Supportive and Dignified Maternity Care (SDMC) - Development and Feasibility Assessment of an Intervention Package for Public Health Systems
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 314
- 试验地点
- 1
- 主要终点
- Mean score of women's experiences of supportive and dignified maternity care
研究概览
简要总结
Brief Summary Poor psychosocial support and demeaning care during childbirth in health facilities are common worldwide, particularly in low- and middle-income countries. Despite a policy directive from the World Health Organization (WHO), there is no operational model that effectively demonstrates the incorporation of these guidelines into routine facility-based maternity services. Recent evidence from Pakistan highlights a high rate of reported disrespect and abuse during childbirth, with several health system factors contributing to this compromised care.
This early-phase research aims to develop, implement, and test the feasibility of a Supportive and Dignified Maternity Care (SDMC) service-delivery model. Based on WHO's guiding principles and framework, the model promotes respectful and supportive intrapartum care in public health facilities. The components of the SDMC model include:
Participatory and co-created service-delivery intervention;
Capacity-building of maternity teams (clinical and support staff) through a partnership approach;
Collaborative Care Model;
Patient orientation in the processes of care and their SDMC rights;
Information system (e.g., complaints register);
Accountability mechanisms (e.g., exit interviews); and
Embedding performance reviews.
Using a mixed-method design and extensive data collection before, during, and after the implementation of the intervention, we will assess the coverage of the intervention and its fidelity-the extent to which SDMC guidelines are being adhered to. Challenges faced, changes in maternity teams' understanding and attitudes, and improvements in women's maternity experiences and psychosocial well-being will also inform the success of the intervention.
Evidence from this research will guide further refinements to the SDMC model package. It will provide insights into behavior change among maternity staff and birthing women, as well as estimate the potential effect size to design a larger evaluation and scalability research in diverse health system contexts.
详细描述
Background:
Respectful and dignified healthcare is a fundamental right for every woman. However, in health facilities, particularly in low- and middle-income countries, women's experiences of maternity care are often characterized by discrimination, poor psychosocial support, and patronizing attitudes from service providers. Such distressing encounters during obstetric care are likely to have adverse effects on both women and newborns. Women with disabilities and mental health needs are especially vulnerable to poor care and the suffering it causes.
Goal and Objectives:
To support inclusive Supportive and Dignified Maternity Care (SDMC) within health systems, particularly from the perspective of:
- The capacity of service providers, and
- Accountability and governance.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 15 Years 至 49 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Postnatal Women
- •Inclusion Criteria:
- •Delivered in a study health facility during the data collection period.
- •Provided informed consent.
排除标准
- •Reside outside the demarcated catchment area.
- •Health Facility Staff
- •Inclusion Criteria:
- •Employed at the study health facility.
- •Provided informed consent.
- •Exclusion Criteria:
- •Recently appointed to the health facility (less than 6 months).
结局指标
主要结局
Mean score of women's experiences of supportive and dignified maternity care
时间窗: Women will be interviewed at baseline. It will follow a six month intervention period. At the end of intervention endline survey will be conducted somewhere Sep - Dec 2021.
The Women's experiences of SDMC will be assessed using a Mistreatment standard tool that will be adapted in the Pakistani context. The score range will be 0-100 where a higher score will indicate higher level of mistreatment whereas lower score will reflect better care.
次要结局
- Perception of service providers about feasibility of SDMC intervention(Endline assessment that will be done at the end of a six month intervention period. The assessment will be done in September-November 2021.)
研究者
Waqas Hameed
Senior Instructor
Aga Khan University