Journal Article

Inclusive, supportive and dignified maternity care (SDMC)—Development and feasibility assessment of an intervention package for public health systems: A study protocol

Hameed, Waqas, Siddiqi, Sameen, Asim, Muhammad, Khan, Bushra, Saleem, Sarah, Avan, Bilal Iqbal

2022

Overview

Mistreatment, discrimination, and poor psycho-social support during childbirth at health facilities are common in lower- and middle-income countries. Despite a policy directive from the World Health Organisation (WHO), no operational model exists that effectively demonstrates incorporation of these guidelines in routine facility-based maternity services. This early-phase implementation research aims to develop, implement, and test the feasibility of a service-delivery strategy to promote the culture of supportive and dignified maternity care (SDMC) at public health facilities. Guided by human-centred design approach, the implementation of this study will be divided into two phases: development of intervention, and implementing and testing feasibility. The service-delivery intervention will be co-created along with relevant stakeholders and informed by contextual evidence that is generated through formative research. It will include capacity-building of maternity teams, and the improvement of governance and accountability mechanisms within public health facilities. The technical content will be primarily based on WHO's intrapartum care guidelines and mental health Gap Action Programme (mhGAP) materials. A mixed-method, pre-post design will be used for feasibility assessment. The intervention will be implemented at six secondary-level healthcare facilities in two districts of southern Sindh, Pakistan. Data from multiple sources will be collected before, during and after the implementation of the intervention. We will assess the coverage of the intervention, challenges faced, and changes in maternity teams' understanding and attitude towards SDMC. Additionally, women's maternity experiences and psycho-social well-being-will inform the success of the intervention. Evidence from this implementation research will enhance understanding of health systems challenges and opportunities around SDMC. A key output from this research will be the SDMC service-delivery package, comprising a comprehensive training package (on inclusive, supportive and dignified maternity care) and a field tested strategy to ensure implementation of recommended practices in routine, facility-based maternity care. Adaptation, Implementation and evaluation of SDMC package in diverse setting will be way forward. The study has been registered with clinicaltrials.gov (Registration number: NCT05146518).

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Accountability / Attitude of Health Personnel / Behavior / Biology and Life Sciences / Capacity development / Childbirth & labor / Collaboration / Delivery, Obstetric - psychology / Delivery, Obstetric - standards / Evaluation / Feasibility Studies / Female / Government Programs - organization & administration / Government Programs - standards / Guidelines / Gynecology / Health care / Health care facilities / Health facilities / Health sciences / Humans / Implementation Science / Infant, Newborn / Intervention / Maternal child nursing / Maternal health services / Maternal Health Services - organization & administration / Maternal Health Services - standards / Maternal Mortality / Medical care / Medicine and Health Sciences / Mental disorders / Mental health / Obstetrics - methods / Obstetrics - organization & administration / Obstetrics - standards / Pakistan - epidemiology / Parturition - psychology / Perinatal Mortality / Pregnancy / Prenatal Care - organization & administration / Prenatal Care - psychology / Prenatal Care - standards / Psychosocial Support Systems / Public health / Public Health - methods / Public Health - standards / Public health administration / Quality management / Quality of Health Care / Respect / Science Policy / Social Inclusion / Social interactions / Social Sciences / Study Protocol / Teams / Well being / Womens health