Midwife-led continuity of care increases women’s satisfaction with antenatal,intrapartum, and postpartum care: North Shoa,Amhara regional state,Ethiopia: A quasi-experimental study |
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| Institution: | 1. School of Midwifery, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia;2. Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia;3. Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institute, Sweden;4. Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;5. Department of Midwifery, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia;1. CNHS, Flinders University, Australia;2. Arctic University of Norway, Rural and Remote Arctic Health, Campus Hammersfest, Norway;1. School of Nursing Midwifery and Social Work, University of Queensland, Level 3 Chamberlain Building, St Lucia, Queensland, Australia;2. Central Coast Local Health District, Holden Street, Gosford, NSW 2250, Australia;3. North Sydney Local Health District, Coronation Street, Mona Vale, NSW 1660, Australia;4. School of Health Sciences, University of Skovde, Box 408, SE541 28, Sweden;5. Molly Wardaguga Research Centre, College of Nursing & Midwifery, Charles Darwin University, Level 11, East Building, 410 Ann St, Brisbane, Queensland, 4000, Australia;1. Judith Lumley Centre, La Trobe University, Bundoora, VIC 3086, Australia;2. School of Nursing & Midwifery, La Trobe University, Bundoora, VIC 3086, Australia;3. The Royal Women’s Hospital, Locked Bag 300, Cnr Grattan St and Flemington Rd, Parkville, VIC 3052, Australia;1. School of Nursing and Midwifery, Griffith University, Brisbane, Australia;2. Transforming Maternity Care Collaborative, Australia;1. Australian Centre for Public and Population Health Research (ACPPHR), School of Public Health, Faculty of Health, University of Technology Sydney, PO Box 222, Jones St, Ultimo, 2007 NSW, Australia;2. Institute for Sustainable Futures, University of Technology Sydney, PO Box 222, Jones St, Ultimo, 2007 NSW, Australia;3. School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751 NSW, Australia |
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| Abstract: | BackgroundThe provision of midwife-led continuity of care (MLCC) is effective in high-resource settings in improving maternal satisfaction. This study aimed to evaluate the effect of MLCC on women’s satisfaction with care in a low-income/resource setting.MethodA study with a quasi-experimental design was conducted from August 2019 to September 2020 in four primary hospitals in the north Shoa zone, Amhara regional state, Ethiopia. A total of 1178 low-risk women were allocated to one of two groups; the MLCC (intervention group) that received all antenatal, intrapartum, and immediate postnatal care from a primary midwife or backup midwife) (n = 589) and the shared model of care (SMC) group that received care following established practice in Ethiopia, care from different staff members at different times) (n = 589). Data for this paper were collected using face-to-face interviews at the women’s home at the end of the postpartum period. The study’s outcome was the mean sum-score of satisfaction with care through the antenatal, intrapartum, and postnatal period continuum, where mean sum-scores range from 1 (lowest) to 5 (highest).FindingsCompared with SMC, MLCC was associated with statistically significantly higher satisfaction with all continuity of care (4.07 vs. 2.79 adjusted mean difference 1.27, 95% CI 1.18–1.35; p < 0.001), during antenatal care (4.14 vs. 2.81 adjusted mean difference 1.33 (95% CI 1.22–1.52), intrapartum care (3.83 vs. 2.71 adjusted mean difference 1.06 (95% CI 0.88–1.23) and postnatal care (5.46 vs. 3.71 adjusted mean difference 1.75 (95% CI 1.54–1.94)).ConclusionMLCC increased women's satisfaction with maternity care for women at low risk of medical complications. These findings confirm that the MLCC model will be applicable in the Ethiopian health care system with similar settings. |
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| Keywords: | Midwife-led continuity of care Continuity of care Satisfaction with care Midwifery North Shoa Ethiopia |
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