Adapting the Quality Maternal and Newborn Care (QMNC) Framework to evaluate models of antenatal care: A pilot study

Andrew Symon (Lead / Corresponding author), Alison McFadden, Marianne White, Katrina Fraser, Allison Cummins

Research output: Contribution to journalArticle

3 Citations (Scopus)
63 Downloads (Pure)

Abstract

Background: Recent evidence indicates that continuity models of maternity care result in improved clinical and psychosocial outcomes, but their causal mechanisms are poorly understood. The recent Lancet Series on Midwifery’s Quality Maternal and Newborn Care Framework describes five components of quality care and their associated characteristics. As an initial step in developing this Framework into an evaluation toolkit, we transformed its components and characteristics into a topic guide to assess stakeholder perceptions and experiences of care provided and received. The main purpose of this study was to assess the feasibility of this process.

Methods: We conducted twelve focus groups in two Scottish health board areas with 13 pregnant women, 18 new mothers, 26 midwives and 12 obstetricians who had experience of a range of different models of maternity care. Transcripts were analysed using a six-phase approach of thematic analysis. We mapped the identified themes and sub-themes back to the Framework.

Results: The emerging themes and sub-themes demonstrated the feasibility of using the QMNC framework as a data collection tool, and as a lens for analysing the data. Of the four emerging themes, only Organisation Culture / Work Structure’ mapped directly to a single Framework component. The others - ‘Relationships’; ‘Information and support’; and ‘Uncertainty’ – mapped to between two and five components, illustrating the interconnectedness of the Framework’s components. Some negative sub-themes mirrored positive Framework characteristics of care. Some re-phrasing and re-ordering of the topic guides in later focus groups ensured we could cover all aspects of the Framework adequately.

Conclusion: Adapting the Quality Maternal and Newborn Care Framework enabled us to focus on aspects of care which worked well and which didn’t work well for these key stakeholders. Identifying ‘what works for whom and why’ in different models of care is a necessary step in reinforcing and replicating the most effective models of care.
Original languageEnglish
Article numbere0200640
Pages (from-to)1-14
Number of pages14
JournalPLoS ONE
Volume13
Issue number8
DOIs
Publication statusPublished - 14 Aug 2018

Fingerprint

prenatal care
Prenatal Care
neonates
Mothers
Newborn Infant
focus groups
Focus Groups
stakeholders
midwives
Quality of Health Care
Midwifery
pregnant women
Lens
Lenses
Uncertainty
Pregnant Women
uncertainty
Health
Organizations

Keywords

  • models of care
  • antenatal care
  • quality care
  • pregnancy
  • continuity of care

Cite this

@article{a008dec3023d49e99260970fcc211a1e,
title = "Adapting the Quality Maternal and Newborn Care (QMNC) Framework to evaluate models of antenatal care: A pilot study",
abstract = "Background: Recent evidence indicates that continuity models of maternity care result in improved clinical and psychosocial outcomes, but their causal mechanisms are poorly understood. The recent Lancet Series on Midwifery’s Quality Maternal and Newborn Care Framework describes five components of quality care and their associated characteristics. As an initial step in developing this Framework into an evaluation toolkit, we transformed its components and characteristics into a topic guide to assess stakeholder perceptions and experiences of care provided and received. The main purpose of this study was to assess the feasibility of this process.Methods: We conducted twelve focus groups in two Scottish health board areas with 13 pregnant women, 18 new mothers, 26 midwives and 12 obstetricians who had experience of a range of different models of maternity care. Transcripts were analysed using a six-phase approach of thematic analysis. We mapped the identified themes and sub-themes back to the Framework.Results: The emerging themes and sub-themes demonstrated the feasibility of using the QMNC framework as a data collection tool, and as a lens for analysing the data. Of the four emerging themes, only Organisation Culture / Work Structure’ mapped directly to a single Framework component. The others - ‘Relationships’; ‘Information and support’; and ‘Uncertainty’ – mapped to between two and five components, illustrating the interconnectedness of the Framework’s components. Some negative sub-themes mirrored positive Framework characteristics of care. Some re-phrasing and re-ordering of the topic guides in later focus groups ensured we could cover all aspects of the Framework adequately.Conclusion: Adapting the Quality Maternal and Newborn Care Framework enabled us to focus on aspects of care which worked well and which didn’t work well for these key stakeholders. Identifying ‘what works for whom and why’ in different models of care is a necessary step in reinforcing and replicating the most effective models of care.",
keywords = "models of care, antenatal care, quality care, pregnancy, continuity of care",
author = "Andrew Symon and Alison McFadden and Marianne White and Katrina Fraser and Allison Cummins",
year = "2018",
month = "8",
day = "14",
doi = "10.1371/journal.pone.0200640",
language = "English",
volume = "13",
pages = "1--14",
journal = "PLoS ONE",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

Adapting the Quality Maternal and Newborn Care (QMNC) Framework to evaluate models of antenatal care : A pilot study. / Symon, Andrew (Lead / Corresponding author); McFadden, Alison; White, Marianne; Fraser, Katrina; Cummins, Allison.

In: PLoS ONE, Vol. 13, No. 8, e0200640, 14.08.2018, p. 1-14.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Adapting the Quality Maternal and Newborn Care (QMNC) Framework to evaluate models of antenatal care

T2 - A pilot study

AU - Symon, Andrew

AU - McFadden, Alison

AU - White, Marianne

AU - Fraser, Katrina

AU - Cummins, Allison

PY - 2018/8/14

Y1 - 2018/8/14

N2 - Background: Recent evidence indicates that continuity models of maternity care result in improved clinical and psychosocial outcomes, but their causal mechanisms are poorly understood. The recent Lancet Series on Midwifery’s Quality Maternal and Newborn Care Framework describes five components of quality care and their associated characteristics. As an initial step in developing this Framework into an evaluation toolkit, we transformed its components and characteristics into a topic guide to assess stakeholder perceptions and experiences of care provided and received. The main purpose of this study was to assess the feasibility of this process.Methods: We conducted twelve focus groups in two Scottish health board areas with 13 pregnant women, 18 new mothers, 26 midwives and 12 obstetricians who had experience of a range of different models of maternity care. Transcripts were analysed using a six-phase approach of thematic analysis. We mapped the identified themes and sub-themes back to the Framework.Results: The emerging themes and sub-themes demonstrated the feasibility of using the QMNC framework as a data collection tool, and as a lens for analysing the data. Of the four emerging themes, only Organisation Culture / Work Structure’ mapped directly to a single Framework component. The others - ‘Relationships’; ‘Information and support’; and ‘Uncertainty’ – mapped to between two and five components, illustrating the interconnectedness of the Framework’s components. Some negative sub-themes mirrored positive Framework characteristics of care. Some re-phrasing and re-ordering of the topic guides in later focus groups ensured we could cover all aspects of the Framework adequately.Conclusion: Adapting the Quality Maternal and Newborn Care Framework enabled us to focus on aspects of care which worked well and which didn’t work well for these key stakeholders. Identifying ‘what works for whom and why’ in different models of care is a necessary step in reinforcing and replicating the most effective models of care.

AB - Background: Recent evidence indicates that continuity models of maternity care result in improved clinical and psychosocial outcomes, but their causal mechanisms are poorly understood. The recent Lancet Series on Midwifery’s Quality Maternal and Newborn Care Framework describes five components of quality care and their associated characteristics. As an initial step in developing this Framework into an evaluation toolkit, we transformed its components and characteristics into a topic guide to assess stakeholder perceptions and experiences of care provided and received. The main purpose of this study was to assess the feasibility of this process.Methods: We conducted twelve focus groups in two Scottish health board areas with 13 pregnant women, 18 new mothers, 26 midwives and 12 obstetricians who had experience of a range of different models of maternity care. Transcripts were analysed using a six-phase approach of thematic analysis. We mapped the identified themes and sub-themes back to the Framework.Results: The emerging themes and sub-themes demonstrated the feasibility of using the QMNC framework as a data collection tool, and as a lens for analysing the data. Of the four emerging themes, only Organisation Culture / Work Structure’ mapped directly to a single Framework component. The others - ‘Relationships’; ‘Information and support’; and ‘Uncertainty’ – mapped to between two and five components, illustrating the interconnectedness of the Framework’s components. Some negative sub-themes mirrored positive Framework characteristics of care. Some re-phrasing and re-ordering of the topic guides in later focus groups ensured we could cover all aspects of the Framework adequately.Conclusion: Adapting the Quality Maternal and Newborn Care Framework enabled us to focus on aspects of care which worked well and which didn’t work well for these key stakeholders. Identifying ‘what works for whom and why’ in different models of care is a necessary step in reinforcing and replicating the most effective models of care.

KW - models of care

KW - antenatal care

KW - quality care

KW - pregnancy

KW - continuity of care

U2 - 10.1371/journal.pone.0200640

DO - 10.1371/journal.pone.0200640

M3 - Article

C2 - 30106961

VL - 13

SP - 1

EP - 14

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 8

M1 - e0200640

ER -