Jabbari Bayrami Hossein, Abdollahi Sabet Somayae, Naseri Amirreza, Hosseini Mohammad-Salar
Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Community Medicine, Social Determinants of Health Research Center, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.
J Family Reprod Health. 2025 Jun;19(2):136-142. doi: 10.18502/jfrh.v19i2.19302.
Perinatal mortality is an indicating factor in social development, and international measures have been taken to reduce maternal and perinatal mortality. This study aims to collect the experts' opinions about hospitals performance in providing perinatal services and emerge the key indicators for evaluation.
This is a qualitative study using the Delphi technique and based on the focus group discussion sessions with twelve experts, including pediatricians, perinatologists, neonatologists, neonatal care nurses, and midwives with at least five years of work experience. A coordinator managed the sessions, and the discussions continued until saturation. Thematic analysis was performed to extract the major themes and sub-themes.
Three main themes of input/structure, process, and outcome are extracted. The input/structure theme consists of human resources, physical space, equipment, and technical support and information. In human resources, the number and proficiency of healthcare providers and mental health problems are expressed. In terms of physical space, the areas and infrastructure facilities are discussed. The proper purchase and allocation of equipment are emphasized in the equipment sub-theme. The need to establish a Health Information Service in level-one centers is mentioned in the support sub-theme. The process theme consists of medical staff retraining and empowerment, referral, follow-up, education, and audits. The maternal and neonatal mortality and morbidity indices are cited in the outcome theme.
Our findings provide a wide range of context-specific challenges the healthcare systems face in provision of perinatal health services. As a result of this study, the primary indicators for assessing the hospitals' performance in providing perinatal services are emerged.
围产期死亡率是社会发展的一个指示性因素，国际上已采取措施降低孕产妇和围产期死亡率。本研究旨在收集专家对医院提供围产期服务表现的意见，并找出评估的关键指标。
这是一项采用德尔菲技术的定性研究，基于与12名专家进行的焦点小组讨论，这些专家包括儿科医生、围产医学专家、新生儿科医生、新生儿护理护士和至少有五年工作经验的助产士。一名协调员主持会议，讨论持续进行直至达到饱和状态。进行主题分析以提取主要主题和子主题。
提取了输入/结构、过程和结果三个主要主题。输入/结构主题包括人力资源、物理空间、设备以及技术支持和信息。在人力资源方面，提到了医疗服务提供者的数量和专业水平以及心理健康问题。在物理空间方面，讨论了区域和基础设施。设备子主题强调了设备的合理采购和分配。支持子主题提到了在一级中心建立健康信息服务的必要性。过程主题包括医务人员再培训与赋权、转诊、随访、教育和审计。结果主题引用了孕产妇和新生儿死亡率及发病率指标。
我们的研究结果揭示了医疗系统在提供围产期健康服务方面面临的一系列特定背景下的挑战。通过本研究，得出了评估医院围产期服务表现的主要指标。
