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. 2017 Sep 29;17(1):327.
doi: 10.1186/s12884-017-1464-8.

Quality of perinatal care services from the user's perspective: a Dutch study applies the World Health Organization's responsiveness concept

Jacoba van der Kooy  1 , Erwin Birnie  2   3 , Nicole B Valentine  4   5 , Johanna P de Graaf  2 , Semiha Denktas  2 , Eric A P Steegers  2 , Gouke J Bonsel  2   3   6   5
Affiliations

Quality of perinatal care services from the user's perspective: a Dutch study applies the World Health Organization's responsiveness concept

Jacoba van der Kooy et al. BMC Pregnancy Childbirth. .

Abstract

Background: The concept of responsiveness was introduced by the World Health Organization (WHO) to address non-clinical aspects of service quality in an internationally comparable way. Responsiveness is defined as aspects of the way individuals are treated and the environment in which they are treated during health system interactions. The aim of this study is to assess responsiveness outcomes, their importance and factors influencing responsiveness outcomes during the antenatal and delivery phases of perinatal care.

Method: The Responsiveness in Perinatal and Obstetric Health Care Questionnaire was developed in 2009/10 based on the eight-domain WHO concept and the World Health Survey questionnaire. After ethical approval, a total of 171 women, who were 2 weeks postpartum, were recruited from three primary care midwifery practices in Rotterdam, the Netherlands, using face-to-face interviews. We dichotomized the original five ordinal response categories for responsiveness attainment as 'poor' and good responsiveness and analyzed the ranking of the domain performance and importance according to frequency scores. We used a series of independent variables related to health services and users' personal background characteristics in multiple logistic regression analyses to explain responsiveness.

Results: Poor responsiveness outcomes ranged from 5.9% to 31.7% for the antenatal phase and from 9.7% to 27.1% for the delivery phase. Overall for both phases, 'respect for persons' (Autonomy, Dignity, Communication and Confidentiality) domains performed better and were judged to be more important than 'client orientation' domains (Choice and Continuity, Prompt Attention, Quality of Basic Amenities, Social Consideration). On the whole, responsiveness was explained more by health-care and health related issues than personal characteristics.

Conclusion: To improve responsiveness outcomes caregivers should focus on domains in the category 'client orientation'.

Keywords: Birth care; Perinatal care; Quality of care; Responsiveness.

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Conflict of interest statement

Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Study approval was granted by the Medical Ethical Committee, Erasmus Medical Centre, Rotterdam, the Netherlands, no MEC2012207.

Consent for publication

Not applicable.

Competing interests

Author Jacoba van der Kooy declares that she has no conflict of interest. Author Erwin Birnie declares that he has no conflict of interest. Author Nicole B. Valentine declares that she has no conflict of interest. Author Johanna P. de Graaf declares that she has no conflict of interest. Author Semiha Denktas declares that she has no conflict of interest. Author Eric A.P Steegers declares that he has no conflict of interest. Author Gouke.J. Bonsel declares that he has no conflict of interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
A comparison of the pattern of responsiveness quality for antenatal and birth phases: (a) by parity, (b) by etnicity, (c) by privilege of neighboorhood, (d) by perinatal health care pathway, and (e) by admission of the child
Fig. 2
Fig. 2
Comparison of the importance assigned to the responsiveness domains and the performance of domains: antenatal and birth phases
See this image and copyright information in PMC

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