Health workers' perspectives on the quality of maternal and newborn health care around the time of childbirth: Results of the Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) project in 12 countries of the World Health Organization European Region.

Humans World Health Organization Female Cross-Sectional Studies Europe Infant, Newborn Pregnancy Adult Quality of Health Care Health Personnel Surveys and Questionnaires Quality Improvement Attitude of Health Personnel Maternal-Child Health Services / standards Parturition

Journal

Journal of global health

ISSN: 2047-2986

Titre abrégé: J Glob Health

Pays: Scotland

ID NLM: 101578780

Informations de publication

Date de publication:
06 Sep 2024

Historique:

medline: 6 9 2024

pubmed: 6 9 2024

entrez: 6 9 2024

Statut: epublish

Résumé

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. 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. 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). 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. ClinicalTrials.gov NCT04847336.

Sections du résumé

Background UNASSIGNED

Methods UNASSIGNED

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 UNASSIGNED

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 UNASSIGNED

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 UNASSIGNED

ClinicalTrials.gov NCT04847336.

Identifiants

DOI: 10.7189/jogh.14.04164 PMID: 39238363

pubmed: 39238363

doi: 10.7189/jogh.14.04164

doi:

Banques de données

ClinicalTrials.gov

['NCT04847336']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

04164

Investigateurs

Martina König-Bachmann (M)

Christoph Zenzmaier (C)

Simon Imola (S)

Elisabeth D'Costa (E)

Anne Galle (A)

Silke D'Hauwers (S)

Amira Ćerimagić (A)

Ourania Kolokotroni (O)

Eleni Hadjigeorgiou (E)

Maria Karanikola (M)

Nicos Middleton (N)

Ioli Orphanide (I)

Daniela Drandić (D)

Magdalena Kurbanović (M)

Lenka Laubrova Zirovnicka (LL)

Miloslava Kramná (M)

Rozée Virginie (R)

Elise de La Rochebrochard (E)

Kristina Löfgren (K)

Céline Miani (C)

Stephanie Batram-Zantvoort (S)

Antigoni Sarantaki (A)

Dimitra Metallinou (D)

Aikaterini Lykeridou (A)

Eirini Orovou (E)

Ilana Chertok (I)

Rada Artzi-Medvedik (R)

Marzia Lazzerini (M)

Emanuelle Pessa Valente (EP)

Ilaria Mariani (I)

Arianna Bomben (A)

Stefano Delle Vedove (S)

Sandra Morano (S)

Antonella Nespoli (A)

Simona Fumagalli (S)

Elizabete Pumpure (E)

Dace Rezeberga (D)

Dārta Jakovicka (D)

Gita Jansone-Šantare (G)

Anna Šibalova (A)

Elīna Voitehoviča (E)

Dārta Krēsliņa (D)

Alina Liepinaitienė (A)

Andželika Kondrakova (A)

Marija Mizgaitienė (M)

Simona Juciūtė (S)

Maryse Arendt (M)

Barbara Tasch (B)

Enrico Lopriore (E)

Thomas Van den Akker (T)

Ingvild Hersoug Nedberg (IH)

Sigrun Kongslien (S)

Eline Skirnisdottir Vik (ES)

Barbara Baranowska (B)

Urszula Tataj-Puzyna (U)

Beata Szlendak (B)

Paulina Pawlicka (P)

Raquel Costa (R)

Catarina Barata (C)

Teresa Santos (T)

Heloísa Dias (H)

Tiago Miguel Pinto (TM)

Sofia Marques (S)

Ana Meireles (A)

Joana Oliveira (J)

Mariana Pereira (M)

Maria Arminda Nunes (MA)

Marina Ruxandra Otelea (MR)

Jelena Radetić (J)

Jovana Ružičić (J)

Zalka Drglin (Z)

Anja Bohinec (A)

Serena Brigidi (S)

Alejandra Oliden (A)

Lara Martín Castañeda (LM)

Helen Elden (H)

Region Västra Götaland (RV)

Karolina Linden (K)

Mehreen Zaigham (M)

Claire de Labrusse (C)

Alessia Abderhalden-Zellweger (A)

Anouck Pfund (A)

Harriet Thorn (H)

Susanne Grylka (S)

Michael Gemperle (M)

Antonia Mueller (A)

Informations de copyright

Déclaration de conflit d'intérêts

Disclosure of interests: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests.