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Mohammadkhani N. Translation and adaptation of the person-centered maternity care scale to a Persian-speaking population: a confirmatory factor analysis. BMC Public Health 2024; 24:1619. [PMID: 38886704 PMCID: PMC11184814 DOI: 10.1186/s12889-024-19117-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Recognized as the most exhaustive multidimensional evaluation of women's person-centered experiences during childbirth, the Person-Centered Maternity Care (PCMC) Scale offers domain-specific insights into facets of care. This instrument has yet to be translated into Persian. Hence, this study purposed to translate and ascertain the reliability and validity of a Persian version of the PCMC scale for postpartum women in Iran. METHODS A cross-sectional study was facilitated at multiple comprehensive health centers within Tehran, Iran, from February 2022 until July 2022. Postpartum women within seven days after childbirth who were referred to selected comprehensive health centers for newborn thyroid screening were conveniently sampled. The validation process for the questionnaire utilized confirmatory factor analysis (CFA), while it gauged convergent validity via factor loads, average variance extracted (AVE), along with composite reliability (CR). Discriminant credibility was evaluated utilizing HTMT alongside the Fornell-Larcker Criteria. Data analysis procedures were conducted through IBM SPSS Statistics for Windows Version 16 and SMART PLS Statistics for Windows Version 4.0.9.9. RESULTS All the items were within the acceptable range of factor loading, except for questions 3 of the facility and 6 of dignity, which were removed from the model. The AVE values for all the variables were above 0.50, and the CR values were above 0.78, indicating convergent validity. On the horizontal loading table, all of the indicators met the conditions. Additionally, the findings validate that the HTMT indicator associated with all constructs remained below 0.9, which confirms divergent relevance about the survey tool under consideration. The composite reliability values also indicated good overall reliability for all the constructs, ranging from 0.78 to 0.91. CONCLUSIONS The results of the present study indicate that the Persian version of the PCMC is a reliable and valid tool for measuring person-centered maternity care in Persian-speaking populations.
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Affiliation(s)
- Nafiseh Mohammadkhani
- Department of Nursing and Midwifery, Iran , University of Medical Science, Tehran, Iran.
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Manalai P, Ansari N, Tappis H, Kim YM, Stekelenburg J, van Roosmalen J, Currie S. Women's experience of childbirth care in health facilities: a qualitative assessment of respectful maternity care in Afghanistan. BMC Pregnancy Childbirth 2024; 24:48. [PMID: 38200450 PMCID: PMC10777596 DOI: 10.1186/s12884-023-06234-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Respectful maternity care (RMC) remains a key challenge in Afghanistan, despite progress on improving maternal and newborn health during 2001-2021. A qualitative study was conducted in 2018 to provide evidence on the situation of RMC in health facilities in Afghanistan. The results are useful to inform strategies to provide RMC in Afghanistan in spite of the humanitarian crisis due to Taliban's takeover in 2021. METHODS Focus group discussions were conducted with women (4 groups, 43 women) who had used health facilities for giving birth and with providers (4 groups, 21 providers) who worked in these health facilities. Twenty key informant interviews were conducted with health managers and health policy makers. Motivators for, deterrents from using, awareness about and experiences of maternity care in health facilities were explored. RESULTS Women gave birth in facilities for availability of maternity care and skilled providers, while various verbal and physical forms of mistreatment were identified as deterrents from facility use by women, providers and key informants. Low awareness, lack of resources and excessive workload were identified among the reasons for violation of RMC. CONCLUSION Violation of RMC is unacceptable. Awareness of women and providers about the rights of women to respectful maternity care, training of providers on the subject, monitoring of care to prevent mistreatment, and conditioning any future technical and financial assistance to commitments to RMC is recommended.
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Affiliation(s)
| | | | - Hannah Tappis
- Jhpiego - Johns Hopkins University Affiliate, Baltimore, USA
| | - Young Mi Kim
- Jhpiego - Johns Hopkins University Affiliate, Baltimore, USA
| | - Jelle Stekelenburg
- Department of Health Sciences, Global Health Unit, University Medical Centre Groningen, Groningen, Netherlands
| | | | - Sheena Currie
- Jhpiego - Johns Hopkins University Affiliate, Baltimore, USA
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Vallely LH, Shalit A, Nguyen R, Althabe F, Pingray V, Bonet M, Armari E, Bohren M, Homer C, Vogel JP. Intrapartum care measures and indicators for monitoring the implementation of WHO recommendations for a positive childbirth experience: a scoping review. BMJ Open 2023; 13:e069081. [PMID: 37993161 PMCID: PMC10668293 DOI: 10.1136/bmjopen-2022-069081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 09/29/2023] [Indexed: 11/24/2023] Open
Abstract
OBJECTIVE We aimed to identify all available studies describing measures or indicators used to monitor 41 intrapartum care practices described in the 2018 WHO intrapartum care recommendations, with a view to informing development of standardised measurement of implementing these recommendations. DESIGN Systematic scoping review. METHODS We conducted a scoping review to identify studies reporting measures of intrapartum care published between 1 January 2000 and 28 June 2021. Primary and secondary outcome measures included study characteristics (publication year, journal, country and World Bank classification) and intrapartum care measure characteristics (definition, numerator, denominator, measurement level and measurement approach). We searched MEDLINE, EMBASE, CINAHL, Cochrane Library, the Maternity and Infant Care Database, Global Index Medicus and grey literature using structured search terms related to included recommendations, focusing on respectful and supportive care, and clinical practices performed throughout labour and birth. The measures identified were classified by the WHO recommendation and their characteristics reported. RESULTS We identified 150 studies which described 1331 intrapartum care measures. These measures corresponded to 35 of the 41 included WHO recommendations, and represented all domains of the WHO recommendations (care throughout labour and birth, first stage of labour, second stage of labour, third stage of labour). A total of 40.1% (534 of 1331 measures) of measures were related to respectful maternity care. Most studies used a questionnaire or survey measurement approach (522 of 1331 measures, 39.2%). CONCLUSION This scoping review presents a database of existing intrapartum care measures used to monitor the quality of intrapartum care globally. There is no clear consensus on a core set of measures for evaluating the practice of the WHO's intrapartum care recommendations. This review provides a foundation to support the development of a core set of internationally standardised intrapartum care measures for the WHO intrapartum care recommendations, highlighting key areas requiring consensus and validation, and measure development.
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Affiliation(s)
- Lauren Hannah Vallely
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anna Shalit
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Renae Nguyen
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Fernando Althabe
- Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland
| | - Verónica Pingray
- Institute for Clinical Effectiveness and Health Policy (IECS), Buenos Aires, Argentina
| | - Mercedes Bonet
- Department of Sexual and Reproductive Health and Research, WHO, Geneva, Switzerland
| | - Elizabeth Armari
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Meghan Bohren
- Centre for Health Equity, University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Caroline Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Joshua Peter Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Wang D, Sacks E, Odiase OJ, Kapula N, Sarakki A, Munson E, Afulani PA, Requejo J. A scoping review, mapping, and prioritisation process for emergency obstetric and neonatal quality of care indicators: Focus on provision and experience of care. J Glob Health 2023; 13:04092. [PMID: 37824168 PMCID: PMC10569369 DOI: 10.7189/jogh.13.04092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
Background Globally, approximately 800 women and 6400 newborns die around the time of childbirth each day. Many of these deaths could be prevented with high-quality emergency obstetric and newborn care (EmONC). The Monitoring Emergency Obstetric Care: A handbook guides strengthening EmONC services. However, the handbook contains limited quality of care measures. Our study identified and prioritised quality of care indicators for potential inclusion in the handbook, which is undergoing revision. Methods We conducted a consultative scoping review, mapping, and prioritisation exercise to select a short list of indicators on facility-based maternal and newborn quality of care. Indicators were identified from literature searches and expert suggestions and organised by the categories of structure, process, and outcomes as defined in the World Health Organization's Standards for Improving Quality of Maternal and Newborn Care in Health Facilities. We focused on process indicators, encompassing the provision of care and experience of care during the intrapartum period, and developed a priority list of indicators using the selection criteria of relevance and feasibility. Experience of care indicators were also mapped against the Person-Centered Maternity Care (PCMC) scale. Results We extracted a total of 3023 quality of care indicators. After removing out-of-scope and duplicate indicators and applying our selection criteria, we identified 20 provision of care indicators for possible inclusion in the revised EmONC handbook. We recommend including a score for experience of care that could be measured with the 30-item or the 13-item PCMC scale. We also identified 29 experience of care items not covered by the PCMC scale that could be used. Provider experience, patient safety, and quality of abortion care were identified as areas for which no or few indicators were found through our scoping review. Conclusions Through a rigorous, consultative, and multi-step process, we selected a short list of process-related, facility-based quality of care indicators for emergency obstetric and newborn care. This list could be included in the EmONC handbook or used for other monitoring purposes. Country consultations to assess the utility and feasibility of the proposed indicators and their adaptation to local contexts will support their refinement and uptake. Registration https://osf.io/msxbd (Open Science Framework).
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Affiliation(s)
- Dee Wang
- Division of Data Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, New York, USA
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Emma Sacks
- Division of Data Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, New York, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Osamuedeme J Odiase
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
| | - Ntemena Kapula
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Alisha Sarakki
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Erica Munson
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
| | - Patience A Afulani
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Jennifer Requejo
- Division of Data Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, New York, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Revisioning Emergency Obstetric and Newborn Care (EmONC) quality of care workstreamCreangaAndreeaMorganAlisonMoranAllisynMaliqiBlertaWarthinCaitlinKamkongCatherine BreenWalkerDilysMonetJean-PierreHillKathleenBenovaLenkaMuzigabaMoiseDayLouise TinaBaileyPatriciaLobisSamanthaSodzi-TetteySodziDegefie HailegebrielTedbabe
- Division of Data Analytics, Planning and Monitoring, United Nations Children’s Fund, New York, New York, USA
- Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, New York, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
- Institute for Global Health Sciences, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
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Warren N, Gresh A, Mkhonta NR, Kazembe A, Engelbrecht S, Feraud J, Patel K, Adandogou-d'Almeida H, Marole P, Reynolds N, Johnson P. Pre-service midwifery education in sub-Saharan Africa: A scoping review. Nurse Educ Pract 2023; 71:103678. [PMID: 37413740 DOI: 10.1016/j.nepr.2023.103678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 05/03/2023] [Accepted: 05/25/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND In response to a global call for more midwives, maternal health stakeholders have called for increased investment in midwifery pre-service education. Given the already long list of challenges and the increasing burden on health care systems due to the COVID-19 pandemic, the need to prioritize investment is acute, particularly in sub-Saharan Africa. An important first step is to examine the current evidence. METHODS We conducted a scoping review of the peer-reviewed literature about pre-service midwifery education in sub-Saharan Africa. A search of studies published between 2015 and 2021 in French or English was conducted using six databases (PubMed, CINAHL, Embase, Scopus, Web of Science and African Index Medicus). RESULTS The search yielded 3061 citations, of which 72 were included. Most were a mix of qualitative and quantitative cross-sectional, country-specific studies. Organized by pre-service educational domain, the literature reflected a misalignment between international standards for midwifery education and what schools and clinical sites and the larger administrative systems where they operate, reliably provide. Inadequate infrastructure, teaching capacity in school and clinical settings and clinical site environment were factors that commonly impede learning. Literature related to faculty development and deployment were limited. CONCLUSION Schools, faculty and clinical sites are overwhelmed yet recommendations by key stakeholders for change are substantive and complex. Efforts are needed to help schools map their current status by pre-service education domain and prioritize where scarce resources should be directed. These results can inform research and investments in pre-service midwifery education in sub-Saharan Africa.
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Affiliation(s)
- Nicole Warren
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Ashley Gresh
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | | | - Abigail Kazembe
- African Forum for Research and Education in Health, PMB, University Post Office, KNUST, Kumasi, Ghana.
| | | | - Jenna Feraud
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Kalin Patel
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Heloise Adandogou-d'Almeida
- La Fédération des Associations des Sages-Femmes d'Afrique Francophone (FASFAF), 229 Rue Sagouda Tokoin Wuiti, Lome, Togo.
| | - Phelelo Marole
- Jhpiego, Plot 155, Unit 4 Kgale Mews, Baborone International Financial Park, Baorone, Botswana.
| | - Nancy Reynolds
- Johns Hopkins School of Nursing, 525 N. Wolfe St., Baltimore, MD 21205, USA.
| | - Peter Johnson
- Jhpiego, 1615 Thames Street, Baltimore, MD 21231, USA.
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Diamond-Smith N, Lin S, Peca E, Walker D. A landscaping review of interventions to promote respectful maternal care in Africa: Opportunities to advance innovation and accountability. Midwifery 2022; 115:103488. [PMID: 36191382 DOI: 10.1016/j.midw.2022.103488] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/15/2022] [Accepted: 09/12/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In the past decade, global recognition of the need to address disrespect and abuse (also described as mistreatment of women) and promote respectful maternal care in facility-based childbirth has increased. While many studies have documented gaps in respectful maternal care, little is known about the design and implementation of these interventions. Our aim was to summarize and describe respectful maternal care -promoting interventions during childbirth implemented in Africa. DESIGN We identified respectful maternal care -promoting interventions in Africa through a rapid scoping of peer-reviewed articles and gray literature, and a crowdsourcing survey distributed through stakeholder networks. SETTING Africa PARTICIPANTS: NA MEASUREMENTS AND FINDINGS: We identified 43 unique interventions implemented in 16 African countries, gathered from a crowdsourcing survey, gray and published literature between 2010 and 2020. Most interventions were implemented in East Africa (N = 13). The interventions had various targets and were categorized into nine approaches, 60% of interventions focused on training providers about respectful maternal care and practice. About two thirds included multiple intervention approaches, and about two thirds addressed respectful maternal care beyond the period of childbirth. Few publications presented data on the effectiveness of the intervention, and those that did used a wide variety of indicators. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE There is a reliance on provider training approaches to promote respectful maternal care and there are few examples of either engaging women in the community or adopting social accountability approaches. We encourage implementors to develop interventions targeting multiple approaches beyond provider training and consider delivery across pre-pregnancy, pregnancy, birth, and the postnatal periods. Finally, in order to effectively move from documenting respectful maternal care gaps to action and scale, we need global consensus on common indicators and measures of effectiveness for interventions promoting respectful care across the life course.
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Affiliation(s)
- Nadia Diamond-Smith
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, United States of America
| | - Sunny Lin
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States of America.
| | - Emily Peca
- University Research Co., LLC., Chevy Chase, Maryland, United States of America
| | - Dilys Walker
- Institute for Global Health Sciences, University of California, San Francisco, San Francisco, CA, United States of America; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, CA, United States of America
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7
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Dhakal P, Creedy DK, Gamble J, Newnham E, McInnes R. Effectiveness of an online education intervention to enhance student perceptions of Respectful Maternity Care: A quasi-experimental study. NURSE EDUCATION TODAY 2022; 114:105405. [PMID: 35598456 DOI: 10.1016/j.nedt.2022.105405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 04/26/2022] [Accepted: 05/10/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childbearing women's relationship with maternity care providers enhance childbirth outcomes. Students need to understand and offer respectful care. OBJECTIVE Evaluate effectiveness and impact of an online education intervention on nursing students' perceptions towards respectful maternity care during labour and childbirth in Nepal. DESIGN A quasi-experimental pre-post design was used. PARTICIPANTS A total of 89 Third Year Bachelor of Nursing students (intervention n = 40; control n = 49) from three participating colleges. METHODS Students completed online pre and post-test surveys using the Students' Perceptions of Respectful Maternity Care scale and questions about impact of the intervention. The intervention group received six hours of education delivered online (three sessions x three weeks). ANCOVA and non-parametric Wilcoxon signed-rank tests measured effects. RESULTS Compared to controls, students in the intervention group reported a significant increase in perceptions towards respectful maternity care (F (1, 86) = 28.19, p < 0.001, ηp2 = 0.25). Participants reported a good understanding of respectful maternity care (75%), positive views about providing such care (82.5%), and a desire to use their new knowledge in practice (65%). CONCLUSION Relatively few intervention studies to promote respectful maternity care in students have been published. This brief online intervention improved students' perceptions. The intervention package can be integrated into nursing or midwifery curricula and in-service training. A larger study with longer follow-up is needed to support current findings.
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Affiliation(s)
- Prativa Dhakal
- School of Nursing and Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook 4131, Queensland, Australia.
| | - Debra K Creedy
- School of Nursing and Midwifery, Griffith University, Australia; Transforming Maternity Care Collaborative, Australia.
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, Australia; School of Nursing, Midwifery and Allied Health, Coventry University, United Kingdom.
| | - Elizabeth Newnham
- School of Nursing and Midwifery, University of Newcastle, Australia.
| | - Rhona McInnes
- School of Nursing and Midwifery, Griffith University, Australia.
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9
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Atkins B, Blencowe H, Boyle FM, Sacks E, Horey D, Flenady V. Is care of stillborn babies and their parents respectful? Results from an international online survey. BJOG 2022; 129:1731-1739. [PMID: 35289061 DOI: 10.1111/1471-0528.17138] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To quantify parents' experiences of respectful care around stillbirth globally. DESIGN Multi-country, online, cross-sectional survey. SETTING AND POPULATION Self-identified bereaved parents (n = 3769) of stillborn babies from 44 high- and middle-income countries. METHODS Parents' perspectives of seven aspects of care quality, factors associated with respectful care and seven bereavement care practices were compared across geographical regions using descriptive statistics. Respectful care was compared between country-income groups using multivariable logistic regression. MAIN OUTCOME MEASURES Self-reported experience of care around the time of stillbirth. RESULTS A quarter (25.4%) of 3769 respondents reported disrespectful care after stillbirth and 23.5% reported disrespectful care of their baby. Gestation less than 30 weeks and primiparity were associated with disrespect. Reported respectful care was lower in middle-income countries than in high-income countries (adjusted odds ratio 0.35, 95% CI 0.29-0.42, p < 0.01). In many countries, aspects of care quality need improvement, such as ensuring families have enough time with providers. Participating respondents from Latin America and southern Europe reported lower satisfaction across all aspects of care quality compared with northern Europe. Unmet need for memory-making activities in middle-income countries was high. CONCLUSIONS Many parents experience disrespectful care around stillbirth. Provider training and system-level support to address practical barriers are urgently needed. However, some practices (which are important to parents) can be readily implemented such as memory-making activities and referring to the baby by name.
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Affiliation(s)
- Bethany Atkins
- EGA Institute for Women's Health, University College London, London, UK
| | - Hannah Blencowe
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Frances M Boyle
- Institute for Social Science Research, The University of Queensland, Brisbane, Queensland, Australia.,NHMRC Centre of Research Excellence, Mater Research Institute-The University of Queensland, South Brisbane, Queensland, Australia
| | - Emma Sacks
- Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA
| | - Dell Horey
- NHMRC Centre of Research Excellence, Mater Research Institute-The University of Queensland, South Brisbane, Queensland, Australia.,Department of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia
| | - Vicki Flenady
- NHMRC Centre of Research Excellence, Mater Research Institute-The University of Queensland, South Brisbane, Queensland, Australia
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10
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Respectful Maternity Care Framework and Evidence-Based Clinical Practice Guideline. J Obstet Gynecol Neonatal Nurs 2022; 51:e3-e54. [PMID: 35101344 DOI: 10.1016/j.jogn.2022.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
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Lazzerini M, Covi B, Mariani I, Drglin Z, Arendt M, Nedberg IH, Elden H, Costa R, Drandić D, Radetić J, Otelea MR, Miani C, Brigidi S, Rozée V, Ponikvar BM, Tasch B, Kongslien S, Linden K, Barata C, Kurbanović M, Ružičić J, Batram-Zantvoort S, Castañeda LM, Rochebrochard EDL, Bohinec A, Vik ES, Zaigham M, Santos T, Wandschneider L, Viver AC, Ćerimagić A, Sacks E, Valente EP. Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region. THE LANCET REGIONAL HEALTH. EUROPE 2022; 13:100268. [PMID: 34977838 PMCID: PMC8703114 DOI: 10.1016/j.lanepe.2021.100268] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic, as defined by WHO Standards, are lacking. METHODS Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. FINDINGS 21,027 mothers were included in the analysis. Among those who experienced labour (N=18,063), 41·8% (26·1%- 63·5%) experienced difficulties in accessing antenatal care, 62% (12·6%-99·0%) were not allowed a companion of choice, 31·1% (16·5%-56·9%) received inadequate breastfeeding support, 34·4% (5·2%-64·8%) reported that health workers were not always using protective personal equipment, and 31·8% (17·8%-53·1%) rated the health workers' number as "insufficient". Episiotomy was performed in 20·1% (6·1%-66·0%) of spontaneous vaginal births and fundal pressure applied in 41·2% (11·5% -100%) of instrumental vaginal births. In addition, 23·9% women felt they were not treated with dignity (12·8%-59·8%), 12·5% (7·0%-23·4%) suffered abuse, and 2·4% (0·1%-26·2%) made informal payments. Most findings were significantly worse among women with prelabour caesarean birth (N=2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significant lower QMNC Indexes and Luxemburg showing a significantly higher QMNC Index than the total sample. Younger women and those with operative births also reported significantly lower QMNC Indexes. INTERPRETATION Mothers reports revealed large inequities in QMNC across countries of the WHO European Region. Quality improvement initiatives to reduce these inequities and promote evidence-based, patient-centred respectful care for all mothers and newborns during the COVID-19 pandemic and beyond are urgently needed. FUNDING The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. STUDY REGISTRATION ClinicalTrials.gov Identifier: NCT04847336.
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Affiliation(s)
- Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Zalka Drglin
- National Institute of Public Health, Ljubljana, Slovenia
| | - Maryse Arendt
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
| | | | - Helen Elden
- Institute of Health and Care sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska university hospital, Dept of Obstetrics & Gynecology, Gothenburg, Sweden
| | - Raquel Costa
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Hei-Lab:Digital Human-Environment Interaction Lab. Faculty of Psychology, Education and Sports, Lusófona University, Porto, Portugal
| | | | | | - Marina Ruxandra Otelea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
| | - Céline Miani
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Serena Brigidi
- Department of Anthropology, Philosophy and Social Work. Medical Anthropology Research Center (MARC). Rovira i Virgili University (URV), Tarragona, Spain
| | - Virginie Rozée
- Sexual and Reproductive Health and Rights Research Unit, Institut National d’Études Démographiques (INED), Paris, France
| | | | - Barbara Tasch
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
- Neonatal intensive care unit, KannerKlinik, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
| | - Sigrun Kongslien
- Department of health and care sciences, UiT The Arctic University of Norway
| | - Karolina Linden
- Institute of Health and Care sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Catarina Barata
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisboa, Portugal
| | | | | | - Stephanie Batram-Zantvoort
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | | | - Elise de La Rochebrochard
- Sexual and Reproductive Health and Rights Research Unit, Institut National d’Études Démographiques (INED), Paris, France
| | - Anja Bohinec
- National Institute of Public Health, Ljubljana, Slovenia
| | - Eline Skirnisdottir Vik
- Department of health and caring sciences, Western Norway University of Applied Sciences, Norway
| | - Mehreen Zaigham
- Obstetrics & Gynecology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
| | - Teresa Santos
- Universidade Europeia, Lisboa, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, Lisbon, Portugal
| | - Lisa Wandschneider
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | | | | | - Emma Sacks
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - IMAgiNE EURO study group
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
- National Institute of Public Health, Ljubljana, Slovenia
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional association of the Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
- Department of community medicine, UiT The Arctic University of Norway
- Institute of Health and Care sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska university hospital, Dept of Obstetrics & Gynecology, Gothenburg, Sweden
- EPIUnit, Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Hei-Lab:Digital Human-Environment Interaction Lab. Faculty of Psychology, Education and Sports, Lusófona University, Porto, Portugal
- Roda – Parents in Action, Zagreb, Croatia
- Centar za mame, Belgrade, Serbia
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
- Department of Anthropology, Philosophy and Social Work. Medical Anthropology Research Center (MARC). Rovira i Virgili University (URV), Tarragona, Spain
- Sexual and Reproductive Health and Rights Research Unit, Institut National d’Études Démographiques (INED), Paris, France
- Neonatal intensive care unit, KannerKlinik, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg
- Department of health and care sciences, UiT The Arctic University of Norway
- Instituto de Ciências Sociais, Universidade de Lisboa, Lisboa, Portugal
- Faculty of Health Studies, University of Rijeka, Rijeka, Croatia
- Institut Català de la Salut, Generalitat de Catalunya, Spain
- Department of health and caring sciences, Western Norway University of Applied Sciences, Norway
- Obstetrics & Gynecology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden
- Universidade Europeia, Lisboa, Portugal
- Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, Lisbon, Portugal
- Institut Català d'Antropologia (ICA), Barcelona, Spain
- NGO Baby Steps, Sarajevo, Bosnia-Herzegovina
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, United States of America
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12
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Lazzerini M, Covi B, Mariani I, Giusti A, Valente EP, Ćerimagić A, Drandić D, Kurbanović M, Virginie R, Rochebrochard E, Löfgren K, Miani C, Batram‐Zantvoort S, Wandschneider L, Verardi G, Zanin B, Morano S, Chertok I, Artzi‐Medvedik R, Pumpure E, Rezeberga D, Vaska A, Jakovicka D, Rudzīte P, Ērmane E, Vilcāne KP, Arendt M, Tasch B, Nedberg IH, Kongslien S, Vik ES, Baranowska B, Tataj‐Puzyna U, Węgrzynowska M, Costa R, Barata C, Santos T, Rodrigues C, Dias H, Otelea MR, Yarotskaya E, Radetić J, Ružičić J, Drglin Z, Ponikvar BM, Bohinec A, Brigidi S, Castañeda LM, Viver AC, Elden H, Linden K, Zaigham M, Sengpiel V, De Labrusse C, Abderhalden A, Pfund A, Thorn H. Quality of care at childbirth: findings of IMAgiNE EURO in Italy during the first year of the COVID‐19 pandemic. Int J Gynaecol Obstet 2022; 157:405-417. [PMID: 35092692 PMCID: PMC9087757 DOI: 10.1002/ijgo.14119] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 11/29/2022]
Abstract
Objective Investigate the quality of maternal and newborn care (QMNC) during childbirth in the first year of COVID‐19 pandemic in Italy, from the mothers' perspective, as key service users. Methods Women who gave birth in an Italian facility from March 1, 2020 to February 29, 2021 answered an online questionnaire including 40 WHO Standard‐based Quality Measures. Descriptive and multivariate quantile regression analyses were performed. Results In total, 4824 women were included, reporting heterogeneity of practices across regions: among 3981 women who underwent labour 78.4% (63.0%–92.0%) were not allowed a companion of choice, 44.6% (28.9%–53.3%) had difficulties in attending routine antenatal visits, 36.3% (24.9%–61.1%) reported inadequate breastfeeding support, 39.2% (23.3%–62.2%) felt not involved in medical choices, 33.0% (23.9%–49.3%) experienced unclear communication from staff, 24.8% (15.9%–39.4%) were not always treated with dignity and 12.7% (10.1%–29.3%) reported abuses. Findings in the group of women who did not experience labour were substantially similar. Multivariate analyses confirmed a significant lower QMNC index for regions in southern Italy compared to North and Central regions. Conclusion Mothers reported substantial inequities in the QMNC across Italian regions. Future studies should monitor QMNC over time. Meanwhile, actions to ensure high QMNC for all mothers and newborns across Italy are urgently required. Mothers giving birth in the first year of the COVID‐19 pandemic reported substantial inequities across Italian regions in the QMNC around the time of childbirth.
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Affiliation(s)
- Marzia Lazzerini
- Institute for Maternal and Child Health ‐ IRCCS “Burlo Garofolo” ‐ WHO Collaborating Centre for Maternal and Child Health Trieste Italy
| | - Benedetta Covi
- Institute for Maternal and Child Health ‐ IRCCS “Burlo Garofolo” ‐ WHO Collaborating Centre for Maternal and Child Health Trieste Italy
| | - Ilaria Mariani
- Institute for Maternal and Child Health ‐ IRCCS “Burlo Garofolo” ‐ WHO Collaborating Centre for Maternal and Child Health Trieste Italy
| | - Angela Giusti
- National Centre for Diseases Prevention and Health Promotion National Institute of Health Rome Italy
| | - Emanuelle Pessa Valente
- Institute for Maternal and Child Health ‐ IRCCS “Burlo Garofolo” ‐ WHO Collaborating Centre for Maternal and Child Health Trieste Italy
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13
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Jolivet RR, Gausman J, Kapoor N, Langer A, Sharma J, Semrau KEA. Operationalizing respectful maternity care at the healthcare provider level: a systematic scoping review. Reprod Health 2021; 18:194. [PMID: 34598705 PMCID: PMC8485458 DOI: 10.1186/s12978-021-01241-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 09/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ensuring the right to respectful care for maternal and newborn health, a critical dimension of quality and acceptability, requires meeting standards for Respectful Maternity Care (RMC). Absence of mistreatment does not constitute RMC. Evidence generation to inform definitional standards for RMC is in an early stage. The aim of this systematic review is clear provider-level operationalization of key RMC principles, to facilitate their consistent implementation. METHODS Two rights-based frameworks define the underlying principles of RMC. A qualitative synthesis of both frameworks resulted in seven fundamental rights during childbirth that form the foundation of RMC. To codify operational definitions for these key elements of RMC at the healthcare provider level, we systematically reviewed peer-reviewed literature, grey literature, white papers, and seminal documents on RMC. We focused on literature describing RMC in the affirmative rather than mistreatment experienced by women during childbirth, and operationalized RMC by describing objective provider-level behaviors. RESULTS Through a systematic review, 514 records (peer-reviewed articles, reports, and guidelines) were assessed to identify operational definitions of RMC grounded in those rights. After screening and review, 54 records were included in the qualitative synthesis and mapped to the seven RMC rights. The majority of articles provided guidance on operationalization of rights to freedom from harm and ill treatment; dignity and respect; information and informed consent; privacy and confidentiality; and timely healthcare. Only a quarter of articles mentioned concrete or affirmative actions to operationalize the right to non-discrimination, equality and equitable care; less than 15%, the right to liberty and freedom from coercion. Provider behaviors mentioned in the literature aligned overall with seven RMC principles; yet the smaller number of available research studies that included operationalized definitions for some key elements of RMC illustrates the nascent stage of evidence-generation in this area. CONCLUSIONS Lack of systematic codification, grounded in empirical evidence, of operational definitions for RMC at the provider level has limited the study, design, implementation, and comparative assessment of respectful care. This qualitative systematic review provides a foundation for maternity healthcare professional policy, training, programming, research, and program evaluation aimed at studying and improving RMC at the provider level.
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Affiliation(s)
- R. Rima Jolivet
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Jewel Gausman
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Neena Kapoor
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Ana Langer
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Jigyasa Sharma
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 USA
| | - Katherine E. A. Semrau
- BetterBirth Program, Ariadne Labs|Brigham and Women’s Hospital and Harvard TH Chan School of Public Health, Boston, MA USA
- Division of Global Health Equity, Brigham and Women’s Hospital, Boston, MA USA
- Department of Medicine, Harvard Medical School, 401 Park Drive, 3rd Floor West, Boston, MA 02215 USA
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14
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Leslie HH, Sharma J, Mehrtash H, Berger BO, Irinyenikan TA, Balde MD, Mon NO, Maya E, Soumah AM, Adu-Bonsaffoh K, Maung TM, Bohren MA, Tunçalp Ö. Women's report of mistreatment during facility-based childbirth: validity and reliability of community survey measures. BMJ Glob Health 2021; 5:bmjgh-2020-004822. [PMID: 34362792 PMCID: PMC8353172 DOI: 10.1136/bmjgh-2020-004822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 07/20/2021] [Indexed: 12/18/2022] Open
Abstract
Background Accountability for mistreatment during facility-based childbirth requires valid tools to measure and compare birth experiences. We analyse the WHO ‘How women are treated during facility-based childbirth’ community survey to test whether items mapping the typology of mistreatment function as scales and to create brief item sets to capture mistreatment by domain. Methods The cross-sectional community survey was conducted at up to 8 weeks post partum among women giving birth at hospitals in Ghana, Guinea, Myanmar and Nigeria. The survey contained items assessing physical abuse, verbal abuse, stigma, failure to meet professional standards, poor rapport with healthcare workers, and health system conditions and constraints. For all domains except stigma, we applied item-response theory to assess item fit and correlation within domain. We tested shortened sets of survey items for sensitivity in detecting mistreatment by domain. Where items show concordance and scale reliability ≥0.60, we assessed convergent validity with dissatisfaction with care and agreement of scale scores between brief and full versions. Results 2672 women answered over 70 items on mistreatment during childbirth. Reliability exceeded 0.60 in all countries for items on poor rapport with healthcare workers and in three countries for items on failure to meet professional standards; brief scales generally showed high agreement with longer versions and correlation with dissatisfaction. Brief item sets were ≥85% sensitive in detecting mistreatment in each country, over 90% for domains of physical abuse and health system conditions and constraints. Conclusion Brief scales to measure two domains of mistreatment are largely comparable with longer versions and can be informative for these four distinct settings. Brief item sets efficiently captured prevalence of mistreatment in the five domains analysed; stigma items can be used and adapted in full. Item sets are suitable for confirmation by context and implementation to increase accountability and inform efforts to eliminate mistreatment during childbirth.
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Affiliation(s)
- Hannah Hogan Leslie
- Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA .,Division of Prevention Science, University of California San Francisco, San Francisco, California, USA
| | - Jigyasa Sharma
- Chief Economist's Office, Human Development Group, World Bank Group, Washington, District of Columbia, USA
| | - Hedieh Mehrtash
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
| | - Blair Olivia Berger
- Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Theresa Azonima Irinyenikan
- Department of Obstetrics and Gynaecology, University of Medical Sciences Teaching Hospital Complex, Akure, Ondo State, Nigeria
| | - Mamadou Dioulde Balde
- Cellulle de Recherche en Sante de la Reproduction en Guinee (CERREGUI), University National Hospital-Donka, Conakry, Guinea
| | - Nwe Oo Mon
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Ernest Maya
- School of Public Health, University of Ghana, Accra, Ghana
| | - Anne-Marie Soumah
- Cellulle de Recherche en Sante de la Reproduction en Guinee (CERREGUI), University National Hospital-Donka, Conakry, Guinea
| | - Kwame Adu-Bonsaffoh
- Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
| | - Thae Maung Maung
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
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15
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Berger BO, Strobino DM, Mehrtash H, Bohren MA, Adu-Bonsaffoh K, Leslie HH, Irinyenikan TA, Maung TM, Balde MD, Tunçalp Ö. Development of measures for assessing mistreatment of women during facility-based childbirth based on labour observations. BMJ Glob Health 2021; 5:e004080. [PMID: 34362791 PMCID: PMC8353173 DOI: 10.1136/bmjgh-2020-004080] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Mistreatment of women during childbirth is increasingly recognised as a significant issue globally. Research and programmatic efforts targeting this phenomenon have been limited by a lack of validated measurement tools. This study aimed to develop a set of concise, valid and reliable multidimensional measures for mistreatment using labour observations applicable across multiple settings. METHODS Data from continuous labour observations of 1974 women in Nigeria (n=407), Ghana (n=912) and Guinea (n=655) were used from the cross-sectional WHO's multicountry study 'How women are treated during facility-based childbirth' (2016-2018). Exploratory factor analysis was conducted to develop a scale measuring interpersonal abuse. Two indexes were developed through a modified Organisation for Economic Co-operation and Development approach for generating composite indexes. Measures were evaluated for performance, validity and internal reliability. RESULTS Three mistreatment measures were developed: a 7-item Interpersonal Abuse Scale, a 3-item Exams & Procedures Index and a 12-item Unsupportive Birth Environment Index. Factor analysis results showed a consistent unidimensional factor structure for the Interpersonal Abuse Scale in all three countries based on factor loadings and interitem correlations, indicating good structural construct validity. The scale had a reliability coefficient of 0.71 in Nigeria and approached 0.60 in Ghana and Guinea. Low correlations (Spearman correlation range: -0.06-0.19; p≥0.05) between mistreatment measures supported our decision to develop three separate measures. Predictive criterion validation yielded mixed results across countries. Both items within measures and measure scores were internally consistent across countries; each item co-occurred with other items in a measure, and scores consistently distinguished between 'high' and 'low' mistreatment levels. CONCLUSION The set of concise, comprehensive multidimensional measures of mistreatment can be used in future research and quality improvement initiatives targeting mistreatment to quantify burden, identify risk factors and determine its impact on health and well-being outcomes. Further validation and reliability testing of the measures in other contexts is needed.
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Affiliation(s)
- Blair O Berger
- Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Donna M Strobino
- Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hedieh Mehrtash
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneve, Switzerland
| | - Meghan A Bohren
- Centre for Health Equity, University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Kwame Adu-Bonsaffoh
- Department of Obstetrics and Gynaecology, School of Medicine and Dentistry, University of Ghana, Accra, Greater Accra, Ghana
| | - Hannah H Leslie
- Division of Prevention Science, University of California, San Francisco, San Francisco, California, USA
| | | | - Thae Maung Maung
- Department of Medical Research, Ministry of Health and Sports, Yangon, Myanmar
| | - Mamadou Dioulde Balde
- Cellulle de Recherche en Sante de la Reproduction en Guinee (CERREGUI), University National Hospital-Donka, Conakry, Guinea
| | - Özge Tunçalp
- UNDP/UNFPA/ UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneve, Switzerland
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Larson E, Sharma J, Nasiri K, Bohren MA, Tunçalp Ö. Measuring experiences of facility-based care for pregnant women and newborns: a scoping review. BMJ Glob Health 2020; 5:e003368. [PMID: 33219000 PMCID: PMC7682195 DOI: 10.1136/bmjgh-2020-003368] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/23/2020] [Accepted: 10/14/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Access to high-quality, person-centred care during pregnancy and childbirth is a global priority. Positive experience of care is key in particular, because it is both a fundamental right and can influence health outcomes and future healthcare utilisation. Despite its importance for accountability and action, systematic guidance on measuring experience of care is limited. METHODS We conducted a scoping review of published literature to identify measures/instruments for experience of facility-based pregnancy and childbirth (abortion, antenatal, intrapartum, postnatal and newborn) care. We systematically searched five bibliographic databases from 1 January 2007 through 1 February 2019. Using a predefined evidence template, we extracted data on study design, data collection method, study population and care type as reported in primary quantitative articles. We report results narratively. RESULTS We retrieved 16 528 unique citations, including 171 eligible articles representing, 157 unique instruments and 144 unique parent instruments across 56 countries. Half of the articles (90/171) did not use a validated instrument. While 82% (n=141) of articles reported on labour and childbirth care, only one reported on early pregnancy/abortion care. The most commonly reported sub-domains of user experience were communication (84%, 132/157) and respect and dignity (71%, 111/157). The primary purpose of most papers was measurement (70%, 119/171), largely through cross-sectional surveys. CONCLUSION There are alarming gaps in measurement of user experience for abortion, antenatal, postnatal and newborn care, including lack of validated instruments to measure the effects of interventions and policies on user experience. PROTOCOL REGISTRATION DETAILS This review was registered and published on PROSPERO (CRD42017070867). PROSPERO is an international database of prospectively registered systematic reviews in health and social care.
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Affiliation(s)
- Elysia Larson
- Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jigyasa Sharma
- Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Khalidha Nasiri
- Schulich School of Medicine and Dentistry, London, Ontario, Canada
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), WHO, Geneve, Switzerland
| | - Meghan A Bohren
- Centre for Health Equity, University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), WHO, Geneve, Switzerland
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