Hospital Performance Indicators in Provision of Perinatal Services: A Qualitative Study.

Abstract

Objective: Perinatal mortality is an indicating factor in social development, and international measures have been taken to reduce maternal and perinatal mortality. This study aims to collect the experts' opinions about hospitals performance in providing perinatal services and emerge the key indicators for evaluation.

Materials and methods: This is a qualitative study using the Delphi technique and based on the focus group discussion sessions with twelve experts, including pediatricians, perinatologists, neonatologists, neonatal care nurses, and midwives with at least five years of work experience. A coordinator managed the sessions, and the discussions continued until saturation. Thematic analysis was performed to extract the major themes and sub-themes.

Results: Three main themes of input/structure, process, and outcome are extracted. The input/structure theme consists of human resources, physical space, equipment, and technical support and information. In human resources, the number and proficiency of healthcare providers and mental health problems are expressed. In terms of physical space, the areas and infrastructure facilities are discussed. The proper purchase and allocation of equipment are emphasized in the equipment sub-theme. The need to establish a Health Information Service in level-one centers is mentioned in the support sub-theme. The process theme consists of medical staff retraining and empowerment, referral, follow-up, education, and audits. The maternal and neonatal mortality and morbidity indices are cited in the outcome theme.

Conclusion: Our findings provide a wide range of context-specific challenges the healthcare systems face in provision of perinatal health services. As a result of this study, the primary indicators for assessing the hospitals' performance in providing perinatal services are emerged.