Identifying implementation research priorities for the ENAP (Every Newborn Action Plan) and EPMM (Ending Preventable Maternal Mortality) networks: mixed-methods study in six Asian countries

Abstract Background The ENAP and EPMM, now unified as Every Woman Every Newborn Everywhere (ENEW), are multi-partner and multi-country networks to end preventable maternal, neonatal mortality, morbidity, and stillbirth, primarily led by United Nations agencies. Several authors promote implementation research (IR) as a key step in adapting maternal-newborn health (MNH) strategies and programmes to different contexts. This study aimed to identify key interventions requiring further IR to improve MNH with high quality of care (QoC) in six Asian countries within the ENAP/EPMM networks by combining data from a literature review and implementers’ opinions. Methods Six countries were selected based on predefined criteria. The study employed a multistep process. First, MNH data and national key documents related to MNH and targets were assessed to understand the country’s health situation and potential policy gaps in promoting high QoC. In parallel, a scoping literature review of MNH care in each country identified, through an inductive qualitative analysis, preliminary key interventions for MNH that require further IR. These were subsequently validated through key stakeholder interviews. Results Based on the document review, all countries were far from reaching the ENAP/EPMM 2030 goals, except for the Philippines. The literature review screened 780 articles and included 356 from all countries, which identified the preliminary IR priorities. After the result validation with stakeholders, several strategies for MNH, shared by more than one country, were identified for further IR as interventions to 1) improve workforce competencies, like employing mobile health (mHealth) technologies, and 2) increase equity in access to care with Community Health Worker (CHW) programmes, which were also helpful in facilitating other IR priorities. Additional IR priorities included interventions to promote 3) respectful maternal care, 4) maternal psychological well-being, 5) contraception access, 6) institutional care with community awareness and husband inclusion in MNH care, 7) malpractice prevention, and 8) caesarean section regulation. Conclusion Identified key interventions for MNH requiring further IR can inform researchers and policymakers. The study provides a model for identifying IR priorities, combining evidence reviews with the perspectives of key implementers.