Author:
Martens Nele,Hindori-Mohangoo Ashna D.,Hindori Manodj P.,Damme Astrid Van,Beeckman Katrien,Reis Ria,Crone Mathilde R.,van der Kleij Rianne RMJJ
Abstract
Abstract
Background
Suriname is a uppermiddle-income country with a relatively high prevalence of preventable pregnancy complications. Access to and usage of high-quality maternity care services are lacking. The implementation of group care (GC) may yield maternal and child health improvements. However, before introducing a complex intervention it is pivotal to develop an understanding of the local context to inform the implementation process.
Methods
A context analysis was conducted to identify local needs toward maternity and postnatal care services, and to assess contextual factor relevant to implementability of GC. During a Rapid Qualitative Inquiry, 63 online and face-to-face semi-structured interviews were held with parents, community members, on-and off-site healthcare professionals, policy makers, and one focus group with parents was conducted. Audio recordings were transcribed in verbatim and analysed using thematic analysis and Framework Method. The Consolidated Framework for Implementation Research served as a base for the coding tree, which was complemented with inductively derived codes.
Results
Ten themes related to implementability, one theme related to sustainability, and seven themes related to reaching and participation of the target population in GC were identified. Factors related to health care professionals (e.g., workload, compatibility, ownership, role clarity), to GC, to recipients and to planning impact the implementability of GC, while sustainability is in particular hampered by sparse financial and human resources. Reach affects both implementability and sustainability. Yet, outer setting and attitudinal barriers of health professionals will likely affect reach.
Conclusions
Multi-layered contextual factors impact not only implementability and sustainability of GC, but also reach of parents. We advise future researchers and implementors of GC to investigate not only determinants for implementability and sustainability, but also those factors that may hamper, or facilitate up-take. Practical, attitudinal and cultural barriers to GC participation need to be examined. Themes identified in this study will inspire the development of adaptations and implementation strategies at a later stage.
Publisher
Springer Science and Business Media LLC
Subject
Obstetrics and Gynecology
Reference53 articles.
1. Rising SS. Centering pregnancy. An interdisciplinary model of empowerment. J Nurse Midwifery. 1998;43:46–54.
2. Centering Health Care Institute. Centering Healthcare – A Snapshot The 13 Essential Elements that define the Centering model. 2023. https://www.centeringhealthcare.org/uploads/files/FX_Fact-Sheet-Full-Set.pdf.
3. Hunter LJ, et al. Better together: A qualitative exploration of women’s perceptions and experiences of group antenatal care. Women Birth. 2019;32:336–45.
4. Picklesimer AH, Billings D, Hale N, Blackhurst D, Covington-Kolb S. The effect of CenteringPregnancy group prenatal care on preterm birth in a low-income population. Am J Obstet Gynecol. 2012;206(415):e411-415.e417.
5. Ickovics JR, et al. Group prenatal care and perinatal outcomes. Obstet Gynecol. 2007;110:330–9.