Developing an Evaluation Model for Maternity Care: A Mixed-Method Study from Iran
,
Abstract
Background: Maternity care is an integral part of primary health care (PHC) systems worldwide. This study aimed to develop a new model for evaluating the maternity health program (MHP) in Iran.
Methods: In this mixed-methods study, first, the challenges of MHP were surveyed through systematic review and expert interviews. Next, to identify the existing shortcomings in MHP evaluation system, the SWOT technique, cross-sectional study and comparative analyses were used. Finally, the Delphi technique was used to reach consensus on developed evaluation standards.
Results: The final developed evaluation model contains five dimensions including reproductive health/family planning, maternity health, health records, evaluation, and resources management. Overall, this model has 32 standards and 289 measures. The scores obtained for the sum of the measures in two importance and applicability criteria were 8.24 and 7.85, which these scores are estimated to be equal to 91.55 and 87.22 percent of the highest possible scores, respectively.
Conclusion: Considering the comprehensiveness of the obtained model, it is hoped that it could lead to performance improvement of the PHC centers in the area of maternity health.
1. Wilson A, Tabrizi JS, Gholipour K, Farahbakhsh M (2013). Technical quality of maternity care: the pregnant women’s perspective. Health Promot Perspect,3(1):23-30.
2. de Bernis L, Kinney MV, Stones W, Ten Hoope-Bender P, Vivio D, Leisher S (2016). Stillbirths: ending preventable deaths by 2030. Lancet, 387(10019):703-16.
3. Nahar S, Banu M, Nasreen HE (2011). Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study. BMC Pregnancy Childbirth, 11(11):1-10.
4. Debiec KE, Paul KJ, Mitchell CM, Hitti JE (2010). Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years. Am J Obstet Gynecol, 203(2):1-6.
5. WHO (2003). Low birth weight - a tabulation of available information: Maternity and safe motherhood program. Geneva: The World Health Organization Publisher.
6. Goberna-Tricas J, s-Gime´ nez RB, Palacio-Tauste A, Linares-Sancho S (2011). Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women. Midwifery, 27(6):231-7.
7. WHO (2014). Trends in maternity mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. The World Health Organization Publisher: Geneva.
8. Aboagye E, Agyemang OS (2013). Maternity Health-seeking Behaviour: The role of financing and organisation of health services in Ghana. Global J Health Sci, 5(5):67-79.
9. Lawn JE, Cousens S, Zupan J (2005). 4 million neonatal deaths: when? Where? Why? Lancet, 365(9462):891-900.
10. Ghazivakili Z, Lotfi R, Kabir K, Norouzinia R, Rajabi Naeeni M (2016). Maternity near miss approach to evaluate quality of care in Alborz province, Iran. Midwifery, 41(2):118-124.
11. Azizi A (2015). The prevalence of the causes of high risk pregnancies in pregnant women of sonqor city, 2011. Iran J Obstet Gynecol Infertil, 18(153):10-9.
12. Tabrizi JS, Gholipoor K, Asghari Jafarabadi M, Farahbakhsh M, Mohammadzedeh M (2012). Customer quality and maternity care in Tabriz urban health centers and health posts. J Clin Res Gov, 1(1):11-5.
13. Tabrizi JS, Askari S, Fardiazar Z, Koshavar H, Gholipour K (2014). Service quality of delivered care from the perception of women with caesarean section and normal delivery. Health Promot Perspect, 4(2):137-43.
14. Eden AP, Peterson LE (2017). Impact of potential accreditation and certification in family medicine maternity care. Fam Med,49(1):14-21.
15. Talungchit P, Liabsuetrakul T, Lindmark G (2013). Development and assessment of indicators for quality of care in severe preeclampsia/eclampsia and postpartum hemorrhage. J Health Care Qual, 35(3):22-34.
16. Rich R, D’Hont T, Linton J, Murphy KE, Veillard J, Chatwood S (2016). Performance indicators for maternity care in a circumpolar context: a scoping review. Int J Circumpolar Health, 2016;75:1-14.
17. Jehan K, Sidney K, Smith H, de Costad A (2012). Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia. Reproductive Health Matters, 20(39):142-54.
18. Sapountzi-Krepia D, Raftopoulos V, Tzavelas G, Psychogiou M, Callister LC, Vehvilainen-Julkunen K (2009). Mothers’ experiences of maternity services: internal consistency and test-retest reliability of the Greek translation of the Kuopio Instrument for Mothers. Midwifery, 25(6):691-700.
19. Mourad SM, Hermens RP, Nelen WL, Braat DD, Grol RP, Kremer JA (2007). Guideline-based development of quality indicators for subfertility care. Hum Reprod, 22(10):2665-72.
20. Tabrizi JS, Gharibi F, Pirahary S (2013). Developing of National Accreditation Model for Rural Health Centers in Iran Health System. Iran J Public Health, 42(12):1438-45.
21. Tabrizi JS, Gharibi F (2019). Primary healthcare accreditation standards: a systematic review. Int J Health Care Qual Assur, 2019;32(2):310-20.
22. Tabrizi JS, Gharibi F (2011). Systematic survey of accreditation models for designing a national model. Sci J Kurdistan Med Sci, 26(3):95-109.
23. Ghavarskhar F, Matlabi H, Gharibi F (2018). A systematic review to compare residential care facilities for older people in developed countries: practical implementations for Iran. Cogent Social Sci, 4(1):1478493.
24. Gharibi F, Dadgar E (2020). Pay-for-performance challenges in familly physician programs. Malays Fam Physician, 15(2):19-29.
25. Wang J, Wang Z (2020). Strengths, weaknesses, opportunities and threats (SWOT)a analysis of China’s prevention and control strategy for the COVID-19 epidemic. Int J Environ Res Public Health, 17(7):2235.
26. Imani A, Gharibi F, Khezri A, Joudyian N, Dalal K (2020). Economic costs incurred by the patients with multiple sclerosis at different levels of the disease: a cross-sectional study in Northwest Iran. BMC Neurol, 20(205):1-10.
27. Gharibi F, Tabrizi JS (2018). Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study. Health Promot Perspect, 8(2):155-62.
28. Tabrizi JS, Gharibi F (2020). Developing national functional accreditation model for primary healthcares with emphasis on family practice in Iran. Korean J Fam Med (In Press).
29. Standards for Primary Healthcare Units/Centers. Available at: http://www.mohp.gov.eg/ DocLib9/p9.pdf
30. Primary Healthcare Standards, Available at: http://www.moh.gov.sa/depts/Pharmacy/ Documents.pdf
2. de Bernis L, Kinney MV, Stones W, Ten Hoope-Bender P, Vivio D, Leisher S (2016). Stillbirths: ending preventable deaths by 2030. Lancet, 387(10019):703-16.
3. Nahar S, Banu M, Nasreen HE (2011). Women-focused development intervention reduces delays in accessing emergency obstetric care in urban slums in Bangladesh: a cross-sectional study. BMC Pregnancy Childbirth, 11(11):1-10.
4. Debiec KE, Paul KJ, Mitchell CM, Hitti JE (2010). Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years. Am J Obstet Gynecol, 203(2):1-6.
5. WHO (2003). Low birth weight - a tabulation of available information: Maternity and safe motherhood program. Geneva: The World Health Organization Publisher.
6. Goberna-Tricas J, s-Gime´ nez RB, Palacio-Tauste A, Linares-Sancho S (2011). Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women. Midwifery, 27(6):231-7.
7. WHO (2014). Trends in maternity mortality: 1990 to 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. The World Health Organization Publisher: Geneva.
8. Aboagye E, Agyemang OS (2013). Maternity Health-seeking Behaviour: The role of financing and organisation of health services in Ghana. Global J Health Sci, 5(5):67-79.
9. Lawn JE, Cousens S, Zupan J (2005). 4 million neonatal deaths: when? Where? Why? Lancet, 365(9462):891-900.
10. Ghazivakili Z, Lotfi R, Kabir K, Norouzinia R, Rajabi Naeeni M (2016). Maternity near miss approach to evaluate quality of care in Alborz province, Iran. Midwifery, 41(2):118-124.
11. Azizi A (2015). The prevalence of the causes of high risk pregnancies in pregnant women of sonqor city, 2011. Iran J Obstet Gynecol Infertil, 18(153):10-9.
12. Tabrizi JS, Gholipoor K, Asghari Jafarabadi M, Farahbakhsh M, Mohammadzedeh M (2012). Customer quality and maternity care in Tabriz urban health centers and health posts. J Clin Res Gov, 1(1):11-5.
13. Tabrizi JS, Askari S, Fardiazar Z, Koshavar H, Gholipour K (2014). Service quality of delivered care from the perception of women with caesarean section and normal delivery. Health Promot Perspect, 4(2):137-43.
14. Eden AP, Peterson LE (2017). Impact of potential accreditation and certification in family medicine maternity care. Fam Med,49(1):14-21.
15. Talungchit P, Liabsuetrakul T, Lindmark G (2013). Development and assessment of indicators for quality of care in severe preeclampsia/eclampsia and postpartum hemorrhage. J Health Care Qual, 35(3):22-34.
16. Rich R, D’Hont T, Linton J, Murphy KE, Veillard J, Chatwood S (2016). Performance indicators for maternity care in a circumpolar context: a scoping review. Int J Circumpolar Health, 2016;75:1-14.
17. Jehan K, Sidney K, Smith H, de Costad A (2012). Improving access to maternity services: an overview of cash transfer and voucher schemes in South Asia. Reproductive Health Matters, 20(39):142-54.
18. Sapountzi-Krepia D, Raftopoulos V, Tzavelas G, Psychogiou M, Callister LC, Vehvilainen-Julkunen K (2009). Mothers’ experiences of maternity services: internal consistency and test-retest reliability of the Greek translation of the Kuopio Instrument for Mothers. Midwifery, 25(6):691-700.
19. Mourad SM, Hermens RP, Nelen WL, Braat DD, Grol RP, Kremer JA (2007). Guideline-based development of quality indicators for subfertility care. Hum Reprod, 22(10):2665-72.
20. Tabrizi JS, Gharibi F, Pirahary S (2013). Developing of National Accreditation Model for Rural Health Centers in Iran Health System. Iran J Public Health, 42(12):1438-45.
21. Tabrizi JS, Gharibi F (2019). Primary healthcare accreditation standards: a systematic review. Int J Health Care Qual Assur, 2019;32(2):310-20.
22. Tabrizi JS, Gharibi F (2011). Systematic survey of accreditation models for designing a national model. Sci J Kurdistan Med Sci, 26(3):95-109.
23. Ghavarskhar F, Matlabi H, Gharibi F (2018). A systematic review to compare residential care facilities for older people in developed countries: practical implementations for Iran. Cogent Social Sci, 4(1):1478493.
24. Gharibi F, Dadgar E (2020). Pay-for-performance challenges in familly physician programs. Malays Fam Physician, 15(2):19-29.
25. Wang J, Wang Z (2020). Strengths, weaknesses, opportunities and threats (SWOT)a analysis of China’s prevention and control strategy for the COVID-19 epidemic. Int J Environ Res Public Health, 17(7):2235.
26. Imani A, Gharibi F, Khezri A, Joudyian N, Dalal K (2020). Economic costs incurred by the patients with multiple sclerosis at different levels of the disease: a cross-sectional study in Northwest Iran. BMC Neurol, 20(205):1-10.
27. Gharibi F, Tabrizi JS (2018). Development of an accreditation model for health education and promotion programs in the Iranian primary healthcare system: a Delphi study. Health Promot Perspect, 8(2):155-62.
28. Tabrizi JS, Gharibi F (2020). Developing national functional accreditation model for primary healthcares with emphasis on family practice in Iran. Korean J Fam Med (In Press).
29. Standards for Primary Healthcare Units/Centers. Available at: http://www.mohp.gov.eg/ DocLib9/p9.pdf
30. Primary Healthcare Standards, Available at: http://www.moh.gov.sa/depts/Pharmacy/ Documents.pdf
| Files | ||
| Issue | Vol 51 No 1 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i1.8307 | |
| Keywords | ||
| Maternity health Evaluation Model Iran | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Firooznia R, Dargahi H, Jafari-Koshki T, Khaledian Z. Developing an Evaluation Model for Maternity Care: A Mixed-Method Study from Iran. Iran J Public Health. 2022;51(1):160-171.
