Quality of Facility-Based Maternal and Newborn Care During the Covid-19 Pandemic: A Multicountry Cross-Sectional Study in the Who European Region Investigating Service Users’ Perspectives
| Autor: | Marzia Lazzerini, Benedetta Covi, Ilaria Mariani, Zalka Drglin, Maryse Arendt, Ingvild Hersoug Nedberg, Helen Elden, Raquel Costa, Daniela Drandić, Jelena Radetić, Marina Ruxandra Otalea, Céline Miani, Serena Brigidi, Virginie Rozee, Barbara Mihevc Ponikvar, Barbara Tasch, Sigrun Kongslien, Karolina Linden, Catarina Barata, Magdalena Kurbanović, Jovana Ružičić, Stephanie Batram-Zantvoort, Lara Martín Castañeda, Elise de La Rochebrochard, Anja Bohinec, Eline Skirnisdottir Vik, Mehreen Zaigham, Teresa Santos, Lisa Wandschneider, Ana Canales Viver, Amira Ćerimagić, Emma Sacks, Moise Muzigaba, Nino Berdzuli, Ornella Lincetto, Emanuelle Pessa Valente, IMAgiNE EURO Study Group |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Episiotomy
History medicine.medical_specialty Multivariate analysis Polymers and Plastics business.industry Cross-sectional study medicine.medical_treatment Declaration Norwegian Computer-assisted web interviewing Institutional review board Industrial and Manufacturing Engineering language.human_language Family medicine Pandemic language Medicine Business and International Management business |
| Popis: | Background: Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID-19 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 to March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based quality measures. Findings: 21,027 women were included in the analysis. Among those who experienced labour (N=18,063), 49·9% (37·2%-60·7%) perceived a reduction in QMNC due to the COVID-19 pandemic, 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 health workers not always using protective personal equipment, and 31·8% (17·8%-53·1%) rated the number of health workers 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. Findings were significantly worst among women with elective caesarean (CS) and emergency CS during labour (N=2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significant lower QMNC Indexes; younger women and those with operative births also had significant lower QMNC Indexes. Interpretation: Findings reveal large inequities in the QMNC across countries of the WHO European Region. Actions to reduce these inequities and promote high-quality, evidence-based, patient-centred respectful care for all mothers and newborns are urgently needed. Trial Registration: Study registration ClinicalTrials.gov Identifier: NCT04847336. Funding: The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. Declaration of Interest: None to declare. Ethical Approval: The study was approved by the Institutional Review Board of the coordinating centre: the IRCCS Burlo Garofolo Trieste (IRB-BURLO 05/2020 15.07.2020). The study protocol was also reviewed and approved by the ethical committees of three other countries to comply with local regulations: Portugal (Instituto de Saude Publica da Universidade do Porto, CE20159); Norway (Norwegian Regional Committee for Medical Research Ethics, 2020/213047) and Germany (Bielefeld University ethics committee, 2020-176). |
| Databáze: | OpenAIRE |
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