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

Validation of a Midwifery Model in Palestine

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.

Study Overview

• Status: Completed
• Conditions: Maternal Behavior
• Intervention / Treatment: Behavioral: Midwife-led continuity of care

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 200

Contacts and Locations

Study Locations

• Palestinian Territory, occupied
  • West Bank
    • Nablus, West Bank, Palestinian Territory, occupied
      • Palestinian Ministry of Health

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years to 50 years (Child, Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: Female

• Sampling Method: Probability Sample

Study Population

Rural women in the West Bank, occupied Palestine

Description

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

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Midwife-led continuity of care; 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; Midwives from governmental hospitals provide antenatal and postnatal case-load-care in rural villages governmental clinics
Regular care; 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?

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

Collaborators and Investigators

• Sponsor: Oslo University Hospital
• Collaborators: The Research Council of Norway
• Investigators: Principal Investigator: Erik Fosse, MD, Phd, Oslo University Hospital

Publications and helpful links

General Publications

• Mortensen B, Diep LM, Lukasse M, Lieng M, Dwekat I, Elias D, Fosse E. Women's satisfaction with midwife-led continuity of care: an observational study in Palestine. BMJ Open. 2019 Nov 3;9(11):e030324. doi: 10.1136/bmjopen-2019-030324.

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2017
• Primary Completion (Actual): May 31, 2018
• Study Completion (Actual): March 1, 2019

Study Registration Dates

• First Submitted: February 26, 2019
• First Submitted That Met QC Criteria: March 3, 2019
• First Posted (Actual): March 5, 2019

Study Record Updates

• Last Update Posted (Actual): June 11, 2019
• Last Update Submitted That Met QC Criteria: June 8, 2019
• Last Verified: June 1, 2019

More Information

Terms related to this study

• Keywords: Continuity of care; Satisfaction with care; Low-middle income country; Maternal care
• Other Study ID Numbers: Midwif 3

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED
• IPD Plan Description: The anonymous IPD might be provided upon request

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No