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Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure

Globally, low and middle-income countries bear the greatest burden of maternal and newborn mortality. To reduce these high levels, the quality of care provided needs to be improved. This study aimed to develop a patient reported outcome measure for use in maternity services in low and middle-income...

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Autores principales: Dickinson, Fiona M., Madaj, Barbara, Muchemi, Onesmus M., Ameh, Charles
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021686/
https://www.ncbi.nlm.nih.gov/pubmed/36962279
http://dx.doi.org/10.1371/journal.pgph.0000062
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author Dickinson, Fiona M.
Madaj, Barbara
Muchemi, Onesmus M.
Ameh, Charles
author_facet Dickinson, Fiona M.
Madaj, Barbara
Muchemi, Onesmus M.
Ameh, Charles
author_sort Dickinson, Fiona M.
collection PubMed
description Globally, low and middle-income countries bear the greatest burden of maternal and newborn mortality. To reduce these high levels, the quality of care provided needs to be improved. This study aimed to develop a patient reported outcome measure for use in maternity services in low and middle-income countries, to facilitate improvements in quality of care. Semi-structured interviews and focus groups discussions were conducted with women who had recently given birth in selected healthcare facilities in Malawi and Kenya. Transcripts of these were analysed using a thematic approach and analytic codes applied. Draft outcomes were identified from the data, which were reviewed by a group of clinical experts and developed into a working copy of the Maternity Patient Reported Outcome Measure (MPROM). A further sample of new mothers were asked to evaluate the draft MPROM during cognitive debriefing interviews, and their views used to revise it to produce the final proposed measure. Eighty-three women were interviewed, and 44 women took part in 10 focus group discussions. An array of outcomes was identified from the data which were categorised under the domains of physical and psychological symptoms, social issues, and baby-related health outcomes. The draft outcomes were configured into 79 questions with answers provided using a five-point Likert scale. Minor revisions were made following cognitive debriefing interviews with nine women, to produce the final proposed MPROM. In conjunction with women from the target population and clinical experts, this study has developed what is believed to be the first condition-specific PROM suitable for assessing care quality in maternity services in low and middle-income countries. Following further validation studies, it is anticipated that this will be a useful tool in facilitating improvements in the quality of care provided to women giving birth in healthcare facilities in these settings.
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spelling pubmed-100216862023-03-17 Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure Dickinson, Fiona M. Madaj, Barbara Muchemi, Onesmus M. Ameh, Charles PLOS Glob Public Health Research Article Globally, low and middle-income countries bear the greatest burden of maternal and newborn mortality. To reduce these high levels, the quality of care provided needs to be improved. This study aimed to develop a patient reported outcome measure for use in maternity services in low and middle-income countries, to facilitate improvements in quality of care. Semi-structured interviews and focus groups discussions were conducted with women who had recently given birth in selected healthcare facilities in Malawi and Kenya. Transcripts of these were analysed using a thematic approach and analytic codes applied. Draft outcomes were identified from the data, which were reviewed by a group of clinical experts and developed into a working copy of the Maternity Patient Reported Outcome Measure (MPROM). A further sample of new mothers were asked to evaluate the draft MPROM during cognitive debriefing interviews, and their views used to revise it to produce the final proposed measure. Eighty-three women were interviewed, and 44 women took part in 10 focus group discussions. An array of outcomes was identified from the data which were categorised under the domains of physical and psychological symptoms, social issues, and baby-related health outcomes. The draft outcomes were configured into 79 questions with answers provided using a five-point Likert scale. Minor revisions were made following cognitive debriefing interviews with nine women, to produce the final proposed MPROM. In conjunction with women from the target population and clinical experts, this study has developed what is believed to be the first condition-specific PROM suitable for assessing care quality in maternity services in low and middle-income countries. Following further validation studies, it is anticipated that this will be a useful tool in facilitating improvements in the quality of care provided to women giving birth in healthcare facilities in these settings. Public Library of Science 2022-03-15 /pmc/articles/PMC10021686/ /pubmed/36962279 http://dx.doi.org/10.1371/journal.pgph.0000062 Text en © 2022 Dickinson et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Dickinson, Fiona M.
Madaj, Barbara
Muchemi, Onesmus M.
Ameh, Charles
Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure
title Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure
title_full Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure
title_fullStr Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure
title_full_unstemmed Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure
title_short Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure
title_sort assessing quality of care in maternity services in low and middle-income countries: development of a maternity patient reported outcome measure
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021686/
https://www.ncbi.nlm.nih.gov/pubmed/36962279
http://dx.doi.org/10.1371/journal.pgph.0000062
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