Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries: A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic - INED - Institut National Etudes Démographiques
Article Dans Une Revue Acta Obstetricia et Gynecologica Scandinavica Année : 2024

Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries: A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic

Mehreen Zaigham
  • Fonction : Auteur
Karolina Linden
  • Fonction : Auteur
Helen Elden
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Stefano Delle Vedove
  • Fonction : Auteur
Ilaria Mariani
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Sigrun Kongslien
  • Fonction : Auteur
Daniela Drandić
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Elizabete Pumpure
  • Fonction : Auteur
Zalka Drglin
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Raquel Costa
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Antigoni Sarantaki
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Claire de Labrusse
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Marina Ruxandra Otelea
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Alina Liepinaitienė
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Barbara Baranowska
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Virginie Rozée
Emanuelle Pessa Valente
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Eline Skirnisdottir Vik
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Magdalena Kurbanović
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Dārta Jakovicka
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Anja Bohinec
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Heloísa Dias
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Dimitra Metallinou
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Antonia N. Mueller
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Stephanie Batram-Zantvoort
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Claudia Mariana Handra
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Marija Mizgaitienė
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Urszula Tataj-Puzyna
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Arianna Bomben
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Ingvild Hersoug Nedberg
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Elīna Voitehoviča
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Tiago Miguel Pinto
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Aikaterini Lykeridou
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Susanne Grylka-Baeschlin
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Simona Jazdauskienė
  • Fonction : Auteur
Beata Szlendak
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Emma Sacks
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Marzia Lazzerini
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Imagine Euro Study Group
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Résumé

INTRODUCTION: Maternal-neonatal healthcare services were severely disrupted during the COVID-19 pandemic in even high-income countries within the World Health Organization (WHO) European Region. The objective of this study was to compare trends in the quality of maternal and neonatal care (QMNC) in Sweden and Norway to 12 other countries from the WHO European Region during the COVID-19 pandemic, and to identify domains for improvement. MATERIAL AND METHODS: This cross-sectional study included women giving birth in Europe from March 1, 2020 to December 31, 2022. Women answered an online, anonymous questionnaire which included 40 WHO Standard-based Quality Measures collectively scored as the total QMNC index (0-400) and separately in four subdomains (0-100): provision of care, experience of care, availability of human and physical resources, and reorganizational changes due to COVID-19. To assess reported QMNC changes over time, we used adjusted quantile regression models. RESULTS: Of the 45151 women included in the study, 13 117 (29.1%) were from Sweden and Norway and 32034 (70.9%) from the 12 WHO European countries. The total QMNC index for Sweden and Norway (median: 325, IQR: 285-355) was higher than the 12 WHO European countries (median: 315, IQR: 265-350, p < 0.001) as were trends in QMNC index over time (Sweden and Norway median: 310-345; 12 WHO European countries median: 305-340). Sweden and Norway also had higher scores in three-of-four QMNC subdomains, with the 12 WHO European countries scoring higher only for reorganizational changes due to COVID-19. In adjusted quantile models of the total QMNC index, Sweden and Norway had higher scores, with largest differences in the lower quantiles (p < 0.001 in all percentiles). CONCLUSIONS: Across Europe, there are significant gaps in the quality of maternal-neonatal healthcare services. Although women giving birth in Sweden and Norway reported higher QMNC scores in all subdomains except for "reorganizational changes due to COVID-19," there is room for improvement and shared learning across Europe. Policymakers should prioritize long-term investments in maternal and neonatal healthcare, ensuring that facilities are adequately equipped during public health crises and that all women have access to high-quality, evidence-based, equitable, and respectful care.
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hal-04884533 , version 1 (13-01-2025)

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Mehreen Zaigham, Karolina Linden, Helen Elden, Stefano Delle Vedove, Ilaria Mariani, et al.. Trends in the quality of maternal and neonatal care in Sweden and Norway as compared to 12 WHO European countries: A cross-sectional survey investigating maternal perspectives during the COVID-19 pandemic. Acta Obstetricia et Gynecologica Scandinavica, 2024, 103 (12), pp.2325-2575. ⟨10.1111/aogs.14994⟩. ⟨hal-04884533⟩
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