Midwife-led Continuity and Satisfaction With Care - an Observational Case-Control Study in Palestine

Study Overview
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Brief Summary
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This study investigate if a midwife-led continuity model of care in Palestine, had impact on rural women's satisfaction with care through the continuum of antenatal, intrapartum and postnatal period.

Detailed Description
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Between 2013 and 2016 a midwife-led continuity model of care was implemented in parts of the Palestinian governmental health system, to improve maternal services to women in rural areas on the occupied West Bank. This study investigated if and how the model influenced women's satisfaction with care, through the continuum of the antenatal-, intrapartum- and postnatal period. Using an observational case-control design to compare the midwife-led continuity model of care with regular maternity care. Women with singleton pregnancies, who had registered for antenatal care at a rural governmental clinic, were during the first six months after birth invited to answer a questionnaire containing 60 questions with a 7-points Likert scale, rating different aspects of satisfaction with care.

Official Title
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Validation of a Midwifery Model in Palestine

Conditions
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Maternal Behavior

Intervention / Treatment
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* Behavioral: Midwife-led continuity of care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Residing in rural village Registered for pregnancy care at the villages governmental clinic With singleton pregnancy Gave birth the last one to six month Exclusion Criteria: Residing in urban areas With multiple pregnancy Not registered for antenatal care at the local governmental clinic

Ages Eligible for Study
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Minimum Age: 16 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Midwife-led continuity of care<br>Women receiving midwife-led model of care though the continuum of pregnancy, birth and postnatal period, and who registered at the governmental clinic in a rural village. | Behavioral: Midwife-led continuity of care<br>* Midwives from governmental hospitals provide antenatal and postnatal case-load-care in rural villages governmental clinics<br>|
| Regular care<br>Women receiving regular maternal care through the continuum of pregnancy, birth and postnatal period, and who registered at the governmental clinic in a rural village. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean sum-score satisfaction with care during the continuum of pregnancy,intrapartum and postnatal period | Summarising mean score in all questions measuring satisfaction and dividing on number of questions included | One to six months after birth | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean sum-score satisfaction with care during pregnancy | Summarising the mean score of the questions measuring satisfaction with care during pregnancy and dividing on number of questions included | One to six months after birth | 
| Mean sum-score satisfaction with care during Labour and birth | Summarising mean score of questions measuring satisfaction with care during Labour and birth, dividing on number of questions included | One to six months after birth | 
| Mean sum-score satisfaction with care during postnatal period | Summarising mean scores of questions measuring satisfaction with care during postnatal period, and dividing on number of questions included | One to six month after birth | 
| Duration of exclusive breastfeeding | The proportion of women who were still exclusive breastfeeding at the timepoint of interview, adjusted with number of weeks since birth | One to six month after birth | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Satisfaction with care, Low-middle income country, Continuity of care, Maternal care