Authorization of midwives to perform basic emergency obstetric and newborn care signal functions in Argentina, Ghana, and India: A multi-country validation study of a key global maternal and newborn health indicator

被引：4

作者：

Ramesh, Sowmya ^{[1
]}

Chakraborty, Suchandrima ^{[1
]}

Adanu, Richard M. ^{[2
]}

Bandoh, Delia A. B. ^{[3
]}

Berrueta, Mabel ^{[4
]}

Gausman, Jewel ^{[5
]}

Khan, Nizamuddin ^{[1
]}

Kenu, Ernest ^{[3
]}

Langer, Ana ^{[5
]}

Nigri, Carolina ^{[4
]}

Odikro, Magdalene A. ^{[3
]}

Pingray, Veronica ^{[4
]}

Saggurti, Niranjan ^{[1
]}

Vazquez, Paula ^{[4
,6
]}

Williams, Caitlin R. ^{[4
,7
]}

Jolivet, R. Rima ^{[5
]}

机构：

[1] Populat Council, New Delhi, India

[2] Univ Ghana, Dept Populat Family & Reprod Hlth, Sch Publ Hlth, Accra, Ghana

[3] Univ Ghana, Dept Epidemiol & Dis Control, Sch Publ Hlth, Accra, Greater Accra, Ghana

[4] Inst Clin Effectiveness & Hlth Policy, Buenos Aires, Argentina

[5] Harvard Univ, TH Chan Sch Publ Hlth, Dept Global Hlth & Populat, Women & Hlth Initiat, Boston, MA 02115 USA

[6] Univ Nacl La Matanza, Dept Hlth Sci Kinesiol & Rehabil, Buenos Aires, Argentina

[7] Univ N Carolina, Gillings Sch Global Publ Hlth, Dept Maternal & Child Hlth, Chapel Hill, NC USA

来源：

PLOS ONE | 2023年 / 18卷 / 04期

关键词：

MIDWIFERY; FRAMEWORK; DELIVERY; QUALITY; POLICY;

D O I：

10.1371/journal.pone.0283029

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

BackgroundMidwives' authorization to deliver the seven basic emergency obstetric and newborn care (BEmONC) functions is a core policy indicator in global monitoring frameworks, yet little evidence supports whether such data are captured accurately, or whether authorization demonstrates convergence with midwives' skills and actual provision of services. In this study, we aimed to validate the data reported in global monitoring frameworks (criterion validity) and to determine whether a measure of authorization is a valid indicator for BEmONC availability (construct validity). MethodsWe conducted a validation study in Argentina, Ghana, and India. To assess accuracy of the reported data on midwives' authorization to provide BEmONC services, we reviewed national regulatory documents and compared with reported country-specific data in Countdown to 2030 and the World Health Organization Maternal, Newborn, Child and Adolescent Health Policy Survey. To assess whether authorization demonstrates convergent validity with midwives' skills, training, and performance of BEmONC signal functions, we surveyed 1257 midwives/midwifery professionals and assessed variance. ResultsWe detected discrepancies between data reported in the global monitoring frameworks and the national regulatory framework in all three countries. We found wide variations between midwives' authorization to perform signal functions and their self-reported skills and actual performance within the past 90 days. The percentage of midwives who reported performing all signal functions for which they were authorized per country-specific regulations was 17% in Argentina, 23% in Ghana, and 31% in India. Additionally, midwives in all three countries reported performing some signal functions that the national regulations did not authorize. ConclusionOur findings suggest limitations in criterion and construct validity for this indicator in Argentina, Ghana, and India. Some signal functions such as assisted vaginal delivery may be obsolete based on current practice patterns. Findings suggest the need to re-examine the emergency interventions that should be included as BEmONC signal functions.

引用

页数：22