Negotiating quality standards for effective delivery of labor and childbirth care in Nigeria and Uganda

Oladapo, Olufemi T.; Bohren, Meghan A.; Fawole, Bukola; Mugerwa, Kidza; Ojelade, Olubunmi A.; Titiloye, Musibau A.; Alu, Francis E.; Mambya, Musana O.; Oyeneyin, Lawal; Bataale, Salim; Akintan, Adesina; Alabi, Olubunmi; Adebayo, Amos; Okike, Ola; Idris, Hadiza; Wilfred, Sanni; Bello, Halima Adeola -; Kyaddondo, David; Olutayo, Akinpelu Olanrewaju; Byamugisha, Josaphat; Souza, João Paulo; Gülmezoglu, A. Metin

doi:10.1002/ijgo.12398

Cited by 13 publications

(23 citation statements)

References 16 publications

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“…The pain that women experience is influenced by both physiological and psychological processes, including the way in which labor is managed, birthing positions, and mobility during labor . During a dissemination workshop, we asked women in both Nigeria and Uganda about their expectations regarding pain management during labor and childbirth, and most were unaware of measures that could be taken to alleviate pain . Similarly, a survey of maternity care providers in Nigeria concluded that providers had a positive attitude toward pain relief during labor, but gaps existed between provider attitudes and the provision of pain relief during labor .…”

Section: Discussionmentioning

confidence: 99%

“…Participants received the equivalent of approximately USD $10 to compensate for transportation costs. No additional contact with research participants occurred after data collection, but preliminary results were presented to community members for feedback during a process of developing negotiated standards of care . Transcription and translation occurred in parallel to data collection and field notes were integrated into transcripts.…”

Section: Methodsmentioning

confidence: 99%

“…The WHO quality of care framework for pregnant women and newborns was used to organize emerging results into theoretical concepts and explore relationships between themes. Preliminary findings were presented during a 2‐day workshop in each country with a subset of participants, local investigators, and the WHO study team to interpret the findings in the Ugandan and Nigerian contexts …”

Section: Methodsmentioning

confidence: 99%

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Defining quality of care during childbirth from the perspectives of Nigerian and Ugandan women: A qualitative study

Bohren

Titiloye

Kyaddondo

et al. 2017

Intl J Gynecology & Obste

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Objective: To explore what "quality of care" means to childbearing women in Nigeria and Uganda, as a means of ensuring that women's voices and opinions are prioritized when developing interventions to improve quality in maternity care provision. Methods:Qualitative methods, with a purposive sample of women in Nigeria and Uganda. Participants were asked to define quality of care and to provide examples of when it was and was not provided. Thematic analysis was used to synthesize findings based on an a priori framework (the WHO quality of care framework).Results: 132 in-depth interviews and 21 focus group discussions are included.Participants spontaneously discussed each of the WHO framework domains of quality of care. Data were richest across the domains of effective communication, respect and dignity, emotional support, competent and motivated human resources, and essential physical resources. Women believed that good quality of care ensured optimal psychological and physiological outcomes for the woman and her baby. Positive interpersonal relationships between women and health providers were important. These included supportive care, building rapport, and using positive and clear language. Conclusion:To provide good quality of care, maternity services should consider and act on the expectations and experiences of women and their families.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Defining quality of care during childbirth from the perspectives of Nigerian and Ugandan women: A qualitative study

Bohren

Titiloye

Kyaddondo

et al. 2017

Intl J Gynecology & Obste

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“…Having found out what mattered to stakeholders locally, the next step was to translate these views into a set of agreed quality standards, as presented in Oladapo et al 13 Translation of qualitative insights into clear standards for practice is uncommon. Both the participatory development methods, and the core elements The final and completely unique step in the process was to integrate the collaboratively developed quality standards into locally relevant tools.…”

Section: In 2000 That Integrated Evidence With Values and Skillsmentioning

confidence: 99%

“…Having found out what mattered to stakeholders locally, the next step was to translate these views into a set of agreed quality standards, as presented in Oladapo et al . Translation of qualitative insights into clear standards for practice is uncommon.…”

mentioning

confidence: 99%

Turning local knowledge and experience into innovative tools for quality care during labor and childbirth: The BOLD project experience

Downe

Gülmezoglu

2017

Intl J Gynecology & Obste

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A service concept and tools to improve maternal and newborn health in Nigeria and Uganda

Salgado¹,

Wendland²,

Rodriguez³

et al. 2017

Intl J Gynecology & Obste

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Objective: The "Better Outcomes in Labor Difficulty" (BOLD) project used a service design process to design a set of tools to improve quality of care during childbirth by strengthening linkages between communities and health facilities in Nigeria andUganda. This paper describes the Passport to Safer Birth concept and the tools developed as a result.Methods: Service design methods were used to identify facilitators and barriers to quality care, and to develop human-centered solutions. The service design process had three phases: Research for Design, Concept Design, and Detail Design, undertaken in eight hospitals and catchment communities. Results:The service concept "Better Beginnings" comprises three tools. The "Pregnancy Purse" provides educational information to women throughout pregnancy. The "Birth Board" is a visual communication tool that presents the labor and childbirth process.The "Family Pass" is a set of wearable passes for the woman and her supporter to facilitate communication of care preferences. Conclusion:The Better Beginnings service concept and tools form the basis for the promotion of access to information and knowledge acquisition, and could improve communication between the healthcare provider, the woman, and her family during childbirth. K E Y W O R D SCo-design; Maternal health; Newborn health; Nigeria; Quality of care; Service concept; Service design; Uganda | INTRODUCTIONGood quality maternity care is a multidimensional concept that includes timely, effective, and appropriate use of clinical and nonclinical interventions that are sensitive to women's values and preferences. 1 To achieve improved quality of care, efforts are needed to address both facility-and community-based factors, including perceptions of quality, decision-making processes, and demand for womancentered services. There is growing recognition of the importance of including the perspectives of service users and providers to improve quality and organization of care. 2-4 However, the expectations, needs, and values of women and communities have often been neglected in the design of maternity services, particularly in low-and middleincome countries.To address this gap, the WHO initiated the "Better Outcomes in Labour Difficulty" (BOLD) project to improve quality of care during facility-based childbirth. The BOLD project was conducted in Nigeria and Uganda, two settings with a high burden of maternal and neonatal morbidity and mortality. As part of this project, the concept of the "Passport to Safer Birth" (PSB) was developed, its aim to increase

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Negotiating quality standards for effective delivery of labor and childbirth care in Nigeria and Uganda

Cited by 13 publications

References 16 publications

Defining quality of care during childbirth from the perspectives of Nigerian and Ugandan women: A qualitative study

Defining quality of care during childbirth from the perspectives of Nigerian and Ugandan women: A qualitative study

Turning local knowledge and experience into innovative tools for quality care during labor and childbirth: The BOLD project experience

A service concept and tools to improve maternal and newborn health in Nigeria and Uganda

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