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

Valente, Emanuelle Pessa; Mariani, Ilaria; Bomben, Arianna; Morano, Sandra; Gemperle, Michael; Otelea, Marina Ruxandra; Miani, Céline; Elden, Helen; Sarantaki, Antigoni; Costa, Raquel; Baranowska, Barbara; König-Bachmann, Martina; Kongslien, Sigrun; Drandić, Daniela; Rozée, Virginie; Nespoli, Antonella; Abderhalden-Zellweger, Alessia; Nanu, Ioana; Batram-Zantvoort, Stephanie; Linden, Karolina; Metallinou, Dimitra; Dias, Heloísa; Tataj-Puzyna, Urszula; D'Costa, Elisabeth; Nedberg, Ingvild Hersoug; Kurbanović, Magdalena; de La Rochebrochard, Elise; Fumagalli, Simona; Grylka-Baeschlin, Susanne; Handra, Claudia Mariana; Zaigham, Mehreen; Orovou, Eirini; Barata, Catarina; Szlendak, Beata; Zenzmaier, Christoph; Vik, Eline Skirnisdottir; Liepinaitienė, Alina; Drglin, Zalka; Arendt, Maryse; Sacks, Emma; Lazzerini, Marzia

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

Mark

Valente, Emanuelle Pessa ; Mariani, Ilaria ; Bomben, Arianna ; Morano, Sandra ; Gemperle, Michael ; Otelea, Marina Ruxandra ; Miani, Céline ; Elden, Helen ; Sarantaki, Antigoni and Costa, Raquel , et al. (2024) In Journal of Global Health 14. p.1-18

Abstract

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... (More)

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.

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Please use this url to cite or link to this publication: https://lup.lub.lu.se/record/27ffb957-1cf6-4485-8a72-726d19b22867

author

Valente, Emanuelle Pessa ; Mariani, Ilaria ; Bomben, Arianna ; Morano, Sandra ; Gemperle, Michael ; Otelea, Marina Ruxandra ; Miani, Céline ; Elden, Helen ; Sarantaki, Antigoni and Costa, Raquel , et al. (More)

Valente, Emanuelle Pessa ; Mariani, Ilaria ; Bomben, Arianna ; Morano, Sandra ; Gemperle, Michael ; Otelea, Marina Ruxandra ; Miani, Céline ; Elden, Helen ; Sarantaki, Antigoni ; Costa, Raquel ; Baranowska, Barbara ; König-Bachmann, Martina ; Kongslien, Sigrun ; Drandić, Daniela ; Rozée, Virginie ; Nespoli, Antonella ; Abderhalden-Zellweger, Alessia ; Nanu, Ioana ; Batram-Zantvoort, Stephanie ; Linden, Karolina ; Metallinou, Dimitra ; Dias, Heloísa ; Tataj-Puzyna, Urszula ; D'Costa, Elisabeth ; Nedberg, Ingvild Hersoug ; Kurbanović, Magdalena ; de La Rochebrochard, Elise ; Fumagalli, Simona ; Grylka-Baeschlin, Susanne ; Handra, Claudia Mariana ; Zaigham, Mehreen ^LU

; Orovou, Eirini ; Barata, Catarina ; Szlendak, Beata ; Zenzmaier, Christoph ; Vik, Eline Skirnisdottir ; Liepinaitienė, Alina ; Drglin, Zalka ; Arendt, Maryse ; Sacks, Emma and Lazzerini, Marzia (Less)

author collaboration

Improving MAternal Newborn carE in the EURO Region (IMAgiNE EURO) Study Group

organization

Obstetrics and Gynaecology (Lund)

publishing date

2024-09-06

type

Contribution to journal

publication status

published

subject

Health Care Service and Management, Health Policy and Services and Health Economy

keywords

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

in

Journal of Global Health

volume

14

article number

04164

pages

1 - 18

publisher

Edinburgh University Global Health Society

external identifiers

pmid:39238363

ISSN

2047-2986

DOI

10.7189/jogh.14.04164

language

English

LU publication?

yes

additional info

id

27ffb957-1cf6-4485-8a72-726d19b22867

date added to LUP

2024-09-10 10:18:57

date last changed

2024-09-10 12:24:26

@article{27ffb957-1cf6-4485-8a72-726d19b22867,
  abstract     = {{<p>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.</p><p>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.</p><p>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 &lt; 0.001). Over time, there was a significant monthly linear decrease in the QMNC index (P &lt; 0.001), lacking correlation with the coronavirus disease 2019 (COVID-19) pandemic trends (P &gt; 0.05). Multivariate analyses confirmed large QMNC variation by country. HWs with &lt;10 years of experience, HWs from public facilities, and midwives rated QMNC with significantly lower scores (P &lt; 0.001).</p><p>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.</p><p>REGISTRATION: ClinicalTrials.gov NCT04847336.</p>}},
  author       = {{Valente, Emanuelle Pessa and Mariani, Ilaria and Bomben, Arianna and Morano, Sandra and Gemperle, Michael and Otelea, Marina Ruxandra and Miani, Céline and Elden, Helen and Sarantaki, Antigoni and Costa, Raquel and Baranowska, Barbara and König-Bachmann, Martina and Kongslien, Sigrun and Drandić, Daniela and Rozée, Virginie and Nespoli, Antonella and Abderhalden-Zellweger, Alessia and Nanu, Ioana and Batram-Zantvoort, Stephanie and Linden, Karolina and Metallinou, Dimitra and Dias, Heloísa and Tataj-Puzyna, Urszula and D'Costa, Elisabeth and Nedberg, Ingvild Hersoug and Kurbanović, Magdalena and de La Rochebrochard, Elise and Fumagalli, Simona and Grylka-Baeschlin, Susanne and Handra, Claudia Mariana and Zaigham, Mehreen and Orovou, Eirini and Barata, Catarina and Szlendak, Beata and Zenzmaier, Christoph and Vik, Eline Skirnisdottir and Liepinaitienė, Alina and Drglin, Zalka and Arendt, Maryse and Sacks, Emma and Lazzerini, Marzia}},
  issn         = {{2047-2986}},
  keywords     = {{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}},
  language     = {{eng}},
  month        = {{09}},
  pages        = {{1--18}},
  publisher    = {{Edinburgh University Global Health Society}},
  series       = {{Journal of Global Health}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.7189/jogh.14.04164}},
  doi          = {{10.7189/jogh.14.04164}},
  volume       = {{14}},
  year         = {{2024}},
}

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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