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.
IF 4.5 3区 医学Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Emanuelle Pessa Valente, Ilaria Mariani, Arianna Bomben, Sandra Morano, Michael Gemperle, Marina Ruxandra Otelea, Céline Miani, Helen Elden, Antigoni Sarantaki, Raquel Costa, Barbara Baranowska, Martina König-Bachmann, Sigrun Kongslien, Daniela Drandić, Virginie Rozée, Antonella Nespoli, Alessia Abderhalden-Zellweger, Ioana Nanu, Stephanie Batram-Zantvoort, Karolina Linden, Dimitra Metallinou, Heloísa Dias, Urszula Tataj-Puzyna, Elisabeth D'Costa, Ingvild Hersoug Nedberg, Magdalena Kurbanović, Elise de La Rochebrochard, Simona Fumagalli, Susanne Grylka-Baeschlin, Claudia Mariana Handra, Mehreen Zaigham, Eirini Orovou, Catarina Barata, Beata Szlendak, Christoph Zenzmaier, Eline Skirnisdottir Vik, Alina Liepinaitienė, Zalka Drglin, Maryse Arendt, Emma Sacks, Marzia Lazzerini
{"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.","authors":"Emanuelle Pessa Valente, Ilaria Mariani, Arianna Bomben, Sandra Morano, Michael Gemperle, Marina Ruxandra Otelea, Céline Miani, Helen Elden, Antigoni Sarantaki, Raquel Costa, Barbara Baranowska, Martina König-Bachmann, Sigrun Kongslien, Daniela Drandić, Virginie Rozée, Antonella Nespoli, Alessia Abderhalden-Zellweger, Ioana Nanu, Stephanie Batram-Zantvoort, Karolina Linden, Dimitra Metallinou, Heloísa Dias, Urszula Tataj-Puzyna, Elisabeth D'Costa, Ingvild Hersoug Nedberg, Magdalena Kurbanović, Elise de La Rochebrochard, Simona Fumagalli, Susanne Grylka-Baeschlin, Claudia Mariana Handra, Mehreen Zaigham, Eirini Orovou, Catarina Barata, Beata Szlendak, Christoph Zenzmaier, Eline Skirnisdottir Vik, Alina Liepinaitienė, Zalka Drglin, Maryse Arendt, Emma Sacks, Marzia Lazzerini","doi":"10.7189/jogh.14.04164","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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><strong>Methods: </strong>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><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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><strong>Registration: </strong>ClinicalTrials.gov NCT04847336.</p>","PeriodicalId":48734,"journal":{"name":"Journal of Global Health","volume":"14 ","pages":"04164"},"PeriodicalIF":4.5000,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377968/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Global Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7189/jogh.14.04164","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
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 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.
期刊介绍：
Journal of Global Health is a peer-reviewed journal published by the Edinburgh University Global Health Society, a not-for-profit organization registered in the UK. We publish editorials, news, viewpoints, original research and review articles in two issues per year.
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