Faktor Lachlan M, Wilson Alyce N, Melepia Pele, Babona Delly, Wapi Pinip, Suruka Rose, Hezeri Priscah, Kabiu Duk Duk, Vallely Lisa M, Kennedy Elissa, Scoullar Michelle J L, Spotswood Naomi, Homer Caroline S E
Maternal, Child and Adolescent Health Program, International Development, Burnet Institute, Melbourne, Australia.
School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
PLOS Glob Public Health. 2024 May 21;4(5):e0002548. doi: 10.1371/journal.pgph.0002548. eCollection 2024.
Quality maternal and newborn healthcare is essential to improve experiences and health outcomes for mothers and babies. In many low to middle income countries, such as Papua New Guinea, there are initiatives to increase antenatal care attendance and facility births. To develop and implement initiatives that are appropriate, relevant, and contextualised to a community, it is important to understand how quality of care is perceived and defined by different maternal and newborn healthcare stakeholders. The aim of this study was to understand how women, their partners, healthcare professionals, healthcare managers, and provincial health administrators in East New Britain, Papua New Guinea define quality of pregnancy, childbirth, and immediate postnatal care. An exploratory qualitative study underpinned by a partnership-defined quality approach was undertaken. In total, 42 participants from five different healthcare facilities in East New Britain, Papua New Guinea, were interviewed. These included women, partners, healthcare professionals, healthcare managers, and provincial health administrators. Interviews were analysed using thematic analysis, assisted by NVivo computer software. Four themes were identified aligning with the journey a woman takes throughout the health system. These included (I) Ensuring Access: Arriving at the health centre, (II) Experiencing Positive Care: What the staff do, (III) Having the Bare Minimum: Resources available to the service, and (IV) Meeting Expectations: Outcomes of care. Stakeholder groups had significant overlap in how quality of care was defined, however women and partners focussed more on elements relating to experience of care, while clinical stakeholders focussed on elements relating to provision of care. There is a gap in how stakeholders define quality maternal and newborn healthcare, and the quality of the care which is administered and received.
优质的孕产妇和新生儿医疗保健对于改善母亲和婴儿的体验及健康结局至关重要。在许多低收入和中等收入国家,如巴布亚新几内亚,都有增加产前检查就诊率和在医疗机构分娩的举措。要制定和实施适合社区、相关且因地制宜的举措,了解不同的孕产妇和新生儿医疗保健利益相关者如何看待和界定医疗质量很重要。本研究的目的是了解巴布亚新几内亚东新不列颠省的妇女、其伴侣、医疗保健专业人员、医疗保健管理人员和省级卫生管理人员如何界定孕期、分娩期及产后即时护理的质量。开展了一项以伙伴关系界定质量方法为基础的探索性定性研究。总共对来自巴布亚新几内亚东新不列颠省五个不同医疗保健机构的42名参与者进行了访谈。这些参与者包括妇女、伴侣、医疗保健专业人员、医疗保健管理人员和省级卫生管理人员。访谈采用主题分析法进行分析,并借助NVivo计算机软件辅助。确定了四个与妇女在整个卫生系统中的就医过程相符的主题。这些主题包括:(一)确保就医机会:抵达健康中心;(二)体验积极护理:工作人员的所作所为;(三)具备最低限度条件:服务可用资源;(四)达到期望:护理结果。利益相关者群体在如何界定医疗质量方面有很大重叠,然而妇女和伴侣更关注与护理体验相关的要素,而临床利益相关者则更关注与护理提供相关的要素。利益相关者在如何界定优质孕产妇和新生儿医疗保健以及所提供和接受的护理质量方面存在差距。