Maternal Health Infrastructure and Interpersonal Quality of Care During Childbirth: An Examination of Facility Delivery in Malawi.

Objectives: The maternal health field has recently focused on the importance of interpersonal quality of care and continues to cite structural deficits as a contributor to poor interpersonal treatment. This hypothesis is supported by qualitative evidence. This study quantitatively tested the effect...

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Publicado en:Maternal & Child Health Journal Vol. 25; no. 3; pp. 460 - 471
Autor principal: Kujawski, Stephanie A.
Formato: research tables/charts Journal Article
Publicado: Springer Nature Mar2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2021
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s10995-020-03081-4
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        atl: Maternal Health Infrastructure and Interpersonal Quality of Care During Childbirth: An Examination of Facility Delivery in Malawi.
      aug:
        au: Kujawski, Stephanie A.
        affil: Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168 Street, 10032, New York, NY, USA
      sug:
        subj:
          Maternal Health Services Malawi
          Health Care Delivery
          Childbirth
          Interpersonal Relations
          Quality of Health Care
          Quantitative Studies
          Human
          Malawi
          Linear Regression
          Female
          Confidence Intervals
          Respect
          Surveys
          Questionnaires
          Univariate Statistics
          Bivariate Statistics
          Data Analysis Software
          Young Adult
          Adult
          Adolescence
          Adult: 19-44 years
          Adolescent: 13-18 years
          Female
      ab: Objectives: The maternal health field has recently focused on the importance of interpersonal quality of care and continues to cite structural deficits as a contributor to poor interpersonal treatment. This hypothesis is supported by qualitative evidence. This study quantitatively tested the effect of maternal health structural inputs on interpersonal quality of care during childbirth. Methods: Analyses were conducted using data from the 2013 to 2014 Malawi Service Provision Assessment, which documented the availability and quality of health facility services and included the observation of laboring and delivering women. Maternal health structural inputs were measured using 26 facility infrastructure variables. The outcome, interpersonal quality of care, was measured as a sum score of 12 items collected during the observations. Crude and adjusted associations between maternal health structural inputs on interpersonal quality of care were assessed using linear regression with cluster robust standard errors. Results: 345 Observations of delivering women in 174 health facilities were included in the analysis. 19.1% of women delivered in a facility with high maternal health structural inputs, and the mean interpersonal quality of care score was 8.9/12. Maternal health structural inputs had a small, non-meaningful association with interpersonal quality of care during childbirth (adjusted β − 0.19, 95% CI − 0.85, 0.47). Conclusions for Practice: These findings do not verify the quality of care frameworks or qualitative evidence that support the relationship between structure and interpersonal quality of care. While structural inputs are important for health system performance, the results suggest that they might not be necessary for a respectful childbirth experience.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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