Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure.

Dickinson, Fiona M ORCID: 0000-0002-5298-9127, Madaj, Barbara ORCID: 0000-0002-4073-3191, Muchemi, Onesmus M ORCID: 0000-0003-3509-4345 and Ameh, Charles ORCID: 0000-0002-2341-7605 (2022) Assessing quality of care in maternity services in low and middle-income countries: Development of a Maternity Patient Reported Outcome Measure. PLOS global public health, 2 (3). e0000062-.

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Abstract

Globally, low and middle-income countries bear the greatest burden of maternal and newborn mortality. To reduce these high levels, the quality of care provided needs to be improved. This study aimed to develop a patient reported outcome measure for use in maternity services in low and middle-income countries, to facilitate improvements in quality of care. Semi-structured interviews and focus groups discussions were conducted with women who had recently given birth in selected healthcare facilities in Malawi and Kenya. Transcripts of these were analysed using a thematic approach and analytic codes applied. Draft outcomes were identified from the data, which were reviewed by a group of clinical experts and developed into a working copy of the Maternity Patient Reported Outcome Measure (MPROM). A further sample of new mothers were asked to evaluate the draft MPROM during cognitive debriefing interviews, and their views used to revise it to produce the final proposed measure. Eighty-three women were interviewed, and 44 women took part in 10 focus group discussions. An array of outcomes was identified from the data which were categorised under the domains of physical and psychological symptoms, social issues, and baby-related health outcomes. The draft outcomes were configured into 79 questions with answers provided using a five-point Likert scale. Minor revisions were made following cognitive debriefing interviews with nine women, to produce the final proposed MPROM. In conjunction with women from the target population and clinical experts, this study has developed what is believed to be the first condition-specific PROM suitable for assessing care quality in maternity services in low and middle-income countries. Following further validation studies, it is anticipated that this will be a useful tool in facilitating improvements in the quality of care provided to women giving birth in healthcare facilities in these settings.

Item Type:	Article
Uncontrolled Keywords:	Health Services, Clinical Research, Basic Behavioral and Social Science, Behavioral and Social Science, 8.1 Organisation and delivery of services, 8 Health and social care services research, Reproductive health and childbirth, 3 Good Health and Well Being
Depositing User:	Symplectic Admin
Date Deposited:	06 Jul 2023 14:18
Last Modified:	14 Mar 2024 20:16
DOI:	10.1371/journal.pgph.0000062
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3171465