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Terefe B, Mekonnen BA, Tamir TT, Assimamaw NT, Limenih MA. Evaluation of Quality of Prevention of Mother to Child Transmission of HIV Service Provision and Its Determinants: The Case of Health Facility Readiness and Mothers' Perspectives. J Multidiscip Healthc 2024; 17:93-110. [PMID: 38205128 PMCID: PMC10778913 DOI: 10.2147/jmdh.s446035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Background Prevention of Mother-To-Child Transmission of HIV (PMTCT) is a comprehensive intervention aimed at reducing vertical transmission. More than 90% of pediatric AIDS cases are caused by MTCT. However, the quality of care has lagged in terms of service integration, client satisfaction, and facility readiness, although improvements have been observed. Evidence on the quality of PMTCT services is required by clinicians, and policymakers. Therefore, this study aimed to evaluate the effectiveness of PMTCT services provided by public health facilities in Northwest Ethiopia. Methods This cross-sectional study was conducted at nine public health facilities in Gondar city between June 1 and July 17, 2022. A total of 334 mothers were participated. The Structure-Process-Outcome components were used to evaluate service quality. About 135 counseling sessions were observed. The SPSS 26 software was used for statistical analyses. To identify mothers' satisfaction with the service, P-values < 0.25, and < 0.05 were considered in the binary and multiple logistic regression analyses to identify significant variables, respectively. Results The overall performance of the health facilities was 74.09% (72.19-76.01 CI 95%). In 88.89% of cases, the output quality was higher and rated as good. However, the quality of the input and process services was 60.40% and 72.97%, respectively. Women's satisfaction was 67.09%. Women aged 15-24 years (AOR= 0.31; 95% CI:0.06, 0.79), formally educated (AOR=0.59; 95% CI:0.35, 0.67), > one hour of arrival (AOR=0.71; 95% CI:0.55, 0.93), > 30 minutes waiting time (AOR=0.23; 95% CI:0.11, 0.37), sufficient time for counseling (AOR=2.83; 95% CI:1.72, 3.97), and opening hours (AOR=4.27; 95% CI:2.09, 6.67) were factors associated with satisfaction in women. Conclusion The quality of PMTCT service provision and mothers' satisfaction were low. Reducing waiting time, punctuality of service providers, adequate counselling, and availability of basic resources can boost mothers' satisfaction.
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Affiliation(s)
- Bewuketu Terefe
- Department of Community Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanu Abie Mekonnen
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nega Tezera Assimamaw
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Miteku Andualem Limenih
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tolesa F, Alemu A, Beya M, Feyisa M, Gezahagn A, Negash A, Shigign E, Getaye A, Negash A, Merga B. Maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals of the South West Shewa Zone, Ethiopia, 2022. Front Glob Womens Health 2023; 4:1203798. [PMID: 37854166 PMCID: PMC10579941 DOI: 10.3389/fgwh.2023.1203798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023] Open
Abstract
Background Maternal satisfaction with intrapartum care is a multidimensional assumption of satisfaction with self and with the physical environment of the delivery ward and quality of care. Maternal satisfaction with intrapartum care affects the selection of birthplace and helps to identify gaps between actual and intended healthcare outcomes. This study aims to assess factors that affect maternal satisfaction with intrapartum care. Objectives To assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in the South-west Shewa Zone, Ethiopia, 2022. Methods A cross-sectional study approach among 420 mothers was conducted between April 14 and June 14, 2022. Systematic random sampling was used to select mothers for face-to-face interviews every two intervals. Bivariate and multivariable logistic regression analyses were carried out. P-values of <0.25 in association with study variables were transferred to multivariable logistic regression models. An adjusted odds ratio with a 95% confidence interval was computed, and p-values of <0.05 were considered statistically significant in the multivariable model. The results of this study are presented using text, tables, and charts. Results Data were collected from 420 participants, and 413 mothers completed the interview, giving a response rate of 98.33%. The overall maternal satisfaction with intrapartum care was 245 (59.32%) [95% CI: 55-64]. Mothers who were considered normal during labor and delivery (AOR = 2.57 (95% CI: 1.30-5.07), had a labor duration of 12 h or less (AOR = 1.59 (95% CI: 1.03-2.44), and experienced a waiting time of <15 min (AOR = 2.06 (95% CI: 1.21-3.52) were significantly associated with maternal satisfaction with intrapartum care. Conclusion and Recommendations More than half of mothers were satisfied with the overall intrapartum care they received. Health facility managers and healthcare providers work together to improve maternal satisfaction with intrapartum care.
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Affiliation(s)
- Fikadu Tolesa
- Department of Midwifery, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Adugna Alemu
- Department of Midwifery, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Moges Beya
- Department of Midwifery, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Mulugeta Feyisa
- Department of Midwifery, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Andualem Gezahagn
- Department of Midwifery, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Abdi Negash
- Department of Medical Laboratory, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Erean Shigign
- Department of Public Health, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Asfaw Getaye
- Department of Nursing, Salale University, College of Health Sciences, Fitche, Ethiopia
| | - Abraham Negash
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Bacha Merga
- Ameya Hospital, South West Shewa Zone, Waliso, Ethiopia
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Drandić D, Drglin Z, Mihevc Ponikvar B, Bohinec A, Ćerimagić A, Radetić J, Ružičić J, Kurbanović M, Covi B, Valente EP, Mariani I, Lazzerini M, Drandić D, Kurbanović M, Virginie R, de La Rochebrochard E, Löfgren K, Miani C, Batram‐Zantvoort S, Wandschneider L, Lazzerini M, Valente EP, Covi B, Mariani I, Morano S, Chertok I, Hefer E, Artzi‐Medvedik R, Pumpure E, Rezeberga D, Jansone‐Šantare G, Jakovicka D, Knoka AR, Vilcāne KP, Liepinaitienė A, Kondrakova A, Mizgaitienė M, Juciūtė S, 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, Radetić J, Ružičić J, Drglin Z, Ponikvar BM, Bohinec A, Brigidi S, Castañeda LM, Elden H, Sengpiel V, Linden K, Zaigham M, De Labrusse C, Abderhalden A, Pfund A, Thorn H, Grylka S, Gemperle M, Mueller A. Women's perspectives on the quality of hospital maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Results from the IMAgiNE EURO study in Slovenia, Croatia, Serbia, and Bosnia-Herzegovina. Int J Gynaecol Obstet 2022; 159 Suppl 1:54-69. [PMID: 36530003 PMCID: PMC9877897 DOI: 10.1002/ijgo.14457] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To assess the quality of maternal and newborn care (QMNC) in countries of the former Yugoslavia. METHOD Women giving birth in a facility in Slovenia, Croatia, Serbia, and Bosnia-Herzegovina between March 1, 2020 and July 1, 2021 answered an online questionnaire including 40 WHO standards-based quality measures. RESULTS A total of 4817 women were included in the analysis. Significant differences were observed across countries. Among those experiencing labor, 47.4%-62.3% of women perceived a reduction in QMNC due to the COVID-19 pandemic, 40.1%-69.7% experienced difficulties in accessing routine antenatal care, 60.3%-98.1% were not allowed a companion of choice, 17.4%-39.2% reported that health workers were not always using personal protective equipment, and 21.2%-53.8% rated the number of health workers as insufficient. Episiotomy was performed in 30.9%-62.8% of spontaneous vaginal births. Additionally, 22.6%-55.9% of women received inadequate breastfeeding support, 21.5%-62.8% reported not being treated with dignity, 11.0%-30.5% suffered abuse, and 0.7%-26.5% made informal payments. Multivariate analyses confirmed significant differences among countries, with Slovenia showing the highest QMNC index, followed by Croatia, Bosnia-Herzegovina, and Serbia. CONCLUSION Differences in QMNC among the countries of the former Yugoslavia during the COVID-19 pandemic were significant. Activities to promote high-quality, evidence-based, respectful care for all mothers and newborns are urgently needed. CLINICALTRIALS gov Identifier: NCT04847336.
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Affiliation(s)
| | - Zalka Drglin
- National Institute of Public HealthLjubljanaSlovenia
| | | | - Anja Bohinec
- National Institute of Public HealthLjubljanaSlovenia
| | | | | | | | | | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
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Lazzerini M, Valente EP, Covi B, Rozée V, Costa R, Otelea MR, Abderhalden-Zellweger A, Węgrzynowska M, Linden K, Arendt M, Brigidi S, Miani C, Pumpure E, Radetic J, Drandic D, Cerimagic A, Nedberg IH, Liepinaitienė A, Rodrigues C, de Labrusse C, Baranowska B, Zaigham M, Castañeda LM, Batram-Zantvoort S, Jakovicka D, Ruzicic J, Juciūtė S, Santos T, Gemperle M, Tataj-Puzyna U, Elden H, Mizgaitienė M, Lincetto O, Sacks E, Mariani I. Rates of instrumental vaginal birth and cesarean and quality of maternal and newborn health care in private versus public facilities: Results of the IMAgiNE EURO study in 16 countries. Int J Gynaecol Obstet 2022; 159 Suppl 1:22-38. [PMID: 36530007 PMCID: PMC10108180 DOI: 10.1002/ijgo.14458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To explore the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic by facility type among 16 European countries, comparing rates of instrumental vaginal birth and cesarean. METHODS Women who gave birth in the WHO European Region from March 1, 2020, to February 7, 2022, answered a validated online questionnaire. Rates of instrumental birth, instrumental vaginal birth, and cesarean, and a QMNC index were calculated for births in public versus private facilities. RESULTS Responses from 25 206 participants were analyzed. Women giving birth in private compared with public facilities reported significantly more frequent total cesarean (32.5% vs 19.0%; aOR 1.70; 95% CI 1.52-1.90), elective cesarean (17.3% vs 7.8%; aOR 1.90; 95% CI 1.65-2.19), and emergency cesarean before labor (7.4% vs 3.9%; aOR 1.39; 95% CI 1.14-1.70) (P < 0.001 for all comparisons), with analyses by country confirming these results. QMNC index results were heterogeneous across countries and regions in the same country and were largely affected by geographical distribution of regions rather than by type of facility alone. CONCLUSION The study confirms that births in private facilities have higher odds of cesarean. It also suggests that QMNC should be closely monitored in all facilities to achieve high-quality care, independent of facility type or geographical distribution. 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
| | - Emanuelle Pessa Valente
- 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
| | - Virginie Rozée
- Sexual and Reproductive Health and Rights Research Unit, Institut National d'Études Démographiques (INED), Paris, France
| | - Raquel Costa
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.,Lusófona University/HEI-Lab: Digital Human-environment Interaction Labs, Lisbon, Portugal
| | - Marina Ruxandra Otelea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania.,SAMAS Association, Bucharest, Romania
| | - Alessia Abderhalden-Zellweger
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Maria Węgrzynowska
- Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maryse Arendt
- Beruffsverband vun de Laktatiounsberoderinnen zu Lëtzebuerg asbl (Professional Association of Lactation Consultants in Luxembourg), Luxembourg, Luxembourg
| | - Serena Brigidi
- Department of Anthropology, Philosophy and Social Work, Medical Anthropology Research Center (MARC), Rovira i Virgili University (URV), Tarragona, Spain
| | - Céline Miani
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Elizabete Pumpure
- Department of Obstetrics and Gynecology, Riga Stradins University, Rīga, Latvia.,Riga Maternity Hospital, Rīga, Latvia
| | | | | | | | | | | | - Carina Rodrigues
- Epidemiology Research Unit (EPIUnit), Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.,Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Claire de Labrusse
- School of Health Sciences (HESAV), HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - Barbara Baranowska
- Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Mehreen Zaigham
- Department of Obstetrics and Gynecology, Institution of Clinical Sciences Lund, Lund University, Lund and Skåne University Hospital, Malmö, Sweden
| | | | - Stephanie Batram-Zantvoort
- Department of Epidemiology and International Public Health, School of Public Health, Bielefeld University, Bielefeld, Germany
| | | | | | - Simona Juciūtė
- Kaunas University of Applied Sciences, Kaunas, Lithuania
| | - Teresa Santos
- Universidade Europeia, Lisbon, Portugal.,Plataforma CatólicaMed/Centro de Investigação Interdisciplinar em Saúde (CIIS) da Universidade Católica Portuguesa, Lisbon, Portugal
| | - Michael Gemperle
- Research Institute of Midwifery, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Urszula Tataj-Puzyna
- Department of Midwifery, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marija Mizgaitienė
- Kaunas Hospital of the Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ornella Lincetto
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Emma Sacks
- Department of International Health, Johns Hopkins University, Baltimore, Massachusetts, USA
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
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Pumpure E, Jakovicka D, Mariani I, Vaska A, Covi B, Valente EP, Jansone‐Šantare G, Knoka AR, Vilcāne KP, Rezeberga D, Lazzerini M, Roda DD, Kurbanović M, Virginie R, de La Rochebrochard E, Löfgren K, Miani C, Batram‐Zantvoort S, Wandschneider L, Morano S, Chertok I, Artzi‐Medvedik R, Liepinaitienė A, Kondrakova A, Mizgaitienė M, Juciūtė S, 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, Radetić J, Ružičić J, Drglin Z, Ponikvar BM, Bohinec A, Brigidi S, Castañeda LM, Elden H, Sengpiel V, Linden K, Zaigham M, De Labrusse C, Abderhalden A, Pfund A, Thorn H, Grylka S, Gemperle M, Mueller A. Women's perspectives on the quality of maternal and newborn care in childbirth during the COVID-19 pandemic in Latvia: Results from the IMAgiNE EURO study on 40 WHO standards-based quality measures. Int J Gynaecol Obstet 2022; 159 Suppl 1:97-112. [PMID: 36530013 PMCID: PMC9878132 DOI: 10.1002/ijgo.14461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth during the COVID-19 pandemic in Latvia, comparing the years 2020 and 2021, among women who went into labor or had a prelabor cesarean. METHODS Women giving birth in healthcare facilities in Latvia from March 1, 2020, to October 28, 2021, answered an online questionnaire including 40 WHO standards-based quality measures. Descriptive and multivariate quantile regression analyses were performed to compare QMNC in 2020 and 2021. RESULTS 2079 women were included in the analysis: 1860 women who went into labor (group 1) and 219 with prelabor cesarean (group 2). Among group 1, 66.4% (n = 99/149) of women received fundal pressure in an instrumental vaginal birth, 43.5% (n = 810) lacked involvement in choices, 17.4% (n = 317) reported suffering abuse, 32.7% (n = 609) reported inadequate breastfeeding support while 5.2% (n = 96) lack of early breastfeeding. A significant reduction in QMNC due to the COVID-19 pandemic was reported by 29.5% (n = 219) and 25.0% (n = 270) of respondents in 2020 and 2021, respectively (P = 0.045). Multivariate analyses highlighted a significantly lower QMNC index for 2020 compared with 2021 (P < 0.001). CONCLUSION This first study investigating QMNC in Latvia showed significant gaps in QMNC perceived by respondents, with slightly better results in 2021. Appropriate healthcare strategies to improve health care for women and newborns in Latvia are required. CLINICALTRIALS gov Identifier:NCT04847336.
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Affiliation(s)
- Elizabete Pumpure
- Department of Obstetrics and GynecologyRiga Stradins UniversityRigaLatvia,Riga Maternity HospitalRigaLatvia
| | | | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | | | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
| | - Gita Jansone‐Šantare
- Department of Obstetrics and GynecologyRiga Stradins UniversityRigaLatvia,Riga Maternity HospitalRigaLatvia
| | | | | | - Dace Rezeberga
- Department of Obstetrics and GynecologyRiga Stradins UniversityRigaLatvia,Riga Maternity HospitalRigaLatvia
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child HealthInstitute for Maternal and Child Health IRCCS “Burlo Garofolo”TriesteItaly
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Community-based bilingual doula support during labour and birth to improve migrant women's intrapartum care experiences and emotional well-being-Findings from a randomised controlled trial in Stockholm, Sweden [NCT03461640]. PLoS One 2022; 17:e0277533. [PMID: 36399476 PMCID: PMC9674173 DOI: 10.1371/journal.pone.0277533] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 10/11/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To evaluate the effectiveness of community-based bilingual doula (CBD) support for improving the intrapartum care experiences and postnatal wellbeing of migrant women giving birth in Sweden. DESIGN Randomised controlled trial. SETTING Six antenatal care clinics and five hospitals in Stockholm, Sweden. PARTICIPANTS 164 pregnant Somali-, Arabic-, Polish-, Russian- and Tigrinya-speaking women who could not communicate fluently in Swedish, were ≥18 years and had no contra-indications for vaginal birth. INTERVENTION In addition to standard labour support, women were randomised to CBD support (n = 88) or no such support during labour (n = 76). Trained CBDs met with women prior to labour, provided support by telephone after labour had started, then provided emotional, physical and communication support to women throughout labour and birth in hospital, and then met again with women after the birth. PRIMARY OUTCOMES Women's overall ratings of the intrapartum care experiences (key question from the Migrant Friendly Maternity Care Questionnaire) and postnatal wellbeing (mean value of Edinburgh Postnatal Depression Scale) at 6-8 weeks after birth. RESULTS In total, 150 women remained to follow-up; 82 women (93.2%) randomised to receive CBD support and 68 women (89.5%) randomised to standard care (SC). Of women allocated CBD support, 60 (73.2%) received support during labour. There were no differences between the groups regarding women's intrapartum care experiences (very happy with care: CBD 80.2% (n = 65) vs SC 79.1% (n = 53); OR 1.07 CI 95% 0.48-2.40) or emotional wellbeing (EPDS mean value: CBD 4.71 (SD 4.96) vs SC 3.38 (SD 3.58); mean difference 1.33; CI 95% - 0.10-2.75). CONCLUSIONS Community-based doula support during labour and birth for migrant women neither increased women's ratings of their care for labour and birth nor their emotional well-being 2 months postpartum compared with receiving standard care only. Further studies on the effectiveness of CBD powered to evaluate obstetric outcomes are needed. TRIAL REGISTRATION Trial registration at ClinicalTrial.gov NCT03461640 https://www.google.com/search?client=firefox-b-d&q=NCT03461640.
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Shamoradifar Z, Asghari-Jafarabadi M, Nourizadeh R, Mehrabi E, Areshtanab HN, Shaigan H. The impact of effective communication-based care on the childbirth experience and satisfaction among primiparous women: an experimental study. J Egypt Public Health Assoc 2022; 97:12. [PMID: 35941334 PMCID: PMC9360278 DOI: 10.1186/s42506-022-00108-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 07/04/2022] [Indexed: 12/04/2022]
Abstract
Background There is insufficient scientific evidence on the effect of communication skills of childbirth care providers on maternal childbirth experience and satisfaction. The present study aimed to determine the effect of communication-based care on the childbirth experience and satisfaction among primiparous women. Methods A total of 80 primiparous women participated in this experimental study who were randomly assigned into the intervention and control groups. According to the World Health Organization (WHO) care model, the intervention group received effective communication-based care, and the control group received the routine care. Data were collected using demographic and obstetric questionnaires, Labor Agentry Scale (LAS) and Birth Satisfaction Scale-Revised (BSS-R), and Support and Control in Birth (SCIB) scale applied 12 to 24 h after the intervention. Results After controlling the effect of confounding variables, the mean scores of childbirth experience (51.23(1.54) and satisfaction (26.03(0.81) in the intervention group were significantly higher than that in the control group (45.33 (1.54) and 22.66 (0.81) respectively; [adjusted mean difference (AMD) = 5.90, CI = 95%: 1.17 to 10.62, P = 0.01] versus AMD =3.37, CI: 95%: 0.87 to 5.87, P = 0.001]. Conclusion Eeffective communication-based care improved childbirth experience and satisfaction of primiparous women. Therefore, it is recommended that health-care providers should be trained on the communication skills in the delivery room especially during a vital threatened crises such as the Covid pandemic.
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Affiliation(s)
- Zahra Shamoradifar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Center for the Development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghaiyeh Nourizadeh
- Department of Nursing and Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esmat Mehrabi
- Department of Nursing and Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hoorieh Shaigan
- Department of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Carus EG, Albayrak N, Bildirici HM, Ozmen SG. Immersive virtual reality on childbirth experience for women: a randomized controlled trial. BMC Pregnancy Childbirth 2022; 22:354. [PMID: 35461248 PMCID: PMC9034564 DOI: 10.1186/s12884-022-04598-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/16/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of immersive virtual reality (VR) on patient satisfaction as a distractive tool and pain relief among laboring women. METHODS This was a randomized, controlled clinical trial with 42 laboring women allocated to VR intervention and control groups. Among women in the VR group, patient satisfaction with the use of VR was assessed by a Virtual Reality Satisfaction Survey, measured by a Visual Analog Scale (VAS) score and evaluated by questioning them about whether they would choose VR in future labor. As a primary outcome, patient satisfaction scores regarding the overall childbirth experience were compared between women in the two groups. A secondary outcome was pain assessed by a visual pain rating scale in the early and active phases of labor in women in both groups. Psychometric information was also collected from participants in each group using the Beck Anxiety Inventory and Beck Depression Inventory. RESULTS We observed a high level of patient satisfaction with the use of immersive VR during labor. The VAS revealed a mean satisfaction score of 87.7 ± 12.9 out of a maximum of 100. Twenty out of 21 (95%) women in the VR group stated that they would like to use VR again in future labor. VR improved pain scores in early labor and contributed positively to the overall childbirth experience. The mean pain score pre-VR was 2.6 ± 1.2 compared to 2.0 ± 1.3 post-VR (p < 0.01). Anxiety and depression scores were similar in participants in the intervention and control groups (p = 0.103 and p = 0.13, respectively). CONCLUSION Immersive VR application during labor was associated with higher patient satisfaction based on our study findings. VR also improved participants' pain scores in early labor before epidural administration. Immersive VR may find a place as an adjunct in labor and delivery units to improve lengthy labor experiences for women. Studies with larger groups of participants are needed to confirm these observations. TRIAL REGISTRATION ClinicalTrials.gov: NCT05032456.
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Affiliation(s)
- Elif Gizem Carus
- Graduate School of Health Sciences, Neuroscience Master’s Program, Bahcesehir University, Istanbul, Turkey
| | - Nazli Albayrak
- Department of Obstetrics and Gynecology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | | | - Selen Gur Ozmen
- Department of Physiotherapy and Rehabilitation, Faculty Of Health Sciences, Bahcesehir University, Istanbul, Turkey
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Valente EP, Covi B, Mariani I, Morano S, Otalea M, Nanu I, Nanu MI, Elden H, Linden K, Zaigham M, Vik ES, Kongslien S, Nedberg I, Costa R, Rodrigues C, Dias H, Drandić D, Kurbanović M, Sacks E, Muzigaba M, Lincetto O, Lazzerini M. WHO Standards-based questionnaire to measure health workers' perspective on the quality of care around the time of childbirth in the WHO European region: development and mixed-methods validation in six countries. BMJ Open 2022; 12:e056753. [PMID: 35396296 PMCID: PMC8995570 DOI: 10.1136/bmjopen-2021-056753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Develop and validate a WHO Standards-based online questionnaire to measure the quality of maternal and newborn care (QMNC) around the time of childbirth from the health workers' perspective. DESIGN Mixed-methods study. SETTING Six countries of the WHO European Region. PARTICIPANTS AND METHODS The questionnaire is based on lessons learnt in previous studies, and was developed in three sequential phases: (1) WHO Quality Measures were prioritised and content, construct and face validity were assessed through a Delphi involving a multidisciplinary board of experts from 11 countries of the WHO European Region; (2) translation/back translation of the English version was conducted following The Professional Society for Health Economics and Outcomes Research guidelines; (3) internal consistency, intrarater reliability and acceptability were assessed among 600 health workers in six countries. RESULTS The questionnaire included 40 items based on WHO Standards Quality Measures, equally divided into four domains: provision of care, experience of care, availability of human and physical resources, organisational changes due to COVID-19; and its organised in six sections. It was translated/back translated in 12 languages: Bosnian, Croatian, French, German, Italian, Norwegian, Portuguese, Romanian, Russian, Slovenian, Spanish and Swedish. The Cronbach's alpha values were ≥0.70 for each questionnaire section where questions were hypothesised to be interrelated, indicating good internal consistence. Cohen K or Gwet's AC1 values were ≥0.60, suggesting good intrarater reliability, except for one question. Acceptability was good with only 1.70% of health workers requesting minimal changes in question wording. CONCLUSIONS Findings suggest that the questionnaire has good content, construct, face validity, internal consistency, intrarater reliability and acceptability in six countries of the WHO European Region. Future studies may further explore the questionnaire's use in other countries, and how to translate evidence generated by this tool into policies to improve the QMNC. TRAIL REGISTRATION NUMBER NCT04847336.
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Affiliation(s)
- Emanuelle Pessa Valente
- 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
| | - Sandra Morano
- Medical School and Midwifery School, Genoa University, Genoa, Italy
| | - Marina Otalea
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
- SAMAS Association, Bucharest, Romania
| | - Ioana Nanu
- National Institute for Mother and Child Health "Alessandrescu - Rusescu", Bucharest, Romania
| | - Micaela Iuliana Nanu
- National Institute for Mother and Child Health "Alessandrescu - Rusescu", Bucharest, Romania
| | - Helen Elden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Karolina Linden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mehreen Zaigham
- Department of Obstetrics and Gynecology - Institution of Clinical Sciences Lund, Lund University, Lund and Skåne University Hospital, Malmö, Sweden
| | - Eline Skirnisdottir Vik
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Sigrun Kongslien
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ingvild Nedberg
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Raquel Costa
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
- Human-Environment Interaction Lab, Universidade Lusófona, Porto, Portugal
| | - Carina Rodrigues
- EPIUnit - Institute of Public Health, University of Porto, Porto, Portugal
- Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal
| | - Heloísa Dias
- Regional Health Administration of the Algarve, IP (ARS - Algarve), Albufeira, Portugal
| | | | | | - Emma Sacks
- Department of International Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Moise Muzigaba
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Ornella Lincetto
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Marzia Lazzerini
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", Trieste, Italy
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10
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Lazzerini M, Mariani I, de Melo E Lima TR, Felici E, Martelossi S, Lubrano R, Lucarelli A, Trobia GL, Cogo P, Peri F, Nisticò D, Were WM, Baltag V, Muzigaba M, Barbi E. WHO standards-based tools to measure service providers' and service users' views on the quality of hospital child care: development and validation in Italy. BMJ Open 2022; 12:e052115. [PMID: 35301202 PMCID: PMC8932272 DOI: 10.1136/bmjopen-2021-052115] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 02/21/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Evidence showed that, even in high-income countries, children and adolescents may not receive high quality of care (QOC). We describe the development and initial validation, in Italy, of two WHO standards-based questionnaires to conduct an assessment of QOC for children and young adolescents at inpatient level, based on the provider and user perspectives. DESIGN Multiphase, mixed-methods study. SETTING, PARTICIPANTS AND METHODS The two questionnaires were developed in four phases equally conducted for each tool. Phase 1 which included the prioritisation of the WHO Quality Measures according to predefined criteria and the development of the draft questionnaires. In phase 2 content face validation of the draft questionnaires was assessed among both experts and end-users. In phase 3 the optimised questionnaires were field tested to assess acceptability, perceived utility and comprehensiveness (N=163 end-users). In phase 4 intrarater reliability and internal consistency were evaluated (N=170 and N=301 end-users, respectively). RESULTS The final questionnaires included 150 WHO Quality Measures. Observed face validity was excellent (kappa value of 1). The field test resulted in response rates of 98% and 76% for service users and health providers, respectively. Among respondents, 96.9% service users and 90.4% providers rated the questionnaires as useful, and 86.9% and 93.9%, respectively rated them as comprehensive. Intrarater reliability was good, with Cohen's kappa values exceeding 0.70. Cronbach alpha values ranged from 0.83 to 0.95, indicating excellent internal consistency. CONCLUSIONS Study findings suggest these tools developed have good content and face validity, high acceptability and perceived utility, and good intrarater reliability and internal consistency, and therefore could be used in health facilities in Italy and similar contexts. Priority areas for future research include how tools measuring paediatric QOC can be more effectively used to help health professionals provide the best possible care.
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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
| | - Ilaria Mariani
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy
| | | | - Riccardo Lubrano
- Department of Pediatrics, "La Sapienza" University -Hospital "Santa Maria Goretti" of Latina, Roma, Italy
| | - Annunziata Lucarelli
- Pediatric Emergency Department, Giovanni XXIII Pediatric Hospital, University of Bari, Bari, Italy
| | - Gian Luca Trobia
- Pediatric and Pediatric Emergency Room Unit, "Cannizzaro" Emergency Hospital, Catania, Italy
| | - Paola Cogo
- Division of Paediatrics, Department of Medicine DAME, Academic Hospital Santa Maria della Misericordia, University of Udine, Udine, Italy
| | | | | | - Wilson Milton Were
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Valentina Baltag
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Moise Muzigaba
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Egidio Barbi
- University of Trieste, Trieste, Italy
- Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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11
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Lazzerini M, Argentini G, Mariani I, Covi B, Semenzato C, Lincetto O, Muzigaba M, Valente EP. WHO standards-based tool to measure women's views on the quality of care around the time of childbirth at facility level in the WHO European region: development and validation in Italy. BMJ Open 2022; 12:e048195. [PMID: 35172991 PMCID: PMC8852667 DOI: 10.1136/bmjopen-2020-048195] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES A comprehensive WHO standards-based tool to measure women's perceived quality of maternal and newborn care (QMNC) in health facilities is needed to allow for comparisons of data across settings and over time. This paper describes the development of such a tool, and its validation in Italy. DESIGN A multiphase, mixed-methods study involving qualitative and quantitative research methods. SETTING Nine health facilities in Italy. METHODS The questionnaire was developed in six phases: (1) Defining the scope, characteristics and a potential list of measures for the tool; (2) initial content and construct validation; (3) first field testing to assess acceptability and perceived utility for end-users (1244 women, 35 decision makers) and further explore construct validity; (4) content optimisation and score development; (5) assessment of face validity, intrarater reliability and internal consistency and (6) second field testing in nine maternity hospitals (4295 women, 78 decision-makers). RESULTS The final version of the tool included 116 questions accounting for 99 out of the 350 of the extended lists of WHO Quality Measures. Observed face validity was very good, with 100% agreement for 101 (87%) questions and Kappa exceeding 0.60 for remaining ones. Reliability was good, with either high agreement or Kappa exceeding 0.60 for all items. Cronbach alpha values ranged from 0.84 to 0.88, indicating very good internal consistency. Acceptability across seven hospitals was good (mean response rate: 57.4%, 95% CI 44.4% to 70.5%). The questionnaire proved to be useful, driving the development of actions plan to improve the QMNC in each facility. CONCLUSIONS Study findings suggest that the tool has good content, construct, face validity, intrarater reliability and internal consistency, while being acceptable and useful. Therefore, it could be used in health facilities in Italy and similar context. More research should investigate how effectively use the tool in different countries for improving the QMNC.
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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
| | - Giorgia Argentini
- 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
| | - Benedetta Covi
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - Chiara Semenzato
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
| | - O Lincetto
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneve, Switzerland
| | - Moise Muzigaba
- Department of Maternal, Newborn, Child and Adolescent Health and Ageing, World Health Organization, Geneve, Switzerland
| | - Emanuelle Pessa Valente
- WHO Collaborating Centre for Maternal and Child Health, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy
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12
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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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13
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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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The Association between Birth Satisfaction and the Risk of Postpartum Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910458. [PMID: 34639758 PMCID: PMC8508559 DOI: 10.3390/ijerph181910458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
Negative experiences with childbirth might have a negative impact on a woman’s overall health, including a higher risk of postpartum depression. The aim of the study was to examine the association between birth satisfaction and the risk of postpartum depression (PPD). A 30-item version of the Birth Satisfaction Scale (BSS) and the Edinburgh Postnatal Depression Scale (EPDS) were used, as well as the Perceived Stress Scale (PSS). The study included 584 women (mean age 30.6 ± 4.9), 2 to 4 days postpartum. In the regression model, the negative effect of birth satisfaction on the risk of postpartum depression was shown: a lower level of satisfaction with childbirth was a significant predictor of a higher risk of PPD (β = −0.18, 95% CI = −0.08; −0.03). The regression model was controlled for the effect of the sociodemographic factors (such as education or marital status) and clinical variables (such as parity, type of delivery, psychiatric history, levels of prenatal stress). Levels of prenatal stress (β = 0.43, 95% CI = 0.27; 0.39), psychiatric history (β = 0.08, 95% CI = 0.01; 3.09), parity (β = −0.12, 95% CI = −1.82; −0.32) and type of delivery (β = 0.11, 95% CI = 0.20; 1.94) were also significantly associated with the levels of postnatal depression. The current study confirmed the association between the level of birth satisfaction and the risk of developing PPD, i.e., a lower satisfaction with childbirth may increase the risk of developing PPD.
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Induction of labour in low-resource settings. Best Pract Res Clin Obstet Gynaecol 2021; 77:90-109. [PMID: 34509391 DOI: 10.1016/j.bpobgyn.2021.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/23/2022]
Abstract
Due to the disparity in resource availability between low- and high-resource settings, practice recommendations relevant to high-income countries are not always relevant and often need to be adapted to low-resource settings. The adaptation applies to induction of labour (IOL) which is an obstetric procedure that deserves special attention because it involves the initiation of a process that requires regular and frequent monitoring of the mother and foetus by experienced healthcare professionals. Lack of problem recognition and/or substandard care during IOL may result in harm with long-term sequelae. In this article, the authors discuss unique challenges such as insufficient resources (including staff, midwives, doctors, equipment, and medications) that result in occasional inadequate patient monitoring and/or delayed interventions during IOL in low-resource settings. We also discuss modifications in indications and methods for IOL, issues related to human immunodeficiency virus (HIV) infections, the feasibility of outpatient induction, clinical protocols and a minimum dataset for quality improvement projects. Overall, the desire to achieve a vaginal birth with IOL should not cloud the necessity to observe the required safety measures and implement necessary interventions; given that childbirth practices are the major determinants of pregnancy outcomes and patient satisfaction.
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Bains S, Sundby J, Lindskog BV, Vangen S, Diep LM, Owe KM, Sorbye IK. Satisfaction with maternity care among recent migrants: an interview questionnaire-based study. BMJ Open 2021; 11:e048077. [PMID: 34272220 PMCID: PMC8287626 DOI: 10.1136/bmjopen-2020-048077] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To examine factors associated with recently migrated women's satisfaction with maternity care in urban Oslo, Norway. DESIGN An interview-based cross-sectional study, using a modified version of Migrant Friendly Maternity Care Questionnaire. SETTING Face-to-face interview after birth in two maternity wards in urban Oslo, Norway, from January 2019 to February 2020. PARTICIPANTS International migrant women, ≤5 years length of residency in Norway, giving birth in urban Oslo, excluding women born in high-income countries. PRIMARY OUTCOME Dissatisfaction of care during pregnancy and birth, measured using a Likert scale, grouped into satisfied and dissatisfied, in relation to socio-demographic/clinical characteristics and healthcare experiences. SECONDARY OUTCOME Negative healthcare experiences and their association with reason for migration. RESULTS A total of 401 women answered the questionnaire (87.6% response rate). Overall satisfaction with maternal healthcare was high. However, having a Norwegian partner, higher education and high Norwegian language comprehension were associated with greater odds of being dissatisfied with care. One-third of all women did not understand the information provided by the healthcare personnel during maternity care. More women with refugee background felt treated differently because of factors such as religion, language and skin colour, than women who migrated due to family reunification. CONCLUSIONS Although the overall satisfaction was high, for certain healthcare experiences such as understanding information, we found more negative responses. The negative healthcare experiences and factors associated with satisfaction identified in this study have implications for health system planning, education of healthcare personnel and strategies for quality improvement.
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Affiliation(s)
- Sukhjeet Bains
- Norwegian Research Centre for Women's Health, Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johanne Sundby
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Benedikte V Lindskog
- Department of International Studies and Interpreting, Section for Diversity Studies, Oslo Metropolitan University, Oslo, Norway
| | - Siri Vangen
- Norwegian Research Centre for Women's Health, Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lien M Diep
- Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Katrine M Owe
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingvil K Sorbye
- Norwegian Research Centre for Women's Health, Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
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