Journal Articles Acta Obstetricia et Gynecologica Scandinavica Year : 2024

Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries: A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic

Mehreen Zaigham
  • Function : Author
Karolina Linden
  • Function : Author
Helen Elden
  • Function : Author
Stefano Delle Vedove
  • Function : Author
Ilaria Mariani
  • Function : Author
Sigrun Kongslien
  • Function : Author
Daniela Drandić
  • Function : Author
Elizabete Pumpure
  • Function : Author
Zalka Drglin
  • Function : Author
Raquel Costa
  • Function : Author
Antigoni Sarantaki
  • Function : Author
Claire de Labrusse
  • Function : Author
Marina Ruxandra Otelea
  • Function : Author
Alina Liepinaitienė
  • Function : Author
Barbara Baranowska
  • Function : Author
Virginie Rozée
Emanuelle Pessa Valente
  • Function : Author
Eline Skirnisdottir Vik
  • Function : Author
Magdalena Kurbanović
  • Function : Author
Dārta Jakovicka
  • Function : Author
Anja Bohinec
  • Function : Author
Heloísa Dias
  • Function : Author
Dimitra Metallinou
  • Function : Author
Antonia N. Mueller
  • Function : Author
Stephanie Batram-Zantvoort
  • Function : Author
Claudia Mariana Handra
  • Function : Author
Marija Mizgaitienė
  • Function : Author
Urszula Tataj-Puzyna
  • Function : Author
Arianna Bomben
  • Function : Author
Ingvild Hersoug Nedberg
  • Function : Author
Elīna Voitehoviča
  • Function : Author
Tiago Miguel Pinto
  • Function : Author
Aikaterini Lykeridou
  • Function : Author
Susanne Grylka-Baeschlin
  • Function : Author
Simona Jazdauskienė
  • Function : Author
Beata Szlendak
  • Function : Author
Emma Sacks
  • Function : Author
Marzia Lazzerini
  • Function : Author
Imagine Euro Study Group
  • Function : Author

Abstract

INTRODUCTION: Maternal-neonatal healthcare services were severely disrupted during the COVID-19 pandemic in even high-income countries within the World Health Organization (WHO) European Region. The objective of this study was to compare trends in the quality of maternal and neonatal care (QMNC) in Sweden and Norway to 12 other countries from the WHO European Region during the COVID-19 pandemic, and to identify domains for improvement. MATERIAL AND METHODS: This cross-sectional study included women giving birth in Europe from March 1, 2020 to December 31, 2022. Women answered an online, anonymous questionnaire which included 40 WHO Standard-based Quality Measures collectively scored as the total QMNC index (0-400) and separately in four subdomains (0-100): provision of care, experience of care, availability of human and physical resources, and reorganizational changes due to COVID-19. To assess reported QMNC changes over time, we used adjusted quantile regression models. RESULTS: Of the 45151 women included in the study, 13 117 (29.1%) were from Sweden and Norway and 32034 (70.9%) from the 12 WHO European countries. The total QMNC index for Sweden and Norway (median: 325, IQR: 285-355) was higher than the 12 WHO European countries (median: 315, IQR: 265-350, p < 0.001) as were trends in QMNC index over time (Sweden and Norway median: 310-345; 12 WHO European countries median: 305-340). Sweden and Norway also had higher scores in three-of-four QMNC subdomains, with the 12 WHO European countries scoring higher only for reorganizational changes due to COVID-19. In adjusted quantile models of the total QMNC index, Sweden and Norway had higher scores, with largest differences in the lower quantiles (p < 0.001 in all percentiles). CONCLUSIONS: Across Europe, there are significant gaps in the quality of maternal-neonatal healthcare services. Although women giving birth in Sweden and Norway reported higher QMNC scores in all subdomains except for "reorganizational changes due to COVID-19," there is room for improvement and shared learning across Europe. Policymakers should prioritize long-term investments in maternal and neonatal healthcare, ensuring that facilities are adequately equipped during public health crises and that all women have access to high-quality, evidence-based, equitable, and respectful care.
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hal-04884533 , version 1 (13-01-2025)

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Mehreen Zaigham, Karolina Linden, Helen Elden, Stefano Delle Vedove, Ilaria Mariani, et al.. Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries: A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic. Acta Obstetricia et Gynecologica Scandinavica, 2024, 103 (12), pp.2325-2575. ⟨10.1111/aogs.14994⟩. ⟨hal-04884533⟩
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