Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries : A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic

Zaigham, Mehreen LU orcid ; Linden, Karolina LU orcid ; Elden, Helen ; Delle Vedove, Stefano ; Mariani, Ilaria ; Kongslien, Sigrun ; Drandić, Daniela ; Pumpure, Elizabete ; Drglin, Zalka and Costa, Raquel , et al. (2024) In Acta Obstetricia et Gynecologica Scandinavica 103(12). p.2485-2498
Abstract

INTRODUCTION: Maternal-neonatal healthcare services were severely disrupted during the COVID-19 pandemic in even high-income countries within the World Health Organization (WHO) European Region. The objective of this study was to compare trends in the quality of maternal and neonatal care (QMNC) in Sweden and Norway to 12 other countries from the WHO European Region during the COVID-19 pandemic, and to identify domains for improvement.

MATERIAL AND METHODS: This cross-sectional study included women giving birth in Europe from March 1, 2020 to December 31, 2022. Women answered an online, anonymous questionnaire which included 40 WHO Standard-based Quality Measures collectively scored as the total QMNC index (0-400) and separately... (More)

INTRODUCTION: Maternal-neonatal healthcare services were severely disrupted during the COVID-19 pandemic in even high-income countries within the World Health Organization (WHO) European Region. The objective of this study was to compare trends in the quality of maternal and neonatal care (QMNC) in Sweden and Norway to 12 other countries from the WHO European Region during the COVID-19 pandemic, and to identify domains for improvement.

MATERIAL AND METHODS: This cross-sectional study included women giving birth in Europe from March 1, 2020 to December 31, 2022. Women answered an online, anonymous questionnaire which included 40 WHO Standard-based Quality Measures collectively scored as the total QMNC index (0-400) and separately in four subdomains (0-100): provision of care, experience of care, availability of human and physical resources, and reorganizational changes due to COVID-19. To assess reported QMNC changes over time, we used adjusted quantile regression models.

CLINICALTRIALS: gov Identifier: NCT04847336.

RESULTS: Of the 45151 women included in the study, 13 117 (29.1%) were from Sweden and Norway and 32034 (70.9%) from the 12 WHO European countries. The total QMNC index for Sweden and Norway (median: 325, IQR: 285-355) was higher than the 12 WHO European countries (median: 315, IQR: 265-350, p < 0.001) as were trends in QMNC index over time (Sweden and Norway median: 310-345; 12 WHO European countries median: 305-340). Sweden and Norway also had higher scores in three-of-four QMNC subdomains, with the 12 WHO European countries scoring higher only for reorganizational changes due to COVID-19. In adjusted quantile models of the total QMNC index, Sweden and Norway had higher scores, with largest differences in the lower quantiles (p < 0.001 in all percentiles).

CONCLUSIONS: Across Europe, there are significant gaps in the quality of maternal-neonatal healthcare services. Although women giving birth in Sweden and Norway reported higher QMNC scores in all subdomains except for "reorganizational changes due to COVID-19," there is room for improvement and shared learning across Europe. Policymakers should prioritize long-term investments in maternal and neonatal healthcare, ensuring that facilities are adequately equipped during public health crises and that all women have access to high-quality, evidence-based, equitable, and respectful care.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
author collaboration
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Acta Obstetricia et Gynecologica Scandinavica
volume
103
issue
12
pages
2485 - 2498
publisher
Wiley-Blackwell
external identifiers
  • scopus:85207300209
  • pmid:39431577
ISSN
1600-0412
DOI
10.1111/aogs.14994
language
English
LU publication?
yes
id
a3a54f46-e072-4c81-bbf1-d22bb713074e
date added to LUP
2024-10-22 08:55:18
date last changed
2025-06-30 22:44:01
@article{a3a54f46-e072-4c81-bbf1-d22bb713074e,
  abstract     = {{<p>INTRODUCTION: Maternal-neonatal healthcare services were severely disrupted during the COVID-19 pandemic in even high-income countries within the World Health Organization (WHO) European Region. The objective of this study was to compare trends in the quality of maternal and neonatal care (QMNC) in Sweden and Norway to 12 other countries from the WHO European Region during the COVID-19 pandemic, and to identify domains for improvement.</p><p>MATERIAL AND METHODS: This cross-sectional study included women giving birth in Europe from March 1, 2020 to December 31, 2022. Women answered an online, anonymous questionnaire which included 40 WHO Standard-based Quality Measures collectively scored as the total QMNC index (0-400) and separately in four subdomains (0-100): provision of care, experience of care, availability of human and physical resources, and reorganizational changes due to COVID-19. To assess reported QMNC changes over time, we used adjusted quantile regression models.</p><p>CLINICALTRIALS: gov Identifier: NCT04847336.</p><p>RESULTS: Of the 45151 women included in the study, 13 117 (29.1%) were from Sweden and Norway and 32034 (70.9%) from the 12 WHO European countries. The total QMNC index for Sweden and Norway (median: 325, IQR: 285-355) was higher than the 12 WHO European countries (median: 315, IQR: 265-350, p &lt; 0.001) as were trends in QMNC index over time (Sweden and Norway median: 310-345; 12 WHO European countries median: 305-340). Sweden and Norway also had higher scores in three-of-four QMNC subdomains, with the 12 WHO European countries scoring higher only for reorganizational changes due to COVID-19. In adjusted quantile models of the total QMNC index, Sweden and Norway had higher scores, with largest differences in the lower quantiles (p &lt; 0.001 in all percentiles).</p><p>CONCLUSIONS: Across Europe, there are significant gaps in the quality of maternal-neonatal healthcare services. Although women giving birth in Sweden and Norway reported higher QMNC scores in all subdomains except for "reorganizational changes due to COVID-19," there is room for improvement and shared learning across Europe. Policymakers should prioritize long-term investments in maternal and neonatal healthcare, ensuring that facilities are adequately equipped during public health crises and that all women have access to high-quality, evidence-based, equitable, and respectful care.</p>}},
  author       = {{Zaigham, Mehreen and Linden, Karolina and Elden, Helen and Delle Vedove, Stefano and Mariani, Ilaria and Kongslien, Sigrun and Drandić, Daniela and Pumpure, Elizabete and Drglin, Zalka and Costa, Raquel and Sarantaki, Antigoni and de Labrusse, Claire and Miani, Céline and Oțelea, Marina Ruxandra and Liepinaitienė, Alina and Baranowska, Barbara and Rozée, Virginie and Valente, Emanuelle Pessa and Vik, Eline Skirnisdottir and Kurbanović, Magdalena and Jakovicka, Dārta and Bohinec, Anja and Dias, Heloísa and Metallinou, Dimitra and Mueller, Antonia N and Batram-Zantvoort, Stephanie and Handra, Claudia Mariana and Mizgaitienė, Marija and Tataj-Puzyna, Urszula and Bomben, Arianna and Nedberg, Ingvild Hersoug and Voitehoviča, Elīna and Pinto, Tiago Miguel and Lykeridou, Aikaterini and Grylka-Baeschlin, Susanne and Jazdauskienė, Simona and Szlendak, Beata and Sacks, Emma and Lazzerini, Marzia}},
  issn         = {{1600-0412}},
  language     = {{eng}},
  month        = {{10}},
  number       = {{12}},
  pages        = {{2485--2498}},
  publisher    = {{Wiley-Blackwell}},
  series       = {{Acta Obstetricia et Gynecologica Scandinavica}},
  title        = {{Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries : A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic}},
  url          = {{http://dx.doi.org/10.1111/aogs.14994}},
  doi          = {{10.1111/aogs.14994}},
  volume       = {{103}},
  year         = {{2024}},
}