PUB - Publikationen an der Universität Bielefeld

Background: Health workers' (HWs') perspectives on the quality of maternal and newborn care (QMNC) are not routinely collected. In this cross-sectional study, we aimed to document HWs' perspectives on QMNC around childbirth in 12 World Health Organization (WHO) European countries.; Methods: HWs involved in maternal/neonatal care for at least one year between March 2020 and March 2023 answered an online validated WHO standards-based questionnaire collecting 40 quality measures for improving QMNC. A QMNC index (score 0-400) was calculated as a synthetic measure.; Results: Data from 4143 respondents were analysed. For 39 out of 40 quality measures, at least 20% of HWs reported a 'need for improvement', with large variations across countries. Effective training on healthy women/newborns management (n=2748, 66.3%), availability of informed consent job aids (n=2770, 66.9%), and effective training on women/newborns rights (n=2714, 65.5%) presented the highest proportion of HWs stating 'need for improvement'. Overall, 64.8% (n=2684) of respondents declared that HWs' numbers were insufficient for appropriate care (66.3% in Portugal and 86.6% in Poland), and 22.4% described staff censorship (16.3% in Germany and 56.7% in Poland). The reported QMNC index was low in all countries (Poland median (MD)=210.60, interquartile range (IQR)=155.71, 273.57; Norway MD=277.86; IQR=244.32, 308.30). The 'experience of care' domain presented in eight countries had significantly lower scores than the other domains (P<0.001). Over time, there was a significant monthly linear decrease in the QMNC index (P<0.001), lacking correlation with the coronavirus disease 2019 (COVID-19) pandemic trends (P>0.05). Multivariate analyses confirmed large QMNC variation by country. HWs with <10 years of experience, HWs from public facilities, and midwives rated QMNC with significantly lower scores (P<0.001).; Conclusions: HWs from 12 European countries reported significant gaps in QMNC, lacking association with COVID-19 pandemic trends. Routine monitoring of QMNC and tailored actions are needed to improve health services for the benefit of both users and providers.; Registration: ClinicalTrials.gov NCT04847336. Copyright © 2024 by the Journal of Global Health. All rights reserved.