Improving MAternal Newborn carE In the in the WHO European Region During COVID-19 Pandemic

Study Overview
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Brief Summary
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BACKGROUND COVID-19 response is heavily impacting the availability of essential health services, especially services for pregnant women and newborns that cannot be delayed or rapidly reorganized in other settings. In the current pandemic, due to multiple factors access to high quality and timely maternal and newborn (MN) health care is threatened. Major concerns have also been raised with respect to maternal rights and on disruption of essential practices and increased medicalization of care, despite existing WHO guidance. Based on preliminary reports heterogeneities in practices is expected within the WHO European Region, with major inequities (eg women experiencing disruption of essential MC health services only in selected countries or areas within the countries, while having access to adequate care in others). With IMAgiNE EURO we aim at conducting a survey to explore the health service preparedness, quality and resilience, with a specific focus on health services around the time of childbirth, in the WHO European Region during COVID-19 pandemic, and to make available data, which, in collaboration with WHO and other partners, can contribute in improving the quality of MN health care. HYPHOTESIS AND SIGNIFICANCE This project has been developed in coordination with WHO Regional Office for Europe (EURO) and other partners, and ultimately aims at making available and disseminate data that can help improving the quality of MN health services in the Region. Collecting data on the quality of essential MN health services across different countries within the WHO European Region will help addressing specific gaps and planning coordinate response to improve quality of MN care and improve MN health outcomes. The project will also offer the opportunity to develop tools and methods to monitor the quality of MN health care across different countries and settings. The project will establish and consolidate a research network Primary objective: 1. Record, analyse, and describe data on MN health service preparedness, quality and resilience - with a specific focus around the time of childbirth as measured both from health workers and women perspectives- across different countries within the WHO European Region, during COVID-19 pandemic. Secondary objectives: 2.Develop tools and methods to measure, through rapid online surveys, the quality of MN health care across different countries and settings 3.Establish and consolidate a research network

Official Title
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IMAGINE EURO (Improving MAternal Newborn carE In the EURO Region): Maternal and Newborn Health Service Preparedness, Quality and Resilience, Among Countries of the WHO European Region, During the COVID-19 Pandemic

Conditions
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Quality of Care During Childbirth

Intervention / Treatment
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* Other: No intervention is planned


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Women of any age who gave births in hospitals, from 1 march 2020 Health workers directly involved in assistance at childbirth (pregnancy, childbirth and peripartum) at hospital level, from 1 march 2020 Exclusion Criteria: For women: refusal to participate; home births For health workers: personnel not directly involved in the routine care t childbirth (es physiotherapist, philologist), refusal to participate; absence from work for more than 2 months out of the 4 months immediately before the survey; less than 1 year of experience

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Women<br>Women of any age who gave births in hospitals from WHO European Region, from 1 march 2020 | Other: No intervention is planned<br>* No intervention is planned<br>|
| Health workers<br>Health workers directly involved in assistance at childbirth (pregnancy, childbirth and peripartum) at hospital level in WHO European Region, from 1 march 2020 | Other: No intervention is planned<br>* No intervention is planned<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of Maternal and Newborn Care Index - mean | variable from 0 to 100 points | March 2020 to March 2021 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of Maternal and Newborn Care Index - total value | variable from 0 to 400 points | March 2020 to March 2021 | 
| Index of Quality of Maternal and Newborn Care - value by domains | Index for availability of human and physical resources (variable from 0 to 100 points) Index for provision of care (variable from 0 to 100 points) Index for experience of care (variable from 0 to 100 points) Index for COVID-19 related care (variable from 0 to 100 points) | March 2020 to March 2021 | 
| Frequency of specific indicators/quality measure | Caesarean section rate Episiotomy rate Availability of specific resources | March 2020 to March 2021 |