Evaluation of primary care midwifery in the Netherlands: design and rationale of a dynamic cohort study (DELIVER)

<p>Abstract</p> <p>Background</p> <p>In the Netherlands, midwives are autonomous medical practitioners and 78% of pregnant women start their maternity care with a primary care midwife. Scientific research to support evidence-based practice in primary care midwifery in the Netherlands has been sparse. This paper describes the research design and methodology of the multicenter multidisciplinary prospective DELIVER study which is the first large-scale study evaluating the quality and provision of primary midwifery care.</p> <p>Methods/Design</p> <p>Between September 2009 and April 2011, data were collected from clients and their partners, midwives and other healthcare professionals across the Netherlands. Clients from twenty midwifery practices received up to three questionnaires to assess the expectations and experiences of clients (e.g. quality of care, prenatal screening, emotions, health, and lifestyle). These client data were linked to data from the Netherlands Perinatal Register and electronic client records kept by midwives. Midwives and practice assistants from the twenty participating practices recorded work-related activities in a diary for one week, to assess workload. Besides, the midwives were asked to complete a questionnaire, to gain insight into collaboration of midwives with other care providers, their tasks and attitude towards their job, and the quality of the care they provide. Another questionnaire was sent to all Dutch midwifery practices which reveals information regarding the organisation of midwifery practices, provision of preconception care, collaboration with other care providers, and provision of care to ethnic minorities. Data at client, midwife and practice level can be linked. Additionally, partners of pregnant women and other care providers were asked about their expectations and experiences regarding the care delivered by midwives and in six practices client consults were videotaped to objectively assess daily practice.</p> <p>Discussion</p> <p>In total, 7685 clients completed at least one questionnaire, 136 midwives and assistants completed a diary with work-related activities (response 100%), 99 midwives completed a questionnaire (92%), and 319 practices across the country completed a questionnaire (61%), 30 partners of clients participated in focus groups, 21 other care providers were interviewed and 305 consults at six midwifery practices were videotaped.</p> <p>The multicenter DELIVER study provides an extensive database with national representative data on the quality of primary care midwifery in the Netherlands. This study will support evidence-based practice in primary care midwifery in the Netherlands and contribute to a better understanding of the maternity care system.</p

Measures of satisfaction with care during labour and birth: a comparative review

Background Satisfaction is the one of the most frequently reported outcome measures for quality of care. Assessment of satisfaction with maternity services is crucial, and psychometrically sound measures are needed if this is to inform health practices. This paper comparatively reviews current measures of satisfaction with care during labour and birth. Methods A review of the literature was conducted. Studies were located through computerised databases and hand searching references of identified articles and reviews. Inclusion criteria were that the questionnaire was a multi-item scale of satisfaction with care during labour and birth, and some form of psychometric information (either information about questionnaire construction, or reliability, or validity) had to be reported. Results Nine questionnaires of satisfaction with care during labour and birth were identified. Instruments varied in psychometric properties and dimensions. Most described questionnaire construction and tested some form of reliability and validity. Measures were generally not based on the main theoretical models of satisfaction and varied in scope and application to different types of samples (e.g. satisfaction following caesarean section). For an in-depth measure of satisfaction with intrapartum care, the Intrapartal-Specific Quality from the Patient’s Perspective questionnaire (QPP-I) is recommended. Brief measures with good reliability and validity are provided by the Six Simple Questions (SSQ) or Perceptions of Care Adjective Checklist (PCACL-R). Conclusions Despite the interest in measures of satisfaction there are only a small number of validated measures of satisfaction with care during labour and birth. It is important that brief, reliable and valid measures are available for use in general and specific populations in order to assist research and inform practice

The science of scale for violence prevention: a new agenda for family strengthening in low- and middle-income countries

Ending all violence against children by 2030 is a core part of Sustainable Development Goals 5 and 16. A number of promising violence reduction strategies have been identified in research studies. However, we lack an understanding of the implementation and impact of these programs in respect to their delivery at a large scale or within existing service systems, particularly in low- and middle-income countries (LMICs). We advocate for greater collaboration between researchers, policymakers, donors, governments, non-governmental organizations, and program managers and staff to study how violence prevention programs operate on a large scale. We describe a new initiative aiming to foster such collaborations in the field of family strengthening programs

Transferability of evidence-based parenting programs to routine implementation in postconflict South Sudan

Purpose: This study investigated process and outcomes of the Parenting for Lifelong Health (PLH) for Young Children and for Adolescents programs implemented as part of routine service delivery in postconflict settings. Methods: These group-based programs were delivered by trained facilitators to 97 caregivers (PLH for Young Children) and 108 caregiver–adolescent dyads (PLH for Adolescents) over 12 or 14 (respectively) weekly sessions. Routine monitoring data were collected by the implementing partners using standardized self-report measures. Reducing harsh discipline was specified as the primary outcome, with secondary outcomes including improvements in positive parenting and reductions in poor parental supervision and parental inefficacy. Results: Analyses were intention to treat. Both PLH programs retained effectiveness in routine conditions in a postwar setting, with moderate to large effect sizes. The programs also had high enrollment and attendance rates, indicating high acceptability. Conclusions: Findings suggest promising viability for the implementation of evidence-based parenting programs in challenging postconflict contexts

Transferability of evidence-based parenting programs to routine implementation in postconflict South Sudan

Purpose: This study investigated process and outcomes of the Parenting for Lifelong Health (PLH) for Young Children and for Adolescents programs implemented as part of routine service delivery in postconflict settings. Methods: These group-based programs were delivered by trained facilitators to 97 caregivers (PLH for Young Children) and 108 caregiver–adolescent dyads (PLH for Adolescents) over 12 or 14 (respectively) weekly sessions. Routine monitoring data were collected by the implementing partners using standardized self-report measures. Reducing harsh discipline was specified as the primary outcome, with secondary outcomes including improvements in positive parenting and reductions in poor parental supervision and parental inefficacy. Results: Analyses were intention to treat. Both PLH programs retained effectiveness in routine conditions in a postwar setting, with moderate to large effect sizes. The programs also had high enrollment and attendance rates, indicating high acceptability. Conclusions: Findings suggest promising viability for the implementation of evidence-based parenting programs in challenging postconflict contexts