[Quality assurance by improved cooperation?--Results of a study of prenatal care in Berlin]

Cooperation between the various participants of Public Health services is now recognised as a significant factor to ensure quality in health services. The German system of prenatal care is, because of its heterogenic structure, particularly dependent on a functioning co-ordination between the individual providers of services to pregnant women. However, cooperation between gynaecologists, midwives, social workers and others working in this field in Germany has proved considerably deficient. Within the framework of a qualitative study on the situation of services available to pregnant women in four selected districts of Berlin, a number of decisive barriers to cooperation could be identified, e.g. deficient mutual information among providers, differing concepts of care, as well as different structural and economic conditions of the various members within the health system. On the other hand, a number of different approaches at different levels were perceived which may allow for a better cooperation between the various participants. The results of the study were discussed at conferences attended by regional experts. As a pragmatic aid for the advancement of cooperation, community guides orientated around the needs of pregnant women were drafted for each of the four districts.