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3 results on '"Zalka Drglin"'

1. Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic: online survey investigating maternal perspectives in 12 countries of the WHO European Region

Author

Marzia Lazzerini, Benedetta Covi, Ilaria Mariani, Zalka Drglin, Maryse Arendt, Ingvild Hersoug Nedberg, Helen Elden, Raquel Costa, Daniela Drandić, Jelena Radetić, Marina Ruxandra Otelea, Céline Miani, Serena Brigidi, Virginie Rozée, Barbara Mihevc Ponikvar, Barbara Tasch, Sigrun Kongslien, Karolina Linden, Catarina Barata, Magdalena Kurbanović, Jovana Ružičić, Stephanie Batram-Zantvoort, Lara Martín Castañeda, Elise de La Rochebrochard, Anja Bohinec, Eline Skirnisdottir Vik, Mehreen Zaigham, Teresa Santos, Lisa Wandschneider, Ana Canales Viver, Amira Ćerimagić, Emma Sacks, and Emanuelle Pessa Valente

Subjects
COVID-19, European Region, maternal, newborn, facility, quality of care, Public aspects of medicine, RA1-1270
Abstract

Summary: Background: Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID-19 pandemic, as defined by WHO Standards, are lacking. Methods: Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures. Findings: 21,027 mothers were included in the analysis. Among those who experienced labour (N=18,063), 41·8% (26·1%- 63·5%) experienced difficulties in accessing antenatal care, 62% (12·6%-99·0%) were not allowed a companion of choice, 31·1% (16·5%-56·9%) received inadequate breastfeeding support, 34·4% (5·2%-64·8%) reported that health workers were not always using protective personal equipment, and 31·8% (17·8%-53·1%) rated the health workers’ number as “insufficient”. Episiotomy was performed in 20·1% (6·1%-66·0%) of spontaneous vaginal births and fundal pressure applied in 41·2% (11·5% -100%) of instrumental vaginal births. In addition, 23·9% women felt they were not treated with dignity (12·8%-59·8%), 12·5% (7·0%-23·4%) suffered abuse, and 2·4% (0·1%-26·2%) made informal payments. Most findings were significantly worse among women with prelabour caesarean birth (N=2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significant lower QMNC Indexes and Luxemburg showing a significantly higher QMNC Index than the total sample. Younger women and those with operative births also reported significantly lower QMNC Indexes. Interpretation: Mothers reports revealed large inequities in QMNC across countries of the WHO European Region. Quality improvement initiatives to reduce these inequities and promote evidence-based, patient-centred respectful care for all mothers and newborns during the COVID-19 pandemic and beyond are urgently needed. Funding: The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. Study registration: ClinicalTrials.gov Identifier: NCT04847336

Published
2022
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2. Women's perspectives on the quality of hospital maternal and newborn care around the time of childbirth during the COVID-19 pandemic: Results from the IMAgiNE EURO study in Slovenia, Croatia, Serbia, and Bosnia-Herzegovina

Author

Daniela, Drandić, Zalka, Drglin, Barbara, Mihevc Ponikvar, Anja, Bohinec, Amira, Ćerimagić, Jelena, Radetić, Jovana, Ružičić, Magdalena, Kurbanović, Benedetta, Covi, Emanuelle Pessa, Valente, Ilaria, Mariani, Marzia, Lazzerini, and Antonia, Mueller

Subjects
Bosnia and Herzegovina, Pregnancy, Croatia, Slovenia, Infant, Newborn, Parturition, Humans, COVID-19, Female, Serbia, Pandemics, Hospitals
Abstract

To assess the quality of maternal and newborn care (QMNC) in countries of the former Yugoslavia.Women giving birth in a facility in Slovenia, Croatia, Serbia, and Bosnia-Herzegovina between March 1, 2020 and July 1, 2021 answered an online questionnaire including 40 WHO standards-based quality measures.A total of 4817 women were included in the analysis. Significant differences were observed across countries. Among those experiencing labor, 47.4%-62.3% of women perceived a reduction in QMNC due to the COVID-19 pandemic, 40.1%-69.7% experienced difficulties in accessing routine antenatal care, 60.3%-98.1% were not allowed a companion of choice, 17.4%-39.2% reported that health workers were not always using personal protective equipment, and 21.2%-53.8% rated the number of health workers as insufficient. Episiotomy was performed in 30.9%-62.8% of spontaneous vaginal births. Additionally, 22.6%-55.9% of women received inadequate breastfeeding support, 21.5%-62.8% reported not being treated with dignity, 11.0%-30.5% suffered abuse, and 0.7%-26.5% made informal payments. Multivariate analyses confirmed significant differences among countries, with Slovenia showing the highest QMNC index, followed by Croatia, Bosnia-Herzegovina, and Serbia.Differences in QMNC among the countries of the former Yugoslavia during the COVID-19 pandemic were significant. Activities to promote high-quality, evidence-based, respectful care for all mothers and newborns are urgently needed.gov Identifier: NCT04847336.

Published
2022

3. Individual and country-level variables associated with the medicalization of birth: Multilevel analyses of IMAgiNE EURO data from 15 countries in the WHO European region

Author

Céline, Miani, Lisa, Wandschneider, Stephanie, Batram-Zantvoort, Benedetta, Covi, Helen, Elden, Ingvild Hersoug, Nedberg, Zalka, Drglin, Elizabete, Pumpure, Raquel, Costa, Virginie, Rozée, Marina Ruxandra, Otelea, Daniela, Drandić, Jelena, Radetic, Alessia, Abderhalden-Zellweger, Amira, Ćerimagić, Maryse, Arendt, Ilaria, Mariani, Karolina, Linden, Barbara Mihevc, Ponikvar, Dārta, Jakovicka, Heloisa, Dias, Jovana, Ruzicic, Claire, de Labrusse, Emanuelle Pessa, Valente, Mehreen, Zaigham, Anja, Bohinec, Dace, Rezeberga, Catarina, Barata, Anouk, Pfund, Emma, Sacks, Marzia, Lazzerini, and Antonia, Mueller

Subjects
EUROPE, COVID-19, Obstetrics and Gynecology, General Medicine, World Health Organization, birth, cesarean, episiotomy, Europe, gender equality, IMAgiNE EURO, medicalization, midwifery, respectful maternity care, Pregnancy, Medicalization, Multilevel Analysis, Humans, Female, GENDER, HEALTH, CHILDBIRTH, Pandemics
Abstract

Objective: To investigate potential associations between individual and country-level factors and medicalization of birth in 15 European countries during the COVID-19 pandemic. Methods: Online anonymous survey of women who gave birth in 2020–2021. Multivariable multilevel logistic regression models estimating associations between indicators of medicalization (cesarean, instrumental vaginal birth [IVB], episiotomy, fundal pressure) and proxy variables related to care culture and contextual factors at the individual and country level. Results: Among 27 173 women, 24.4% (n = 6650) had a cesarean and 8.8% (n = 2380) an IVB. Among women with IVB, 41.9% (n = 998) reported receiving fundal pressure. Among women with spontaneous vaginal births, 22.3% (n = 4048) had an episiotomy. Less respectful care, as perceived by the women, was associated with higher levels of medicalization. For example, women who reported having a cesarean, IVB, or episiotomy reported not feeling treated with dignity more frequently than women who did not have those interventions (odds ratio [OR] 1.37; OR 1.61; OR 1.51, respectively; all: PConclusion: We recommend a greater emphasis in health policies on promotion of respectful and patient-centered care approaches to birth to enhance women's experiences of care, and the development of a European-level indicator to monitor medicalization of reproductive care.

Published
2022

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