Validation of the person-centered maternity care scale in India

Afulani, Patience A.; Diamond‐Smith, Nadia; Phillips, Beth; Singhal, Shreya; Sudhinaraset, May

doi:10.1186/s12978-018-0591-7

Cited by 80 publications

(146 citation statements)

References 30 publications

(36 reference statements)

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“…Women were recruited for interviews by research assistants in health facilities in urban Kenya, India, and Ghana, and in health facilities and homes in rural Kenya. The methodology for all four surveys are described in detail elsewhere . These studies were approved by the University of California, San Francisco Committee for Human Subjects, the Kenya Medical Research Institute Scientific and Ethics Review Unit, the Navrongo Health Research Center in Ghana, and the Community Empowerment Lab in India.…”

Section: Methodsmentioning

confidence: 99%

“…The methodology for all four surveys are described in detail elsewhere. 9,15,16 These studies were approved by the University of California, San Francisco Committee for Human Subjects, the Kenya Medical Research Institute Scientific and Ethics Review Unit, the Navrongo Health Research Center in Ghana, and the Community Empowerment Lab in India. All respondents provided written informed consent.…”

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confidence: 99%

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Toward the development of a short multi‐country person‐centered maternity care scale

Afulani

Feeser²,

Sudhinaraset

et al. 2019

Intl J Gynecology & Obste

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Objective To develop a shortened, valid and reliable scale applicable across multiple settings for routine monitoring of person‐centered maternity care (PCMC). Methods Exploratory analysis was used to generate parsimonious versions of a 30‐item PCMC scale in four datasets from cross‐sectional surveys conducted between August 2016 and October 2017, involving women aged 15–49 years in Kenya, Ghana and India who had recently given birth. Analysis was informed by expert opinion via a separate online survey of global maternal and child health experts. Items retained in each dataset were compared, and those unique to a single setting removed. The remaining items were pooled and assessed for construct and criterion validity and reliability in each setting. Results Thirteen items were retained for a potential multi‐setting short PCMC scale, incorporating the domains of dignity and respect, communication and autonomy, and supportive care. Cronbach's alpha for the scale was >0.7 in each setting. Scores on the 13‐item scale were correlated with the 30‐item scale scores, and with global measures of care satisfaction in Kenya and India. Conclusion Analysis yielded a 47% shorter PCMC scale, that showed promise for routine assessment of women's experience of care during childbirth across multiple settings. However, further validation is needed.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

Toward the development of a short multi‐country person‐centered maternity care scale

Afulani

Feeser²,

Sudhinaraset

et al. 2019

Intl J Gynecology & Obste

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“…26,27 The original scale has 30 items with three subscales for dignity and respect, communication and autonomy, and supportive care. Our planned sample size was 300 women at each time point, which we estimated would detect an effect size of 0.45 (assuming 80% power and five clusters (health facilities)), and the assumption that we could recruit about half of eligible women in the intervention facilities.…”

Section: Data Collection Measures and Analysismentioning

confidence: 99%

“…The person-centered maternity care scale was initially validated in Kenya and India and shown to have high content, construct, and criterion validity and with good reliability. 26,27 The original scale has 30 items with three subscales for dignity and respect, communication and autonomy, and supportive care. Each item has a 4-point frequency response option-0: "no, never," 1: "yes, a few times," 2: "yes, most of the time," and 3: "yes, all the time."…”

Section: Data Collection Measures and Analysismentioning

confidence: 99%

Can an integrated obstetric emergency simulation training improve respectful maternity care? Results from a pilot study in Ghana

Afulani

Aborigo

Walker

et al. 2019

Birth

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Background: Few evidence-based interventions exist on how to improve respectful maternity care (RMC) in low-resource settings. We sought to evaluate the effect of an integrated simulation-based training on provision of RMC. Methods: The pilot project was in East Mamprusi District in northern Ghana. We integrated specific components of RMC, emphasizing dignity and respect, communication and autonomy, and supportive care, into a simulation training to improve identification and management of obstetric and neonatal emergencies. Forty-three providers were trained. For evaluation, we conducted surveys at baseline (N = 215) and endline (N = 318) 6 months later, with recently delivered women to assess their experiences of care using the person-centered maternity care scale. Higher scores on the scale represent more respectful care. Results: Compared to the baseline, women in the endline reported more respectful care. The average person-centered maternity care score increased from 50 at baseline to 72 at endline, a relative increase of 43%. Scores on the subscales also increased between baseline and endline: 15% increase for dignity and respect, 87% increase for communication and autonomy, and 55% increase for supportive care. These differences remained significant in multivariate analysis controlling for several potential confounders. Conclusions:The findings suggest that integrated provider trainings that give providers the opportunity to learn, practice, and reflect on their provision of RMC in the context of stressful emergency obstetric simulations have the potential to improve women's childbirth experiences in low-resource settings. Incorporating such trainings into preservice and in-service training of providers will help advance global efforts to promote RMC. K E Y W O R D SGhana, mistreatment, person-centered maternity care, quality of care, respectful maternity care, simulation training 524 | AFULANI et AL.

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“…Person-Centered maternity care Indicator Person-centered maternity care was assessed using the PCMC scale that measures care received within three domains: dignity and respect; communication and autonomy; and supportive care. This scale was validated using survey data speci cally from women who had delivered in Uttar Pradesh and contains 27 items to measure a woman's PCMC experience at the facility (24). Four items could not be matched between baseline and endline.…”

Section: Outcome Variablesmentioning

confidence: 99%

A Comparison of Intensive vs. Light-Touch Quality Improvement Interventions for Maternal Health in Uttar Pradesh, India

Montagu

Giessler

Nakphone

et al. 2020

Preprint

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BackgroundPoor patient experiences during delivery leads to delayed presentation at facilities and contributes to poor maternal health outcomes. Person-centered maternity care (PCMC) is a key component of quality. Improving PCMC requires changing the process of care which can be complex and require significant external input, making replication and scale difficult. This study compared the effectiveness two Quality Improvement (QI) intervention phases, one Intensive, one Light-Touch. MethodsWe used a matched case-control design to compare two phases of a QI Intervention targeting PCMC, with three facilities in each. The Intensive phase was introduced into three government facilities where teams were supported to identify, design, and test potential improvements over 12 months. The Light-Touch phase was subsequently introduced in three other government facilities and changes were tracked over six months. We compared the two groups using multivariate linear regression and difference-in-difference models to assess changes in PCMC outcome. ResultsBoth Intensive and Light-Touch arms demonstrated large improvements in PCMC. On a scale from 0 to 100, Intensive facilities increased in PCMC scores from 85.02 to 97.13, while Light-Touch facilities increased from 63.42 to 87.47. For both there was a ‘halo’ effect, with a similar improvement recorded for the specific improvement activities focused on, as w ell as aspects of PCMC not directly addressed. ConclusionsThis study demonstrated that a short, inexpensive, light-touch and directive intervention can change staff practices and significantly improve the experiences of women during childbirth. It also shows that improvements in a few areas of provider-patient interaction have a ‘halo’ effect, changing many other aspects of patient-provider interaction at the same time. Trial RegistrationQI Phase 1 - NCT04208867. Retrospectively registered. December 19th, 2019. link to the registration:https://clinicaltrials.gov/ct2/show/NCT04208867?term=NCT04208867&draw=2&rank=1QI Phase 2 – NCT04208841. Retrospectively registered. December 23, 2019. link to the registration:https://clinicaltrials.gov/ct2/show/NCT04208841?term=NCT04208841&draw=2&rank=1CONTRIBUTIONS TO THE LITERATURE 98 words· Medical practioners’ treatment of patients are influenced by institutional norms and difficult to change. · Team-based initiatives which actively engage staff have been effective in wealthy countries but are not common in middle-income settings, and have not been applied to person-centered aspects of care.· We found that team-based quality improvement efforts were effective in India at changing patient experience. Once change-practices were identified, these practices were introduced to new facilities with low-intesity support and proved equally effective at improving care.· These findings add to the limited evidence on team-based quality improvement, and provide evidence of effective scaleable implementation opportunities.

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Validation of the person-centered maternity care scale in India

Cited by 80 publications

References 30 publications

Toward the development of a short multi‐country person‐centered maternity care scale

Toward the development of a short multi‐country person‐centered maternity care scale

Can an integrated obstetric emergency simulation training improve respectful maternity care? Results from a pilot study in Ghana

A Comparison of Intensive vs. Light-Touch Quality Improvement Interventions for Maternal Health in Uttar Pradesh, India

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