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Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini

BACKGROUND: Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID19 pandemic, as defined by WHO Standards, are lacking. METHODS: Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionn...

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Autores principales: Lazzerini, M, Covi, B, Mariani, I, Drglin, Z, Arendt, M, Hersoug Nedberg, I, Elden, H, Costa, R, Drandic, D, Pessa Valente, E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593502/
http://dx.doi.org/10.1093/eurpub/ckac129.189
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author Lazzerini, M
Covi, B
Mariani, I
Drglin, Z
Arendt, M
Hersoug Nedberg, I
Elden, H
Costa, R
Drandic, D
Pessa Valente, E
author_facet Lazzerini, M
Covi, B
Mariani, I
Drglin, Z
Arendt, M
Hersoug Nedberg, I
Elden, H
Costa, R
Drandic, D
Pessa Valente, E
author_sort Lazzerini, M
collection PubMed
description BACKGROUND: Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID19 pandemic, as defined by WHO Standards, are lacking. METHODS: Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. RESULTS: 21,027 mothers were included in the analysis. Among those who experienced labour (N = 18,063), 41.8% (26.1%- 63.5%) experienced difficulties in accessing antenatal care, 62% (12.6%-99.0%) were not allowed a companion of choice, 31.1% (16.5%-56.9%) received inadequate breastfeeding support, 34.4% (5.2%-64.8%) reported that health workers were not always using protective personal equipment, and 31.8% (17.8%-53.1%) rated the health workers’ number as “insufficient”. Episiotomy was performed in 20.1% (6.1%-66.0%) of spontaneous vaginal births and fundal pressure applied in 41.2% (11.5% -100%) of instrumental vaginal births. In addition, 23.9% women felt they were not treated with dignity (12.8%-59.8%), 12.5% (7.0%-23.4%) suffered abuse, and 2.4% (0.1%-26.2%) made informal payments. Most findings were significantly worse among women with prelabour caesarean birth (N = 2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significantly lower QMNC Indexes and Luxemburg showing a significantly higher QMNC Index than the total sample. Younger women and those with operative births also reported significantly lower QMNC Indexes. CONCLUSIONS: Mothers reports revealed large inequities in QMNC across countries of the WHO European Region. Quality improvement initiatives to reduce these inequities and promote evidence-based, patient-centred respectful care for all mothers and newborns during the COVID-19 pandemic and beyond are urgently needed. Funding: The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
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spelling pubmed-95935022022-11-04 Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini Lazzerini, M Covi, B Mariani, I Drglin, Z Arendt, M Hersoug Nedberg, I Elden, H Costa, R Drandic, D Pessa Valente, E Eur J Public Health Parallel Programme BACKGROUND: Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID19 pandemic, as defined by WHO Standards, are lacking. METHODS: Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. RESULTS: 21,027 mothers were included in the analysis. Among those who experienced labour (N = 18,063), 41.8% (26.1%- 63.5%) experienced difficulties in accessing antenatal care, 62% (12.6%-99.0%) were not allowed a companion of choice, 31.1% (16.5%-56.9%) received inadequate breastfeeding support, 34.4% (5.2%-64.8%) reported that health workers were not always using protective personal equipment, and 31.8% (17.8%-53.1%) rated the health workers’ number as “insufficient”. Episiotomy was performed in 20.1% (6.1%-66.0%) of spontaneous vaginal births and fundal pressure applied in 41.2% (11.5% -100%) of instrumental vaginal births. In addition, 23.9% women felt they were not treated with dignity (12.8%-59.8%), 12.5% (7.0%-23.4%) suffered abuse, and 2.4% (0.1%-26.2%) made informal payments. Most findings were significantly worse among women with prelabour caesarean birth (N = 2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significantly lower QMNC Indexes and Luxemburg showing a significantly higher QMNC Index than the total sample. Younger women and those with operative births also reported significantly lower QMNC Indexes. CONCLUSIONS: Mothers reports revealed large inequities in QMNC across countries of the WHO European Region. Quality improvement initiatives to reduce these inequities and promote evidence-based, patient-centred respectful care for all mothers and newborns during the COVID-19 pandemic and beyond are urgently needed. Funding: The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. Oxford University Press 2022-10-25 /pmc/articles/PMC9593502/ http://dx.doi.org/10.1093/eurpub/ckac129.189 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. 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 reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Parallel Programme
Lazzerini, M
Covi, B
Mariani, I
Drglin, Z
Arendt, M
Hersoug Nedberg, I
Elden, H
Costa, R
Drandic, D
Pessa Valente, E
Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini
title Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini
title_full Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini
title_fullStr Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini
title_full_unstemmed Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini
title_short Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Marzia Lazzerini
title_sort quality of facility-based maternal and newborn care around the time of childbirth during the covid-19 pandemic: marzia lazzerini
topic Parallel Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593502/
http://dx.doi.org/10.1093/eurpub/ckac129.189
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