Quality of perinatal care services from the user's perspective: a Dutch study applies the World Health Organization's responsiveness concept

Jacoba van der Kooy, Erwin Birnie, Nicole B. Valentine, Johanna P. de Graaf, Semiha Denktas, Eric A. P. Steegers, Gouke J. Bonsel

    Research output: Contribution to journalArticleAcademicpeer-review

    Abstract

    Background
    The concept of responsiveness was introduced by the World Health Organization (WHO) to address non-clinical aspects of service quality in an internationally comparable way. Responsiveness is defined as aspects of the way individuals are treated and the environment in which they are treated during health system interactions.
    The aim of this study is to assess responsiveness outcomes, their importance and factors influencing responsiveness outcomes during the antenatal and delivery phases of perinatal care.
    Method
    The Responsiveness in Perinatal and Obstetric Health Care Questionnaire was developed in 2009/10 based on the eight-domain WHO concept and the World Health Survey questionnaire. After ethical approval, a total of 171 women, who were 2 weeks postpartum, were recruited from three primary care midwifery practices in Rotterdam, the Netherlands, using face-to-face interviews. We dichotomized the original five ordinal response categories for responsiveness attainment as ‘poor’ and good responsiveness and analyzed the ranking of the domain performance and importance according to frequency scores. We used a series of independent variables related to health services and users’ personal background characteristics in multiple logistic regression analyses to explain responsiveness.
    Results
    Poor responsiveness outcomes ranged from 5.9% to 31.7% for the antenatal phase and from 9.7% to 27.1% for the delivery phase. Overall for both phases, ‘respect for persons’ (Autonomy, Dignity, Communication and Confidentiality) domains performed better and were judged to be more important than ‘client orientation’ domains (Choice and Continuity, Prompt Attention, Quality of Basic Amenities, Social Consideration). On the whole, responsiveness was explained more by health-care and health related issues than personal characteristics.
    Conclusion
    To improve responsiveness outcomes caregivers should focus on domains in the category ‘client orientation’.
    Original languageEnglish
    Article number327
    Pages (from-to)327
    JournalBMC Pregnancy and Childbirth [E]
    Volume17
    Issue number1
    DOIs
    Publication statusPublished - 29 Sept 2017

    Keywords

    • Adult
    • Female
    • Humans
    • Journal Article
    • Logistic Models
    • Netherlands
    • Patient Outcome Assessment
    • Patient Satisfaction
    • Perinatal Care
    • Pregnancy
    • Quality Indicators, Health Care
    • Quality of Health Care
    • Surveys and Questionnaires
    • World Health Organization

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