Abstract
An important component of quality of care is the use of evidence-based practices. Three studies from three different continents (Africa, Asia and Latin America) have reported the suboptimal use of evidence - based interventions in obstetric care, proving that despite scientific evidence and dissemination efforts, there are harmful and/or unnecessary procedures still used, while others that are beneficial are ignored. This illustrates the existing bridges and barriers between practice guidelines based on research findings and practitioners. A theoretical framework could help explain these barriers and possibly help target interventions to specific barriers. A review of existing literature shows that an intervention aimed to increase the use of evidence-based practices should have the following components: increase birth attendant concern about the effectiveness of routine clinical practices, stimulate their desire to review the effectiveness of their practice, provide them with skills to perform evidence based clinical guidelines appraisal and development and establish mechanisms through key hospital leaders to implement the guidelines and sustain them over time.
Keywords: episiotomy, active dissemination, evidence-based medicine, antidiarrheal, Transtheoretical Model (TTM), IVF, ICSI, malformations, children anomalies
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