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 - Centre de recherche en Épidémiologie et Santé des Populations
Article Dans Une Revue Journal of Global Health Année : 2024

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

Emanuelle Pessa Valente
  • Fonction : Auteur
Arianna Bomben
  • Fonction : Auteur
Sandra Morano
  • Fonction : Auteur
Michael Gemperle
  • Fonction : Auteur
Marina Ruxandra Otelea
  • Fonction : Auteur
Antigoni Sarantaki
  • Fonction : Auteur
Barbara Baranowska
  • Fonction : Auteur
Martina König-Bachmann
  • Fonction : Auteur
Daniela Drandić
  • Fonction : Auteur
Antonella Nespoli
  • Fonction : Auteur
Alessia Abderhalden-Zellweger
  • Fonction : Auteur
Ioana Nanu
  • Fonction : Auteur
Dimitra Metallinou
  • Fonction : Auteur
Heloísa Dias
  • Fonction : Auteur
Urszula Tataj-Puzyna
  • Fonction : Auteur
Elisabeth D’costa
  • Fonction : Auteur
Ingvild Hersoug Nedberg
  • Fonction : Auteur
Magdalena Kurbanović
  • Fonction : Auteur
Simona Fumagalli
  • Fonction : Auteur
Susanne Grylka-Baeschlin
  • Fonction : Auteur
Claudia Mariana Handra
  • Fonction : Auteur
Mehreen Zaigham
  • Fonction : Auteur
Eirini Orovou
  • Fonction : Auteur
Catarina Barata
  • Fonction : Auteur
Beata Szlendak
  • Fonction : Auteur
Christoph Zenzmaier
  • Fonction : Auteur
Eline Skirnisdottir Vik
  • Fonction : Auteur
Alina Liepinaitienė
  • Fonction : Auteur
Zalka Drglin
  • Fonction : Auteur
Maryse Arendt
  • Fonction : Auteur
Emma Sacks
  • Fonction : Auteur
Marzia Lazzerini
  • Fonction : Auteur

Résumé

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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hal-04692160 , version 1 (09-09-2024)

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Emanuelle Pessa Valente, Ilaria Mariani, Arianna Bomben, Sandra Morano, Michael Gemperle, et al.. 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. Journal of Global Health, 2024, 14, ⟨10.7189/jogh.14.04164⟩. ⟨hal-04692160⟩
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