimi, Dein Vindigni, Karen Hallam, Doa El-Ansary, James Collett, Sophia Xenos, Paul Callaghan","doi":"10.3389/frhs.2026.1888055","DOIUrl":"10.3389/frhs.2026.1888055","url":null,"abstract":"<p><p>Healthcare systems globally face workforce shortages, burnout, and attrition, intensified by the COVID-19 pandemic and the loss of experienced clinicians across disciplines. These pressures are particularly acute within the Aboriginal and Torres Strait Islander health workforce, where culturally unsafe workplaces, limited support structures, and high workloads continue to affect recruitment and retention. This Perspective proposes an Aboriginal-inspired Circular Leadership Model as a culturally grounded and relational approach to strengthening workforce wellbeing, retention, and leadership capacity within healthcare settings. Drawing on Aboriginal ways of knowing, being, and doing, the model integrates principles of kinship, connection, collective responsibility, storytelling, reflection, and shared decision-making. In contrast to traditional hierarchical leadership paradigms, circular leadership positions collective wellbeing at the center of leadership practice and emphasizes peer support, multi-generational learning, culturally safe mentorship, and community connection. This is a conceptual Perspective rather than a systematic review: the paper draws on Indigenous leadership scholarship, collective leadership research, and the healthcare workforce literature to discuss how Aboriginal leadership principles can complement existing approaches. Practical applications, including structured mentorship circles, collective wellbeing practices, and circular decision-making protocols, are presented alongside implementation considerations. The anticipated benefits of the model for wellbeing, retention, and leadership capacity are presented as hypotheses to be tested through the pilot evaluation proposed here, rather than as demonstrated outcomes. The model is offered primarily as a strategy to support and retain the Aboriginal and Torres Strait Islander health workforce; its potential relevance to the broader healthcare workforce is discussed as a secondary and as yet untested possibility.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1888055"},"PeriodicalIF":2.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cultural and religious influences on Arab American healthcare experiences: a qualitative study.","authors":"Mariam Aly, Julie C Dunsmore","doi":"10.3389/frhs.2026.1892061","DOIUrl":"10.3389/frhs.2026.1892061","url":null,"abstract":"<p><p>Immigrants negotiate aspects of their heritage and host cultures to adapt to their new social environment through the acculturation process. This process influences health and well-being in immigrant communities. Arab American immigrants in the United States face unique cultural dynamics that shape their experiences, including healthcare experiences. This study addresses a gap in knowledge about culture as a social determinant of health awareness, healthcare access, and healthcare quality among Arab Americans. Guided by acculturation theory, we conducted thematic analysis of semi-structured interviews with 20 Arab Americans. Themes emerged revealing that culture, religion, and family function as both facilitators and barriers to healthcare. Cultural norms often promote self-care and healthy behaviors, but may discourage seeking medical treatment, particularly for mental health concerns. Religion was described as a flexible influence on healthcare decisions. Participants preferred providers of similar ethnic backgrounds due to perceived cultural understanding, and participant recommendations for providers highlighted the need for improved cultural competency training among healthcare professionals. Research on culturally responsive healthcare and training and policy solutions that enhance providers' cultural responsiveness are needed to improve healthcare experiences for Arab American patients and other immigrant populations.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1892061"},"PeriodicalIF":2.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13533886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financing the transition: a roadmap for sustaining disease control in low- and middle-income countries after the 2025 contraction in development assistance for health.","authors":"Shyamkumar Sriram","doi":"10.3389/frhs.2026.1902705","DOIUrl":"10.3389/frhs.2026.1902705","url":null,"abstract":"<p><p>In 2025, development assistance for health fell by about 21% in a single year, driven largely by a 67% reduction in United States financing, disrupting HIV, tuberculosis, malaria, immunization and maternal health programs across low- and middle-income countries. Modelling indicates millions of avoidable deaths by 2030 if the resulting gap is not filled, yet most recipient governments have not reprioritized budgets or raised domestic revenue in response. This brief argues that the contraction is structural rather than cyclical and sets out a sequenced transition-financing roadmap. It proposes phased, country-led actions: protect frontline services immediately; mobilize domestic revenue through progressive as well as consumption taxes and restructure debt over the medium term; and embed efficiency and pooled procurement under the Lusaka Agenda, without allowing efficiency to substitute for adequate public financing.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1902705"},"PeriodicalIF":2.6,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From data collection to action: environmental health information management practices in eleven municipalities in the east coast of South Africa.","authors":"Siphesihle Siyamukela Masimula, Mpinane Flory Senekane, Nisha Naicker","doi":"10.3389/frhs.2026.1890673","DOIUrl":"10.3389/frhs.2026.1890673","url":null,"abstract":"<p><strong>Background: </strong>The availability of reliable information in the delivery of environmental health services (EHS) is crucial to identifying environmental health threats in communities and deploying targeted interventions. This requires environmental health information management practices and systems to be evaluated from time-to-time to bring efficiency and enable continuous improvement for improved public health outcomes. As a result, this study assesses environmental health information management in municipalities that provide EHS in the east coast of South Africa.</p><p><strong>Methods: </strong>A descriptive quantitative cross-sectional study design was employed, combining an online survey of 105 environmental health practitioners (EHPs) and document reviews across 11 municipalities. Descriptive and inferential statistical analyses were conducted through IBM SPSS Statistics.</p><p><strong>Results: </strong>Findings highlight over-reliance on paper-based data management processes, resulting to data duplication (88.6%) and increased workload (90.5%) for EHPs (<i>p</i> = 0.004). Inadequate training, lack of adequate digital tools (17.1%), inconsistent support (61.9%) and poor feedback (46.6%) impeded effective information utilisation for public health action. The study further underscored the need for improved quality assurance, feedback mechanisms and technical support. Governance, organisational capacity, limited digital infrastructure, and insufficient training emerged as key barriers.</p><p><strong>Conclusion: </strong>Substantial environmental health information management strengthening through digitalisation, improved governance, capacity-building, and stronger quality assurance systems are required. A comprehensive and integrated digital EHIS is needed to improve data quality, information utilisation, and evidence-based environmental health decision-making in South Africa.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1890673"},"PeriodicalIF":2.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastrointestinal bleeding care across hospital and EMS settings in the Almaty region: a cross-sectional survey of organization, practice, and service capacity.","authors":"Sungat Otegen, Mohammad Khoshraftar, Lyudmila S Yermukhanova, Abylai Baimakhanov/Baimahanov, Aruzhan Otegenova Muratkyzy, Altynay Abdu Muratqyzy, Murat Jakanov, Aizat Seidakhmetova, Alireza Afshar","doi":"10.3389/frhs.2026.1918526","DOIUrl":"10.3389/frhs.2026.1918526","url":null,"abstract":"<p><strong>Background: </strong>Gastrointestinal bleeding (GIB), particularly upper gastrointestinal bleeding (UGIB), requires rapid coordination between emergency medical services (EMS) and hospital teams, yet evidence on how service organization affects timeliness and practice is limited in Kazakhstan.</p><p><strong>Aim: </strong>To evaluate the organization of GIB care in Almaty region, with emphasis on clinician knowledge and practice, EMS performance, and organizational features of hospital care.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey between March and October 2024 involving two broad respondent groups and three distinct samples: a hospital-based group comprising 99 inpatient clinicians and 99 hospital representatives, and an EMS group comprising 120 personnel. The three samples completed different questionnaires and were analyzed separately. Descriptive analyses, chi-square or Fisher's exact tests, and exploratory Spearman correlations were used.</p><p><strong>Results: </strong>Inpatient clinicians showed near-universal agreement with guideline-based UGIB management principles, but self-reported adherence was inconsistent. Only 1.0% reported always using validated risk scores, and 99.0% reported only sometimes protecting the airway before endoscopy in patients with active hematemesis and altered mental status. In unadjusted respondent-level analyses, clinicians with ≥5 years of experience more frequently reported adequate training and perceived risk scores as useful (both <i>p</i> < 0.001). In the EMS group, all six respondents reporting arrival within 10 min were in the ≥16-team category (6/58, 10.3%; Fisher's exact <i>p</i> = 0.047). Reported ambulance-team availability showed a modest inverse correlation with continuous arrival time (<i>ρ</i>=-0.277, <i>p</i> = 0.002), while completion of selected examinations and vital-sign assessments differed across team-availability categories (all <i>p</i> < 0.001). All hospital representatives reported 24-hour endoscopist availability, but important elements of written protocol content were reported less consistently.</p><p><strong>Conclusions: </strong>UGIB care in the Almaty region showed consistently described structural endoscopy availability but incomplete protocol content, together with selected inpatient-practice and prehospital differences. The EMS findings were exploratory and require confirmation using operational and patient-level data.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1918526"},"PeriodicalIF":2.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial: Breaks that benefit: international evidence to support innovation in research, policy, and practice around unpaid carer short breaks.","authors":"Diane Seddon, Gillian Toms, Emma Miller, Elizabeth Hanson, Don Williamson, Kate Hogarth, Kim Whitmore","doi":"10.3389/frhs.2026.1932038","DOIUrl":"10.3389/frhs.2026.1932038","url":null,"abstract":"","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1932038"},"PeriodicalIF":2.6,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare utilization patterns and medication burden in post-COVID syndrome: a cross-sectional analysis reveals four phenotypes.","authors":"Jens Hamberger, Linda Kraus, Karin Meissner, Thilo Hinterberger, Thomas Loew, Oliver Schoeffski, Harald Gündel, Steffen Walter, Marc N Jarczok, Katja Weimer","doi":"10.3389/frhs.2026.1838358","DOIUrl":"10.3389/frhs.2026.1838358","url":null,"abstract":"<p><p>Post-COVID syndrome has emerged as a major public health challenge, yet comprehensive characterization of healthcare utilization patterns and medication burden within single cohorts remains limited. This cross-sectional analysis examined baseline data from 76 patients (49 ± 12 years, 62% female) enrolled in a randomized trial of psychosomatic treatment interventions for functional post-COVID syndrome. Participants completed the Health Care Utilization Questionnaire (HCU) assessing physician visits, hospitalizations, alternative healing methods, and other healthcare services over the preceding 12 months. Medication and other preparation (MOP) use was systematically documented and classified using the Anatomical Therapeutic Chemical (ATC) classification system. K-means clustering identified distinct patient phenotypes, and correlations between MOP count and healthcare utilization were examined using Spearman correlation coefficients. Healthcare utilization was universal, with 100% of participants engaging with healthcare services and a mean of 43.5 contacts per year. Medication burden was substantial, with 85.5% taking at least one medication, a mean of 4.57 medications per patient, and polypharmacy (≥5 MOP, all types) present in 39.5% of the cohort (46.1% of patients with any MOP). K-means clustering identified four distinct patient phenotypes: Low Utilizers (64.5%, <i>n</i> = 49), Moderate-High Utilizers (27.6%, <i>n</i> = 21), High-Intensity Users (6.6%), and one outlier. High-Intensity Users demonstrated the most striking profile with 9.60 mean medications, 75.0 total healthcare contacts annually, and mean out-of-pocket costs of €2,881. MOP count showed significant positive correlations with total doctor visits (<i>ρ</i> = 0.471, <i>p</i> < 0.001), total healthcare contacts (<i>ρ</i> = 0.344, <i>p</i> = 0.002), and out-of-pocket costs (<i>ρ</i> = 0.375, <i>p</i> = 0.001). Post-COVID syndrome patients demonstrate high healthcare engagement, substantial medication burden, and meaningful heterogeneity in utilization patterns. The identification of distinct patient clusters and strong correlations between medication burden and healthcare utilization provide insights for developing targeted clinical management strategies. This study is based on a selected clinical cohort, and findings should be interpreted with caution regarding generalizability to the broader post-COVID population. These findings may inform clinical management strategies and health system planning for post-COVID patients.</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1838358"},"PeriodicalIF":2.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and healthcare systems-level interventions for postpartum hemorrhage prevention and management in Nigeria: a systematic review of effectiveness and implementation outcomes.","authors":"Melody Ucho, Princess Okelu, Sarim Faheem, Iretioluwa Adeola, Adwoa Ansong, Dorice Vieira, Nessa Ryan, Joyce Gyamfi, Emmanuel Peprah","doi":"10.3389/frhs.2026.1886853","DOIUrl":"10.3389/frhs.2026.1886853","url":null,"abstract":"<p><strong>Background: </strong>Postpartum hemorrhage (PPH) remains the leading cause of maternal mortality globally and in Nigeria. Although clinical interventions may address PPH, less is known about their implementation within routine health systems. The objective of this systematic review was to synthesize the implementation research outcomes of interventions for PPH prevention and management in Nigeria for healthcare providers and patients.</p><p><strong>Methods: </strong>This systematic review of interventions for PPH in Nigeria searched seven electronic databases (i.e., Embase, Web of Science, MEDLINE, Global Health, Cochrane Library, PubMed, and PAIS) without date restrictions. Peer-reviewed studies reporting implementation and service outcomes, including adoption, sustainability, fidelity, and effectiveness, were included. Data were extracted on intervention type, setting, implementation, service and client outcomes. Risk of bias was assessed and visualized (via ROBVIS tool).</p><p><strong>Results: </strong>Of the 1,255 articles retrieved, 31 met the inclusion criteria, including 20 randomized controlled trials, eight observational, two mixed-methods, and one qualitative study. Most were conducted in tertiary facilities; none exclusively focused on primary-level care. Clinical interventions were mostly reported (<i>n</i> = 25). Evidence suggested comparable effectiveness between misoprostol and oxytocin for low-risk women. Device-based interventions, including the non-pneumatic anti-shock garment, were associated with improved stabilization and reduced mortality. Healthcare Systems-level interventions that include standardized care protocols in clinical management of PPH, particularly multicomponent bundled interventions such as the E-MOTIVE bundle and AMTSL, demonstrated high adoption and were associated with reductions in severe PPH. Implementation outcomes were infrequently reported (5 of 31 articles). Overall risk of bias was low-to-moderate.</p><p><strong>Conclusions: </strong>There was a notable gap in the evaluation and reporting of IS outcomes as well as the assessment of the patient's perspective from the receipt of interventions. Translation of effective PPH interventions may be constrained by limited implementation evaluation in Nigeria, particularly in primary-level care settings. Substantial lack of evidence exists in regions that bear a disproportionately high burden of PPH mortality.</p><p><strong>Systematic review registration: </strong>Open Science Framework (DOI 10.17605/OSF.IO/CYS2M).</p>","PeriodicalId":73088,"journal":{"name":"Frontiers in health services","volume":"6 ","pages":"1886853"},"PeriodicalIF":2.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}