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In this region, where targeting investment is of paramount importance to health outcomes, our analysis of reasons for delivering at home suggests that the motivations for delivering outside of facilities may be primarily social and cultural.
With the majority of the world's women delivering outside of tertiary facilities and without skilled attendants, there may be greater implications for public health in a study conducted outside the tertiary care level.
However, the main barriers to encouraging mobility appeared to be providers' concern over the safety of women who are mobile, their lack of control and their fear of women delivering outside of the labour ward; others suggested that overcrowding on labour wards made it difficult to allow women to get out of bed.
For example, although the population delivering outside of medical supervision is very low (less than 2%), it is notably higher among those who register their births late (5%) and the latter situation may apply differentially by ethnic group status, since many Mapuche live in isolated rural communities.
The international maternal health community's strategy to achieve this goal has primarily focused on increasing access to skilled birth attendants (SBAs) and emergency obstetric care (EmOC), but women delivering outside of health facilities have largely not benefited from these efforts [ 5].
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There is also new evidence that education technology delivered outside of schools — online courses, for example — is steadily improving.
Higher education that is effective and cheap and flexible and accessible from anywhere in the world is as good a good as technology is likely to deliver, outside of miracle cures.
But he added that NHS England was confident that the major changes outlined in October in its Five Year Forward View blueprint for the service's future, including an unprecedented build up of services delivered outside of hospitals, would help the NHS remain viable.
He will on Wednes day begin to sketch out his views on what a radical NHS overhaul would look like – including an improvement of services delivered outside of hospitals and a focus on keeping older people in better health – when he addresses about 2,000 NHS leaders gathered for the NHS Confederation's annual conference in Liverpool.
For patients willing to attend a centre-based group programme, pulmonary rehabilitation is an effective intervention.30,31 Self-management interventions overall may need greater personalisation, as not all people benefit from the current approaches,32,33 and our evidence suggests that these services should be delivered outside of usual primary care.
This has taken shape in experiments with flipped classrooms (an instructional strategy where educational content is delivered outside of the classroom, while activities traditionally considered "homework" move into the classroom), as well as a heavy emphasis on group work and peer collaboration.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com