Assessing the performance of maternity care in Europe : a critical exploration of tools and indicators

Escuriet, Ramón; White, Joanna; Beeckman, Katrien; Frith, Lucy; Leon-Larios, Fatima; Loytved, Christine; Luyben, Ans; Sinclair, Marlene; van Teijlingen, Edwin

doi:10.21256/zhaw-1611

Please use this identifier to cite or link to this item: https://doi.org/10.21256/zhaw-1611

Publication type:	Article in scientific journal
Type of review:	Peer review (publication)
Title:	Assessing the performance of maternity care in Europe : a critical exploration of tools and indicators
Authors:	Escuriet, Ramón White, Joanna Beeckman, Katrien Frith, Lucy Leon-Larios, Fatima Loytved, Christine Luyben, Ans Sinclair, Marlene van Teijlingen, Edwin
DOI:	10.21256/zhaw-1611 10.1186/s12913-015-1151-2
Published in:	BMC Health Services Research
Volume(Issue):	15
Issue:	491
Issue Date:	2-Nov-2015
Publisher / Ed. Institution:	BioMed Central
Publisher / Ed. Institution:	London
ISSN:	1472-6963
Language:	English
Subjects:	Birth; Physical; Measurement; Tools
Subject (DDC):	618: Gynecology, obstetrics and midwifery
Abstract:	Background: This paper critically reviews published tools and indicators currently used to measure maternity care performance within Europe, focusing particularly on whether and how current approaches enable systematic appraisal of processes of minimal (or non-) intervention in support of physiological or “normal birth”. The work formed part of COST Actions IS0907: “Childbirth Cultures, Concerns, and Consequences: Creating a dynamic EU framework for optimal maternity care” (2011-2014) and IS1405: Building Intrapartum Research Through Health – an interdisciplinary whole system approach to understanding and contextualising physiological labour and birth (BIRTH) (2014-). The Actions included the sharing of country experiences with the aim of promoting salutogenic approaches to maternity care. Methods: A structured literature search was conducted of material published between 2005 and 2013, incorporating research databases, published documents in English in peer-reviewed international journals and indicator databases which measured aspects of health care at a national and pan-national level. Given its emergence from two COST Actions the work, inevitably, focused on Europe, but findings may be relevant to other countries and regions. Results: A total of 388 indicators were identified, as well as seven tools specifically designed for capturing aspects of maternity care. Intrapartum care was the most frequently measured feature, through the application of process and outcome indicators. Postnatal and neonatal care of mother and baby were the least appraised areas. An over-riding focus on the quantification of technical intervention and adverse or undesirable outcomes was identified. Vaginal birth (no instruments) was occasionally cited as an indicator; besides this measurement few of the 388 indicators were found to be assessing non-intervention or “good” or positive outcomes more generally. Conclusions: The tools and indicators identified largely enable measurement of technical interventions and undesirable health (or pathological medical) outcomes. A physiological birth generally necessitates few, or no, interventions, yet most of the indicators presently applied fail to capture (a) this phenomenon, and (b) the relationship between different forms and processes of care, mode of birth and good or positive outcomes. A need was identified for indicators which capture non-intervention, reflecting the reality that most births are low-risk, requiring few, if any, technical medical procedures.
URI:	https://digitalcollection.zhaw.ch/handle/11475/2409
Fulltext version:	Published version
License (according to publishing contract):	CC BY 4.0: Attribution 4.0 International
Departement:	School of Health Sciences
Organisational Unit:	Institute of Midwifery and Reproductive Health (IHG)
Appears in collections:	Publikationen Gesundheit

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Escuriet, R., White, J., Beeckman, K., Frith, L., Leon-Larios, F., Loytved, C., Luyben, A., Sinclair, M., & van Teijlingen, E. (2015). Assessing the performance of maternity care in Europe : a critical exploration of tools and indicators. BMC Health Services Research, 15(491). https://doi.org/10.21256/zhaw-1611

Escuriet, R. et al. (2015) ‘Assessing the performance of maternity care in Europe : a critical exploration of tools and indicators’, BMC Health Services Research, 15(491). Available at: https://doi.org/10.21256/zhaw-1611.

R. Escuriet et al., “Assessing the performance of maternity care in Europe : a critical exploration of tools and indicators,” BMC Health Services Research, vol. 15, no. 491, Nov. 2015, doi: 10.21256/zhaw-1611.

ESCURIET, Ramón, Joanna WHITE, Katrien BEECKMAN, Lucy FRITH, Fatima LEON-LARIOS, Christine LOYTVED, Ans LUYBEN, Marlene SINCLAIR und Edwin VAN TEIJLINGEN, 2015. Assessing the performance of maternity care in Europe : a critical exploration of tools and indicators. BMC Health Services Research. 2 November 2015. Bd. 15, Nr. 491. DOI 10.21256/zhaw-1611

Escuriet, Ramón, Joanna White, Katrien Beeckman, Lucy Frith, Fatima Leon-Larios, Christine Loytved, Ans Luyben, Marlene Sinclair, and Edwin van Teijlingen. 2015. “Assessing the Performance of Maternity Care in Europe : A Critical Exploration of Tools and Indicators.” BMC Health Services Research 15 (491). https://doi.org/10.21256/zhaw-1611.

Escuriet, Ramón, et al. “Assessing the Performance of Maternity Care in Europe : A Critical Exploration of Tools and Indicators.” BMC Health Services Research, vol. 15, no. 491, Nov. 2015, https://doi.org/10.21256/zhaw-1611.