Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region

IMAgiNE EURO study group; Teresa Santos

doi:10.1016/j.lanepe.2021.100268

Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region

IMAgiNE EURO study group, Teresa Santos^*

^*Autor correspondente para este trabalho

Resultado de pesquisa › revisão de pares

67 Citações (Scopus)

30 Transferências (Pure)

Resumo

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 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. Findings: 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 significant 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. Interpretation: 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. Study registration: ClinicalTrials.gov Identifier: NCT04847336

Idioma original	English
Número do artigo	100268
Número de páginas	18
Revista	The Lancet Regional Health. Europe
Volume	13
DOIs	https://doi.org/10.1016/j.lanepe.2021.100268
Estado da publicação	Publicado - fev. 2022

ODS da ONU

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10.1016/j.lanepe.2021.100268Licença:

40246818Final published version, 3,25 MBLicença:

http://hdl.handle.net/10400.14/36366Licença:

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1 Terminados

CIIS: Centro de Investigação Interdisciplinar em Saúde
Barros, M. (PI), Rosa, N. (Investigador), Correia, M. J. (Investigador), Caldas, A. C. (Investigador), Amado, J. C. (Investigador), Figueiredo, A. S. (Investigador), Esteves, A. C. (Investigador), Mineiro, A. (Investigador), Abreu, A. M. (Investigador), Duarte, A. S. (Investigador), Almeida, S. F. (Investigador), Correia, A. (Investigador), Moura, A. (Investigador), Almeida, A. (Investigador), Araújo, B. (Investigador), Moura-Netto, C. (Investigador), Ferrito, C. (Investigador), Pais-Vieira, C. (Investigador), Festas, C. (Investigador), Marques-Vieira, C. (Investigador), Catré, D. (Investigador), Nunes, E. (Investigador), Jesus, É. (Investigador), Ribeiro, F. (Investigador), Rosário, F. (Investigador), Fernandes, G. (Investigador), Rato, J. R. (Bolseiro), Salgado, J. R. (Investigador), Neves-Amado, J. (Investigador), Amendoeira, J. (Investigador), Sá, L. (Investigador), Capelas, M. L. (Investigador), Vieira, M. M. (Investigador), Nunes, M. V. S. (Investigador), Cardoso, M. (Investigador), Veiga, N. J. (Investigador), Fonseca, P. (Investigador), Correia, P. N. (Investigador), Couto, P. (Investigador), Pontífice-Sousa, P. (Investigador), Ravasco, P. (Investigador), Carvalho, P. V. D. (Investigador), Alves, P. (Investigador), Melo, P. (Investigador), Silva, R. (Investigador), Canaipa, R. (Investigador), Noites, R. (Investigador), Rio, R. (Investigador), Almeida, S. (Investigador), Deodato, S. (Investigador), Caldeira, S. (Investigador), Silva, S. (Investigador), Borges, T. (Investigador), Silva, V. (Investigador), Charepe, Z. (Investigador), Rodrigues-Pires, F. (Voluntário), Veludo, F. (Investigador), Carmo, H. (Bolseiro), Romeiro, J. (Estudante), Melo, M. (Investigador), Braga, M. (Investigador), Amaral, T. (Investigador), Moreira, M. A. (Investigador), Guerra, N. (Estudante), Santos, P. (Investigador), Paço, S. (Estudante), Lynce, S. (Bolseiro), Miguel, S. (Estudante), Costa, T. (Investigador), Silva-Neves, V. (Investigador), Silva, A. (Investigador), Carvalho, A. R. (Investigador), Almeida, B. (Investigador), Figueiredo, C. (Investigador), Esteves, E. (Bolseiro), Araújo, F. M. (Investigador), Garcia, J. G. (Investigador), Santos, L. (Investigador), Santos, N. M. D. (Investigador), Lopes, P. (Investigador), Bornes, R. (Investigador), Silva, R. (Investigador), Costa, S. (Investigador), Silva, S. M. (Investigador), Marques, T. (Investigador), Almeida, A. (Investigador), Santos, M. (Bolseiro), Santos, P. (Investigador), Miguel, S. (Investigador), Mendes, K. (Investigador), Gomes, A. P. (Investigador), Henriques, J. M. P. (Investigador), Costa, H. A. F. P. (Investigador) & Ribeiro, P. (Investigador)
Fundação para a Ciência e a Tecnologia
1/01/20 → 31/12/24
Projeto

67 Citações
1 Errata

Corrections to “Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Online survey investigating maternal perspectives in 12 countries of the WHO European Region” (The Lancet Regional Health - Europe (2022) 13, (S2666776221002544), (10.1016/j.lanepe.2021.100268))
IMAgiNE EURO study group & Santos, T., ago. 2022, Em: The Lancet Regional Health. Europe. 19, 100461.
Resultado de pesquisa: Errata

Citação

@article{d07b4f3c45d84552876f0591fe6d6c0b,

title = "Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region",

abstract = "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 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. Findings: 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{\textquoteright} 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 significant 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. Interpretation: 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. Study registration: ClinicalTrials.gov Identifier: NCT04847336",

keywords = "COVID-19, European Region, Facility, Maternal, Newborn, Quality of care, Questionnaire, Respectful maternity care, Survey, WHO",

author = "{IMAgiNE EURO study group} and Marzia Lazzerini and Benedetta Covi and Ilaria Mariani and Zalka Drglin and Maryse Arendt and Nedberg, {Ingvild Hersoug} and Helen Elden and Raquel Costa and Daniela Drandi{\'c} and Jelena Radeti{\'c} and Otelea, {Marina Ruxandra} and C{\'e}line Miani and Serena Brigidi and Virginie Roz{\'e}e and Ponikvar, {Barbara Mihevc} and Barbara Tasch and Sigrun Kongslien and Karolina Linden and Catarina Barata and Magdalena Kurbanovi{\'c} and Jovana Ru{\v z}i{\v c}i{\'c} and Stephanie Batram-Zantvoort and Casta{\~n}eda, {Lara Mart{\'i}n} and Rochebrochard, {Elise de La} and Anja Bohinec and Vik, {Eline Skirnisdottir} and Mehreen Zaigham and Teresa Santos and Lisa Wandschneider and Viver, {Ana Canales} and Amira {\'C}erimagi{\'c} and Emma Sacks and Valente, {Emanuelle Pessa}",

note = "Funding Information: This research was funded by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste Italy. Funding Information: C{\'e}line Miani's position as a post-doctoral researcher is funded by Bielefeld University. Funding Information: We would like to thank all project partners and volunteer mothers who helped in the development of the questionnaire and all women who took their time to respond to this survey despite the burden of the COVID-19 pandemic. We also would like to thank a number of colleagues who volunteered in helping different aspects of the project, as follows: •Valbona Nushi-Stavileci who helped with survey translation into Albanian. •Aleksandra Wilk-Przybysz and Ma{\l}gorzata (Meg) Mielczarek who helped with survey translation into Polish. •France: Marie-Laure Trudel, Sarah F{\'e}ron, Gilles Garrouste who helped with the survey dissemination •Germany: Antonia Lei{\ss}e, who helped with the survey translation into German and dissemination. •Italy: Rebecca Lundin for back translation of Italian questionnaires; Elisabetta Danielli from Institute for Maternal and Child Health IRCCS Burlo Garofolo for her technical support on upload and maintenance of questionnaire links on institutional webpage; Michele Bava from Institute for Maternal and Child Health IRCCS Burlo Garofolo for the IT support. •Portugal: Associa{\c c}{\~a}o Portuguesa pelos Direitos da Mulher na Gravidez e Parto (APDMGP) for support on survey dissemination. •Norway: Marit Kongslien for back translation of Norwegian questionnaire. •Romania: Sinziana Ionita-Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association) for their commitment on the translation and on the Romanian questionnaire's dissemination. •Spain: Observatorio de la violencia obstetrica (OVO) - Spain, Medical Anthropology Research Center (MARC, URV) and Institut Catal{\`a} d'Antropologia (ICA) for support on survey dissemination. •Sweden: David Loum Skantz for his help in survey dissemination., This research was funded by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste Italy. C{\'e}line Miani's position as a post-doctoral researcher is funded by Bielefeld University. Catarina Barata had a PhD grant FCT/FSE (SFRH/BD/128600/2017) while she was voluntarily writing this article. She is board member, unpaid collaboration, of Associa{\c c}{\~a}o Portuguesa pelos Direitos da Mulher na Gravidez e Parto (APDMGP). Daniela Drandi{\'c} received a salary during the time she was volunteer-writing this article was from a grant from the Erasmus+ programme of the European Commission, regarding a project on parenting support and from a grant from the UNICEF Croatia, regarding a project on online education for pregnant women during COVID. She is a board member of an NGO called Human Rights in Childbirth, and has been for the entire time she worked on this paper. Dr Emma Sacks has received research funding from the World Health Organization related to the mistreatment of women and newborns in health facilities. The project has no impact on the present manuscript outside of similar topics. She is the former co-chair of the Newborn Health Working Group of the Global Respectful Maternity Care Council. Other authors have none to declare. Data can be made available on reasonable request to the corresponding author. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated. Funding Information: Daniela Drandi{\'c} received a salary during the time she was volunteer-writing this article was from a grant from the Erasmus+ programme of the European Commission, regarding a project on parenting support and from a grant from the UNICEF Croatia, regarding a project on online education for pregnant women during COVID. She is a board member of an NGO called Human Rights in Childbirth, and has been for the entire time she worked on this paper. Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2022",

month = feb,

doi = "10.1016/j.lanepe.2021.100268",

language = "English",

volume = "13",

journal = "The Lancet Regional Health. Europe",

issn = "2666-7762",

publisher = "Elsevier Ltd.",

}

TY - JOUR

T1 - Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic

T2 - online survey investigating maternal perspectives in 12 countries of the WHO European Region

AU - IMAgiNE EURO study group

AU - Lazzerini, Marzia

AU - Covi, Benedetta

AU - Mariani, Ilaria

AU - Drglin, Zalka

AU - Arendt, Maryse

AU - Nedberg, Ingvild Hersoug

AU - Elden, Helen

AU - Costa, Raquel

AU - Drandić, Daniela

AU - Radetić, Jelena

AU - Otelea, Marina Ruxandra

AU - Miani, Céline

AU - Brigidi, Serena

AU - Rozée, Virginie

AU - Ponikvar, Barbara Mihevc

AU - Tasch, Barbara

AU - Kongslien, Sigrun

AU - Linden, Karolina

AU - Barata, Catarina

AU - Kurbanović, Magdalena

AU - Ružičić, Jovana

AU - Batram-Zantvoort, Stephanie

AU - Castañeda, Lara Martín

AU - Rochebrochard, Elise de La

AU - Bohinec, Anja

AU - Vik, Eline Skirnisdottir

AU - Zaigham, Mehreen

AU - Santos, Teresa

AU - Wandschneider, Lisa

AU - Viver, Ana Canales

AU - Ćerimagić, Amira

AU - Sacks, Emma

AU - Valente, Emanuelle Pessa

N1 - Funding Information: This research was funded by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste Italy. Funding Information: Céline Miani's position as a post-doctoral researcher is funded by Bielefeld University. Funding Information: We would like to thank all project partners and volunteer mothers who helped in the development of the questionnaire and all women who took their time to respond to this survey despite the burden of the COVID-19 pandemic. We also would like to thank a number of colleagues who volunteered in helping different aspects of the project, as follows: •Valbona Nushi-Stavileci who helped with survey translation into Albanian. •Aleksandra Wilk-Przybysz and Małgorzata (Meg) Mielczarek who helped with survey translation into Polish. •France: Marie-Laure Trudel, Sarah Féron, Gilles Garrouste who helped with the survey dissemination •Germany: Antonia Leiße, who helped with the survey translation into German and dissemination. •Italy: Rebecca Lundin for back translation of Italian questionnaires; Elisabetta Danielli from Institute for Maternal and Child Health IRCCS Burlo Garofolo for her technical support on upload and maintenance of questionnaire links on institutional webpage; Michele Bava from Institute for Maternal and Child Health IRCCS Burlo Garofolo for the IT support. •Portugal: Associação Portuguesa pelos Direitos da Mulher na Gravidez e Parto (APDMGP) for support on survey dissemination. •Norway: Marit Kongslien for back translation of Norwegian questionnaire. •Romania: Sinziana Ionita-Ciurez, Ana Maita, Cristina Biciila, Raluca Dumitrescu (members of SAMAS Association) for their commitment on the translation and on the Romanian questionnaire's dissemination. •Spain: Observatorio de la violencia obstetrica (OVO) - Spain, Medical Anthropology Research Center (MARC, URV) and Institut Català d'Antropologia (ICA) for support on survey dissemination. •Sweden: David Loum Skantz for his help in survey dissemination., This research was funded by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste Italy. Céline Miani's position as a post-doctoral researcher is funded by Bielefeld University. Catarina Barata had a PhD grant FCT/FSE (SFRH/BD/128600/2017) while she was voluntarily writing this article. She is board member, unpaid collaboration, of Associação Portuguesa pelos Direitos da Mulher na Gravidez e Parto (APDMGP). Daniela Drandić received a salary during the time she was volunteer-writing this article was from a grant from the Erasmus+ programme of the European Commission, regarding a project on parenting support and from a grant from the UNICEF Croatia, regarding a project on online education for pregnant women during COVID. She is a board member of an NGO called Human Rights in Childbirth, and has been for the entire time she worked on this paper. Dr Emma Sacks has received research funding from the World Health Organization related to the mistreatment of women and newborns in health facilities. The project has no impact on the present manuscript outside of similar topics. She is the former co-chair of the Newborn Health Working Group of the Global Respectful Maternity Care Council. Other authors have none to declare. Data can be made available on reasonable request to the corresponding author. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the views, decisions or policies of the institutions with which they are affiliated. Funding Information: Daniela Drandić received a salary during the time she was volunteer-writing this article was from a grant from the Erasmus+ programme of the European Commission, regarding a project on parenting support and from a grant from the UNICEF Croatia, regarding a project on online education for pregnant women during COVID. She is a board member of an NGO called Human Rights in Childbirth, and has been for the entire time she worked on this paper. Publisher Copyright: © 2021 The Author(s)

PY - 2022/2

Y1 - 2022/2

N2 - 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 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. Findings: 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 significant 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. Interpretation: 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. Study registration: ClinicalTrials.gov Identifier: NCT04847336

AB - 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 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. Findings: 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 significant 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. Interpretation: 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. Study registration: ClinicalTrials.gov Identifier: NCT04847336

KW - COVID-19

KW - European Region

KW - Facility

KW - Maternal

KW - Newborn

KW - Quality of care

KW - Questionnaire

KW - Respectful maternity care

KW - Survey

KW - WHO

UR - http://www.scopus.com/inward/record.url?scp=85121585834&partnerID=8YFLogxK

U2 - 10.1016/j.lanepe.2021.100268

DO - 10.1016/j.lanepe.2021.100268

M3 - Article

C2 - 34977838

AN - SCOPUS:85121585834

SN - 2666-7762

VL - 13

JO - The Lancet Regional Health. Europe

JF - The Lancet Regional Health. Europe

M1 - 100268

ER -

Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region

Resumo

ODS da ONU

Acesso ao documento

Outros arquivos e links

Impressão digital

Projetos

CIIS: Centro de Investigação Interdisciplinar em Saúde

Resultado de pesquisa

Citação