Primary maternity care reform: Whose influence is driving the change?

McIntyre, Meredith; Francis, Karen; Chapman, Ysanne

doi:10.1016/j.midw.2011.08.004

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…Over the past two decades, studies and advisory reports [4,10-12] have used both quantitative and qualitative methods [13] to explore discrete components of maternity care (e.g. antenatal or postnatal care [14]).…”

Section: Introductionmentioning

confidence: 99%

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What women want: qualitative analysis of consumer evaluations of maternity care in Queensland, Australia

McKinnon

Prosser

Miller

2014

BMC Pregnancy Childbirth

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BackgroundMaternity care reform plans have been proposed at state and national levels in Australia, but the extent to which these respond to maternity care consumers’ expressed needs is unclear. This study examines open-text survey comments to identify women’s unmet needs and priorities for maternity care. It is then considered whether these needs and priorities are addressed in current reform plans.MethodsWomen who had a live single or multiple birth in Queensland, Australia, in 2010 (n 3,635) were invited to complete a retrospective self-report survey. In addition to questions about clinical and interpersonal maternity care experiences from pregnancy to postpartum, women were asked an open-ended question “Is there anything else you’d like to tell us about having your baby?” This paper describes a detailed thematic analysis of open-ended responses from a random selection of 150 women (10% of 1,510 who responded to the question).ResultsFour broad themes emerged relevant to improving women’s experiences of maternity care: quality of care (interpersonal and technical); access to choices and involvement in decision-making; unmet information needs; and dissatisfaction with the care environment. Some of these topics are reflected in current reform goals, while others provide evidence of the need for further reforms.ConclusionsThe findings reinforce the importance of some existing maternity reform objectives, and describe how these might best be met. Findings affirm the importance of information provision to enable informed choices; a goal of Queensland and national reform agendas. Improvement opportunities not currently specified in reform agendas were also identified, including the quality of interpersonal relationships between women and staff, particular unmet information needs (e.g., breastfeeding), and concerns regarding the care environment (e.g., crowding and long waiting times).

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Section: Introductionmentioning

confidence: 99%

“…Internationally, researchers and policy makers have critiqued the features of a high quality maternity system that is aligned with the values of the community that it serves [ 1 - 4 ]. Objectives for maternity care reform that have arisen from such enquiry include improved: monitoring (e.g.…”

Section: Introductionmentioning

confidence: 99%

What women want: qualitative analysis of consumer evaluations of maternity care in Queensland, Australia

McKinnon

Prosser

Miller

2014

BMC Pregnancy Childbirth

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“…The leadership of the Ministry of Health plays an important role in the effective implementation of this national program through supervision, funding, and policy-making. Natural childbirth promotion programs in other countries, such as Australia and the United Kingdom, have also emphasized the importance of leadership (16,17). In addition, the electronic information systems for recording pregnancy and childbirth care are considered as a strong point of the program (16).…”

Section: Discussionmentioning

confidence: 99%

“…Every health program must have strong financial support to have an executive guarantee and achieve the goals. In the Australian national maternity services program, the government failed to supply the program's funding shortages and staff shortages (17). Government financial support (21), an appropriate payment structure (11), public insurance, and free-of-charge childbirth can also promote natural childbirth (22).…”

Section: Discussionmentioning

confidence: 99%

Designing a Model for Effective Implementation of Promoting Natural Childbirth Program: A Mixed Study

et al. 2021

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Background: The World Health Organization (WHO) has considered the ideal rate for cesarean sections to be 10 - 15%. The Iran Ministry of Health introduced the promoting natural childbirth program (PNCP) in 2014 to lower cesarean sections. Objectives: This study presents a model for the implementation of the PNCP. Methods: A mixed study was conducted to determine and prioritize the factors affecting the implementation of PNCP and present a model. We conducted a qualitative study to determine the effective factors of the program by examining the views of 15 gynecologists, anesthesiologists, midwives, and managers in 2019 at Zabol Medical Sciences University. Semi-structured individual and group interviews were used and analyzed with MAXQDA16. In the quantitative phase, a questionnaire of themes was prepared and ranked by 10 experts based on the Likert scale. Then, we used the technique for order performance by similarity to ideal solution with BT TOPSIS solver software to confirm and rank the themes and design a model. Results: The model included six main themes extracted from the qualitative phase. In the quantitative phase, they were approved and prioritized by experts in the following order: 1- Creating a culture for natural childbirth; 2- Strong and committed leadership; 3- Empowerment; 4- Education; 5- Comprehensive support; and 6- Optimization. Conclusions: The model can provide useful insight for policymakers and care providers to make more qualified decisions, determine the status quo, allocate resources, and enforce policies.

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“…This suggests that the government should increase investment in community health services, especially for rural areas. Some examples could be taken from foreign countries (Banfield & Jardine, ; McIntyre, Francis, & Chapman, ) that have full legal safeguard and support from the government. Meanwhile, care services in the community (e.g., day care and home care) should be enrolled into medical insurance system, which could relieve the economic burden of older people with chronic illnesses.…”

Section: Discussionmentioning

confidence: 99%

Continuity of Care for Older Adults with Chronic Illness in China: An Exploratory Study

Cheng

Zhao

Bai

et al. 2014

Public Health Nursing

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Primary maternity care reform: Whose influence is driving the change?

Cited by 12 publications

References 17 publications

What women want: qualitative analysis of consumer evaluations of maternity care in Queensland, Australia

What women want: qualitative analysis of consumer evaluations of maternity care in Queensland, Australia

Designing a Model for Effective Implementation of Promoting Natural Childbirth Program: A Mixed Study

Continuity of Care for Older Adults with Chronic Illness in China: An Exploratory Study

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