Association between person‐centered maternity care and newborn complications in Kenya

Sudhinaraset, May; Landrian, Amanda; Afulani, Patience A.; Diamond‐Smith, Nadia; Golub, Ginger

doi:10.1002/ijgo.12978

Cited by 33 publications

(38 citation statements)

References 11 publications

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“…We categorized full PCMC and each sub-scale into "low, medium and high". Low was defined as scores in the approximate lower 25th percentile and scores in the top 75th percentile defined as high [38].…”

Section: Data Collectionmentioning

confidence: 99%

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Ogbuabor

Nwankwor

2020

Preprint

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Background Women are not getting adequate person-centred maternity care (PCMC) in low-income and middle-income countries despite being important in reducing maternal morbidity and mortality. This study assessed perceptions and predictors of PCMC among childbearing women in Enugu State, South-east Nigeria.Methods The study was conducted in two health districts in Enugu State using a descriptive, cross-sectional survey design. We conveniently selected 450 childbearing women, within 9 weeks post-partum, from 11 health facilities purposively selected based on high maternal and child health attendance. Data was collected from women using an interviewer administered 30-item PCMC scale (scores 0–90) consisting of: dignity and respect (6 items, scores 0–18), communication and autonomy (9 items, scores 0–27), and supportive care (15 items, scores 0–45). We categorized full PCMC and each sub-scale into “low, medium and high” using 25th and 75th percentile of the summative scores. The questionnaire also collected data on women characteristics, facility characteristics and service type. Data were analysed using descriptive statistics, t- tests, analysis of variance and Generalized Linear Models.Results Women had medium scores on full PCMC scale and sub-scales. The lowest score was in communication and autonomy. A quarter of women perceived PCMC as high. Marrying at age 20–29 years (β = 5.83, ρ = 0.002), self-employed women (β = -10.23, ρ = 0.004), starting antenatal care in the third trimester (β = -7.93, ρ = 0.008), high participation in household decisions (β = -4.98, ρ = 0.011), domestic violence experience (β = 5.41, ρ = 0.002), delivery at health centre (β = 7.09, ρ = 0.000), delivery at private/mission hospital (β = 17.47, ρ = 0.000), delivery by non-skilled attendant (β = -9.61, ρ = 0.001); delivery by community health workers (β = -7.65, ρ = 0.001), and experience of pregnancy complication (β = 6.20, ρ = 0.028) predicted PCMC.Conclusions Person-centred maternity care was generally inadequate. Improving PCMC would entail sustaining dignified care, enhancing provider-patient communication, addressing facility-level drivers, increasing women’s personal empowerment and self-employment, timely initiation of antenatal care, and paying attention to women with pregnancy complication.

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Section: Data Collectionmentioning

confidence: 99%

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Ogbuabor

Nwankwor

2020

Preprint

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“…It also provides an opportunity to develop skip patterns based on prior responses. This smart logic response approach, with limited, coded numerical responses for SMS inquiries, has been tested in several studies [53,[66][67][68]. Deploying SMS on a platform with "longitudinal memory," where follow-up SMS inquiries sent minutes, days, or weeks after a response can resume a skip pattern from a prior SMS survey provides even more flexibility.…”

Section: Errors Due To Phone Quality and Languagementioning

confidence: 99%

Utility of Short Message Service (SMS) for Remote Data Collection for HIV in Low- and Middle-Income Countries

et al. 2020

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Purpose of Review Short message system (SMS) communication is widespread in low-and middle-income countries (LMICs), and may be a viable approach to address challenges with in-person data collection for HIV-related research and monitoring and evaluation. We reviewed the literature to characterize potential benefits and challenges with using SMS for remote data capture, including examples from HIV and sexual and reproductive health. Recent Findings In our review, we found that studies that have used SMS to capture sensitive, self-reported data found this was an acceptable and feasible strategy, and may reduce social desirability bias of self-reported data; but studies are limited. Shared phones and privacy concerns have been described as challenges, but can be addressed with enhanced security features. Response rates to SMS surveys varied significantly by topic, population, and setting. Summary SMS may improve generalizability and precision of health and behavior data for HIV in research and programs, but use in LMICs is limited. SMS systems should be carefully designed to overcome potential implementation hurdles.

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“…PCMC includes multiple dimensions of care that patients experience in a facility and the environment in which a woman seeks care, including interpersonal interactions, freedom from coercion and abuse, informed and consented care, and provision of respectful care (5,8). Higher levels of PCMC is associated with higher patient satisfaction, earlier presentation for care, improved adherence to post-care treatment, and lower health care costs overall (9,10).…”

Section: Bene Ts Of Person-centered Maternity Carementioning

confidence: 99%

A Comparison of Intensive vs. Light-Touch Quality Improvement Interventions for Maternal Health in Uttar Pradesh, India

Montagu

Giessler

Nakphone

et al. 2020

Preprint

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BackgroundPoor patient experiences during delivery leads to delayed presentation at facilities and contributes to poor maternal health outcomes. Person-centered maternity care (PCMC) is a key component of quality. Improving PCMC requires changing the process of care which can be complex and require significant external input, making replication and scale difficult. This study compared the effectiveness two Quality Improvement (QI) intervention phases, one Intensive, one Light-Touch. MethodsWe used a matched case-control design to compare two phases of a QI Intervention targeting PCMC, with three facilities in each. The Intensive phase was introduced into three government facilities where teams were supported to identify, design, and test potential improvements over 12 months. The Light-Touch phase was subsequently introduced in three other government facilities and changes were tracked over six months. We compared the two groups using multivariate linear regression and difference-in-difference models to assess changes in PCMC outcome. ResultsBoth Intensive and Light-Touch arms demonstrated large improvements in PCMC. On a scale from 0 to 100, Intensive facilities increased in PCMC scores from 85.02 to 97.13, while Light-Touch facilities increased from 63.42 to 87.47. For both there was a ‘halo’ effect, with a similar improvement recorded for the specific improvement activities focused on, as w ell as aspects of PCMC not directly addressed. ConclusionsThis study demonstrated that a short, inexpensive, light-touch and directive intervention can change staff practices and significantly improve the experiences of women during childbirth. It also shows that improvements in a few areas of provider-patient interaction have a ‘halo’ effect, changing many other aspects of patient-provider interaction at the same time. Trial RegistrationQI Phase 1 - NCT04208867. Retrospectively registered. December 19th, 2019. link to the registration:https://clinicaltrials.gov/ct2/show/NCT04208867?term=NCT04208867&draw=2&rank=1QI Phase 2 – NCT04208841. Retrospectively registered. December 23, 2019. link to the registration:https://clinicaltrials.gov/ct2/show/NCT04208841?term=NCT04208841&draw=2&rank=1CONTRIBUTIONS TO THE LITERATURE 98 words· Medical practioners’ treatment of patients are influenced by institutional norms and difficult to change. · Team-based initiatives which actively engage staff have been effective in wealthy countries but are not common in middle-income settings, and have not been applied to person-centered aspects of care.· We found that team-based quality improvement efforts were effective in India at changing patient experience. Once change-practices were identified, these practices were introduced to new facilities with low-intesity support and proved equally effective at improving care.· These findings add to the limited evidence on team-based quality improvement, and provide evidence of effective scaleable implementation opportunities.

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Association between person‐centered maternity care and newborn complications in Kenya

Cited by 33 publications

References 11 publications

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Person-Centred Maternity Care in a Poor-Resource Setting: Evidence from a Cross-Sectional Study in Enugu State, Nigeria

Utility of Short Message Service (SMS) for Remote Data Collection for HIV in Low- and Middle-Income Countries

A Comparison of Intensive vs. Light-Touch Quality Improvement Interventions for Maternal Health in Uttar Pradesh, India

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