Selecting contextually appropriate performance indicators in a circumpolar context: a modified Delphi approach.
Arctic regions
Indigenous health services
health care quality indicators
infant health
maternal health
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
30 May 2021
30 May 2021
Historique:
received:
01
08
2020
accepted:
06
05
2021
entrez:
31
5
2021
pubmed:
1
6
2021
medline:
2
6
2021
Statut:
epublish
Résumé
Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions. Fourteen maternity care and health systems experts participated in a modified Delphi consensus process. The list of proposed indicators was derived from a previously published scoping review. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration. Consensus was achieved after two rounds, as measured by a Cronbach's alpha of 0.87. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Travel for care, cultural safety and upstream structural determinants of health were identified as important themes. This study identified the important gaps between current performance measurement strategies and the context and values that permeate maternal-child health in circumpolar regions. The indicators identified in this study provide an important foundation for ongoing work. We recommend that future work encompass an appreciation for the intersectoral nature of social, structural, and colonial determinants of maternal-child health in circumpolar regions.
Sections du résumé
BACKGROUND
BACKGROUND
Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions.
METHODS
METHODS
Fourteen maternity care and health systems experts participated in a modified Delphi consensus process. The list of proposed indicators was derived from a previously published scoping review. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration.
RESULTS
RESULTS
Consensus was achieved after two rounds, as measured by a Cronbach's alpha of 0.87. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Travel for care, cultural safety and upstream structural determinants of health were identified as important themes.
CONCLUSIONS
CONCLUSIONS
This study identified the important gaps between current performance measurement strategies and the context and values that permeate maternal-child health in circumpolar regions. The indicators identified in this study provide an important foundation for ongoing work. We recommend that future work encompass an appreciation for the intersectoral nature of social, structural, and colonial determinants of maternal-child health in circumpolar regions.
Identifiants
pubmed: 34053444
doi: 10.1186/s12913-021-06485-2
pii: 10.1186/s12913-021-06485-2
pmc: PMC8166122
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
530Subventions
Organisme : Canadian Institutes for Health Research
ID : TT6-128271
Organisme : Canadian Foundation for Women's Health (Dawn Walker Grant)
ID : Canadian Foundation for Women's Health (Dawn Walker Grant)
Organisme : Canadian Institutes of Health Research - Strategy for Patient Oriented Research patient engagement
ID : 201511PEG
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