http://localhost:8080/xmlui/handle/123456789/11096 2026-04-11T21:07:44Z http://localhost:8080/xmlui/handle/123456789/11144 Title: ‘Naming and faming’ maternity care providers: A mixed-methods study Authors: Kuipers, Yvonne; Bock, Vanessa De; Craen, Natacha Van de; Bosmans, Valerie Abstract: Background: Positive benchmarking can serve as a catalyst for maternity care improvement. Aim: To retrospectively benchmark Flemish maternity care providers’ qualities, based on women’s positive care experiences, and to explore which attributes of the different care providers contribute to these experiences. Methods: A sequential, two-phased mixed-methods study benchmarking the qualities of the community midwife, the hospital midwife, and the obstetrician. An online questionnaire was used to collect the data among pregnant and postpartum women, who rated their care experiences with the various care providers using the Net Promoter Score. Non-parametric and post hoc tests established the differences between types of clinicians and between antenatal, intrapartum, and postpartum Net Promoter Score mean scores. Content analysis was used to construct a final pool of keywords representing attributes of care professionals, accumulated from the promoters’ free text responses. Ranks were assigned to each keyword based on its frequency. Findings: A total of 2385 Net Promoter Scale scores and 1856 free-text responses of 1587 responders were included. The community midwife received the overall highest NPS scores (p < .001). The promoters (n = 1015) assigned community midwives the highest NPS scores (9.67), followed by obstetricians (9.57) and hospital-based midwives (9.51). The distinct benchmarking attributes of community midwives were availability (p < .001), supportiveness (p = .04) and personalised care (p < .001). Being honest (p < .001), empathic (p < .001) and inexhaustible (p = .04) benchmarked hospital midwives. Calmness (p < .001), a no-nonsense approach (p < .001), being humane (p = .01) and comforting (p = .02) benchmarked obstetricians. Discussion/Conclusion: The findings indicate that all care providers are highly valued, but community midwives are ranked the highest. The distinct differences between the care professionals can serve as exemplary performance for professional development and shape the profiles of maternity care professionals. 2023-12-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11143 Title: Knowledge and attitudes of midwives towards collaboration with traditional birth attendants for maternal and neonatal healthcare services in rural communities in South Africa Authors: Musie, Maurine Rofhiwa; Mulaudzi, Fhumulani Mavis Abstract: Objectives: We assessed the knowledge and attitude of registered midwives towards collaborating with traditional birth attendants for maternal and neonatal healthcare services in rural communities. Design: A descriptive cross-sectional survey was followed in this study. Participants: Registered midwives in selected clinics in the City of Tshwane Municipality. Participants were recruited by stratified random sampling. Data was collected at the Thirty-four primary healthcare facilities in Gauteng province, South Africa. Measurement and results: A self-assessment questionnaire was administered to 304 registered midwives. Twohundred and sixty respondents returned the questionnaire representing a response rate of 86.6 % which was statistically significant. The majority of Midwives in South Africa displayed a low level of knowledge (mean = 41.8, SD=1.7) on the role and practices of traditional birth attendants). Only 30.8 % (n = 80) of midwives knew of the roles of traditional birth attendants for maternal and neonatal healthcare (MNH) services. With respect to knowledge, there was significant associated with the Professional category (p < 0.015). In terms of attitude, registered midwives displayed negative attitudes towards collaborating with traditional birth attendants (mean = 46.8, SD=2.1). Approximately half (54.2 %, n = 140) of midwives were amenable towards collaborating in the provision of antenatal care, and 70.4 % (n = 183) of midwives agreed to collaborate with traditional birth attendants for extended roles such as accompanying women to health facilities. Association of demographic data and level of attitude showed there was significant relationship (p < 0.05) between registered midwives’ level of education and their attitude towards collaboration. Key conclusions: Midwives demonstrated positive attitude towards collaborating with traditional birth attendants at the antenatal care level only. Midwives were not amenable to collaboration at the level of intrapartum and postpartum care. Implications for practice: Based on our results, collaboration should be at antenatal care level to allow for early detection, treatment, and prevention of antenatal complications thus reducing maternal mortality and morbidity. 2024-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11142 Title: “It is because the treatment of this lady is a cascade”: Accumulation of delays and the occurrence of obstetric emergencies in an urban maternity unit in Tanzania Authors: Osaki, Haika; Sørensen, Jane Brandt; Maaløe, Nanna; Mbekenga, Columba; S, Morten Abstract: Objective: To explore healthcare workers’ and women’s experiences of providing and seeking childbirth care in a busy urban maternity facility in Tanzania. Design: A qualitative study with observations, in-depth interviews, and informal conversations, using thematic network analysis. Setting: This study was conducted in a busy urban maternity unit in Dar es Salaam, Tanzania which is a lowresource setting with a need to improve childbirth care. Participants: Six frontline healthcare providers and four hospital managers from the facility, along with six postpartum women who gave birth at the facility. Findings: Delays were observed throughout the childbirth care cascade, encompassing various stages. During antenatal care, timely provision of care was hindered by a high patientto-provider ratio, resulting in inadequate monitoring of risk factors. At the onset of labor, women delayed seeking care, sometimes, attempting a trial of labor after a previous Caesarean section. Within the facility, delays in care decision-making and patient management were evident due to insufficient resources. The accumulation of these delays over time influenced the quality of care provided and challenged the management of obstetric emergencies at the study facility. Key conclusions: The study findings show that delays are prevalent throughout the entire childbirth care cascade. The accumulation of these delays over time has influenced the quality of care provided at the facility and increased the vulnerability of women experiencing obstetric emergencies. To effectively address the imperative of reducing maternal mortality in low-resource settings, it is essential to develop appropriate interventions that span the entire spectrum of childbirth care. Additionally, further research is needed to delve into the complexities of care decision-making and the quality of care delivered within urban maternal facilities. Implications for practice: Our findings stress the need for comprehensive childbirth interventions and contextspecific guidelines to address challenges across the care cascade, particularly in lowresource settings. Urgent attention is required to prioritize care during patient triage and address systemic challenges within the healthcare system to improve birth outcomes and ensure effective facility-based care provision. Trial registration number: NCT04685668 Date of initial trial registration: December 28th, 2020 2024-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11140 Title: “I always felt like I wasn’t supposed to be there”. An international qualitative study of fathers’ engagement in family healthcare during transition to fatherhood Authors: Watkins, Vanessa; Kavanagh, Shane A; Macdonald, Jacqui A; Rasmussen, Bodil; Maindal, Helle Terkildsen; Hosking, Sarah; Wynter, Karen Abstract: Objective: Engagement of fathers in family health services confers benefits for the health and wellbeing of the whole family. The childbirth continuum is traditionally considered a feminine event, however, commensurate with the changing paradigm of gender equity in family healthcare worldwide, the role of fathers is in transformation. The aim of the study is to explore father’s perceptions and experiences of healthcare engagement during pregnancy and early infant care. Design: Qualitative free-text questions were embedded in a large multi-country, cross-sectional survey, to explored fathers’ attendance, participation, and experience of health care during appointments with their pregnant partner and/or baby. Setting and participants: Expectant and new fathers were recruited through Prolific®, an international paid online survey platform. Findings: Qualitative responses (n=889) were provided by fathers from 28 countries, with experiences of a range of contexts and models of care; 46.8% of whose partners were pregnant and 53.2% had given birth since 2020. The findings suggest that although most fathers wanted to attend and participate in maternity and early parenting-related healthcare, multiple barriers were identified at the individual father, organisational context, and societal levels. Fathers reported negative social factors such as gender bias and restrictive gender norms as barriers to their healthcare engagement. In contrast, factors that enabled fathers to overcome barriers included the fathers’ feelings of confidence in their partner’s autonomy and decision-making skills, trusted professional relationships with clinicians, and clinicians with good interpersonal skills. Key conclusions: Multiple barriers restrict the participation of fathers in healthcare for childbearing and early parenting. Knowledge of these barriers can inform healthcare redesign to include more successful engagement strategies for fathers, to benefit fathers, mothers, and infants alike. Implications for practice: Health professionals consulting with the mother, father and infant triad are ideally placed to address the healthcare needs of both parents. Early engagement of fathers in family health care by use of inclusive interpersonal skills and the development of a trusted relationship has potential to improve paternal mental health, and may be associated with benefits for the health, wellbeing and safety of the whole family. 2024-01-01T00:00:00Z