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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

Valente, Emanuelle Pessa ; Covi, Benedetta ; Mariani, Ilaria ; Morano, Sandra ; Otalea, Marina ; Nanu, Ioana ; Nanu, Micaela Iuliana ; Elden, Helen ; Linden, Karolina LU orcid and Zaigham, Mehreen LU orcid , et al. (2022) In BMJ Open 12(4). p.1-10
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... (More)

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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type
Contribution to journal
publication status
published
subject
keywords
COVID-19, Female, Humans, Infant, Newborn, Pregnancy, Psychometrics, Quality of Health Care, Reproducibility of Results, Surveys and Questionnaires, World Health Organization
in
BMJ Open
volume
12
issue
4
article number
e056753
pages
1 - 10
publisher
BMJ Publishing Group
external identifiers
  • scopus:85127860928
  • pmid:35396296
ISSN
2044-6055
DOI
10.1136/bmjopen-2021-056753
language
English
LU publication?
yes
additional info
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
id
79f3d13a-81ce-4710-a263-0f5f7ee0f20d
date added to LUP
2022-04-16 08:17:48
date last changed
2025-05-02 18:24:43
@article{79f3d13a-81ce-4710-a263-0f5f7ee0f20d,
  abstract     = {{<p>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.</p><p>DESIGN: Mixed-methods study.</p><p>SETTING: Six countries of the WHO European Region.</p><p>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.</p><p>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.</p><p>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.</p><p>TRAIL REGISTRATION NUMBER: NCT04847336.</p>}},
  author       = {{Valente, Emanuelle Pessa and Covi, Benedetta and Mariani, Ilaria and Morano, Sandra and Otalea, Marina and Nanu, Ioana and Nanu, Micaela Iuliana and Elden, Helen and Linden, Karolina and Zaigham, Mehreen and Vik, Eline Skirnisdottir and Kongslien, Sigrun and Nedberg, Ingvild and Costa, Raquel and Rodrigues, Carina and Dias, Heloísa and Drandić, Daniela and Kurbanović, Magdalena and Sacks, Emma and Muzigaba, Moise and Lincetto, Ornella and Lazzerini, Marzia}},
  issn         = {{2044-6055}},
  keywords     = {{COVID-19; Female; Humans; Infant, Newborn; Pregnancy; Psychometrics; Quality of Health Care; Reproducibility of Results; Surveys and Questionnaires; World Health Organization}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1--10}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Open}},
  title        = {{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}},
  url          = {{http://dx.doi.org/10.1136/bmjopen-2021-056753}},
  doi          = {{10.1136/bmjopen-2021-056753}},
  volume       = {{12}},
  year         = {{2022}},
}