TY - JOUR
T1 - Health workers’ perspectives on the quality of maternal and newborn health care around the time of childbirth
T2 - Results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region
AU - Improving Maternal Newborn carE in the EURO Region (IMAgiNE EURO) Study Group
AU - Valente, Emanuelle Pessa
AU - Mariani, Ilaria
AU - Bomben, Arianna
AU - Morano, Sandra
AU - Gemperle, Michael
AU - Otelea, Marina Ruxandra
AU - Miani, Céline
AU - Elden, Helen
AU - Sarantaki, Antigoni
AU - Costa, Raquel
AU - Baranowska, Barbara
AU - König-Bachmann, Martina
AU - Kongslien, Sigrun
AU - Drandić, Daniela
AU - Rozée, Virginie
AU - Nespoli, Antonella
AU - Abderhalden-Zellweger, Alessia
AU - Nanu, Ioana
AU - Batram-Zantvoort, Stephanie
AU - Linden, Karolina
AU - Metallinou, Dimitra
AU - Dias, Heloísa
AU - Tataj-Puzyna, Urszula
AU - D’Costa, Elisabeth
AU - Nedberg, Ingvild Hersoug
AU - Kurbanović, Magdalena
AU - de La Rochebrochard, Elise
AU - Fumagalli, Simona
AU - Grylka-Baeschlin, Susanne
AU - Handra, Claudia Mariana
AU - Zaigham, Mehreen
AU - Orovou, Eirini
AU - Barata, Catarina
AU - Szlendak, Beata
AU - Zenzmaier, Christoph
AU - Vik, Eline Skirnisdottir
AU - Liepinaitienė, Alina
AU - Drglin, Zalka
AU - Arendt, Maryse
AU - Sacks, Emma
AU - Lazzerini, Marzia
N1 - Copyright © 2024 by the Journal of Global Health. All rights reserved.
PY - 2024/9/6
Y1 - 2024/9/6
N2 - BACKGROUND: Health workers' (HWs') perspectives on the quality of maternal and newborn care (QMNC) are not routinely collected. In this cross-sectional study, we aimed to document HWs' perspectives on QMNC around childbirth in 12 World Health Organization (WHO) European countries.METHODS: HWs involved in maternal/neonatal care for at least one year between March 2020 and March 2023 answered an online validated WHO standards-based questionnaire collecting 40 quality measures for improving QMNC. A QMNC index (score 0-400) was calculated as a synthetic measure.RESULTS: Data from 4143 respondents were analysed. For 39 out of 40 quality measures, at least 20% of HWs reported a 'need for improvement', with large variations across countries. Effective training on healthy women/newborns management (n = 2748, 66.3%), availability of informed consent job aids (n = 2770, 66.9%), and effective training on women/newborns rights (n = 2714, 65.5%) presented the highest proportion of HWs stating 'need for improvement'. Overall, 64.8% (n = 2684) of respondents declared that HWs' numbers were insufficient for appropriate care (66.3% in Portugal and 86.6% in Poland), and 22.4% described staff censorship (16.3% in Germany and 56.7% in Poland). The reported QMNC index was low in all countries (Poland median (MD) = 210.60, interquartile range (IQR) = 155.71, 273.57; Norway MD = 277.86; IQR = 244.32, 308.30). The 'experience of care' domain presented in eight countries had significantly lower scores than the other domains (P < 0.001). Over time, there was a significant monthly linear decrease in the QMNC index (P < 0.001), lacking correlation with the coronavirus disease 2019 (COVID-19) pandemic trends (P > 0.05). Multivariate analyses confirmed large QMNC variation by country. HWs with <10 years of experience, HWs from public facilities, and midwives rated QMNC with significantly lower scores (P < 0.001).CONCLUSIONS: HWs from 12 European countries reported significant gaps in QMNC, lacking association with COVID-19 pandemic trends. Routine monitoring of QMNC and tailored actions are needed to improve health services for the benefit of both users and providers.REGISTRATION: ClinicalTrials.gov NCT04847336.
AB - BACKGROUND: Health workers' (HWs') perspectives on the quality of maternal and newborn care (QMNC) are not routinely collected. In this cross-sectional study, we aimed to document HWs' perspectives on QMNC around childbirth in 12 World Health Organization (WHO) European countries.METHODS: HWs involved in maternal/neonatal care for at least one year between March 2020 and March 2023 answered an online validated WHO standards-based questionnaire collecting 40 quality measures for improving QMNC. A QMNC index (score 0-400) was calculated as a synthetic measure.RESULTS: Data from 4143 respondents were analysed. For 39 out of 40 quality measures, at least 20% of HWs reported a 'need for improvement', with large variations across countries. Effective training on healthy women/newborns management (n = 2748, 66.3%), availability of informed consent job aids (n = 2770, 66.9%), and effective training on women/newborns rights (n = 2714, 65.5%) presented the highest proportion of HWs stating 'need for improvement'. Overall, 64.8% (n = 2684) of respondents declared that HWs' numbers were insufficient for appropriate care (66.3% in Portugal and 86.6% in Poland), and 22.4% described staff censorship (16.3% in Germany and 56.7% in Poland). The reported QMNC index was low in all countries (Poland median (MD) = 210.60, interquartile range (IQR) = 155.71, 273.57; Norway MD = 277.86; IQR = 244.32, 308.30). The 'experience of care' domain presented in eight countries had significantly lower scores than the other domains (P < 0.001). Over time, there was a significant monthly linear decrease in the QMNC index (P < 0.001), lacking correlation with the coronavirus disease 2019 (COVID-19) pandemic trends (P > 0.05). Multivariate analyses confirmed large QMNC variation by country. HWs with <10 years of experience, HWs from public facilities, and midwives rated QMNC with significantly lower scores (P < 0.001).CONCLUSIONS: HWs from 12 European countries reported significant gaps in QMNC, lacking association with COVID-19 pandemic trends. Routine monitoring of QMNC and tailored actions are needed to improve health services for the benefit of both users and providers.REGISTRATION: ClinicalTrials.gov NCT04847336.
KW - Adult
KW - Attitude of Health Personnel
KW - Cross-Sectional Studies
KW - Europe
KW - Female
KW - Health Personnel
KW - Humans
KW - Infant, Newborn
KW - Maternal-Child Health Services/standards
KW - Parturition
KW - Pregnancy
KW - Quality Improvement
KW - Quality of Health Care
KW - Surveys and Questionnaires
KW - World Health Organization
UR - http://www.scopus.com/inward/record.url?scp=85203419877&partnerID=8YFLogxK
UR - https://research.ulusofona.pt/en/publications/36bb954c-d7f2-4058-9af1-503438c882e0
U2 - 10.7189/JOGH.14.04164
DO - 10.7189/JOGH.14.04164
M3 - Article
C2 - 39238363
AN - SCOPUS:85203419877
SN - 2047-2978
VL - 14
SP - 04164
JO - Journal of Global Health
JF - Journal of Global Health
M1 - 04164
ER -