Using a quality care framework to evaluate user and provider experiences of maternity care: A comparative study

Area of Science:

• Maternal and Newborn Health
• Healthcare Quality Improvement
• Health Services Research

Background:

• The Quality Maternal and Newborn Care Framework emphasizes continuity and relational aspects of care.
• Continuity of care is a key policy focus in UK maternity services, yet the effectiveness of different models remains unclear.
• Evaluating maternity care requires robust frameworks to assess perceptions and experiences.

Purpose of the Study:

• To test an adapted Quality Maternal and Newborn Care Framework using focus groups with service providers.
• To compare service provider perspectives with those of service users (pregnant women and new mothers).
• To inform the development of a maternity care evaluation toolkit.

Main Methods:

• Qualitative comparative inquiry using six focus groups with 26 midwives and 12 obstetricians.
• Six-phase thematic analysis to identify and compare sub-themes.
• Mapping of themes to the Quality Maternal and Newborn Care Framework and comparison with user data.

Main Results:

• Service providers reported significant shared concerns regarding limited resources and time.
• Challenges in achieving tailored care were identified by senior midwives and obstetricians.
• Agreement between user and provider perspectives was highest when discussing negative aspects like inaccessible or inadequate care.

Conclusions:

• The Quality Maternal and Newborn Care Framework effectively identifies strengths and gaps in maternity care provision.
• The Framework can inform the development of a comprehensive evaluation toolkit.
• Further international research is underway to validate and refine the toolkit.