Perceptions of quality of care in Midwife-led Birth Centres (MLBCs) in Uganda: Why do women choose MLBCs over other options?

Nabirye, RC; Mbalinda, SN; Epuitai, J; Nawagi, F; Namyalo, S; Nove, A; Bazirete, O; Hughes, K; Lopes, SC; Turkmani, S; Forrester, M; Homer, CSE

Perceptions of quality of care in Midwife-led Birth Centres (MLBCs) in Uganda: Why do women choose MLBCs over other options?

Nabirye, RC Mbalinda, SN Epuitai, J Nawagi, F Namyalo, S Nove, A Bazirete, O Hughes, K Lopes, SC Turkmani, S

Forrester, M Homer, CSE

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Publisher:: ELSEVIER
Publication Type:: Journal Article
Citation:: Women Birth, 2024, 37, (4), pp. 101612
Issue Date:: 2024-07

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Field	Value	Language
dc.contributor.author	Nabirye, RC
dc.contributor.author	Mbalinda, SN
dc.contributor.author	Epuitai, J
dc.contributor.author	Nawagi, F
dc.contributor.author	Namyalo, S
dc.contributor.author	Nove, A
dc.contributor.author	Bazirete, O
dc.contributor.author	Hughes, K
dc.contributor.author	Lopes, SC
dc.contributor.author	Turkmani, S https://orcid.org/0000-0001-7819-5061
dc.contributor.author	Forrester, M
dc.contributor.author	Homer, CSE
dc.date.accessioned	2024-08-21T03:39:43Z
dc.date.available	2024-03-22
dc.date.available	2024-08-21T03:39:43Z
dc.date.issued	2024-07
dc.identifier.citation	Women Birth, 2024, 37, (4), pp. 101612
dc.identifier.issn	1871-5192
dc.identifier.issn	1878-1799
dc.identifier.uri	http://hdl.handle.net/10453/180438
dc.description.abstract	BACKGROUND: Midwife-led birth centres (MLBCs) are associated with reduced childbirth interventions, higher satisfaction rates, and improved birth outcomes. The evidence on quality of care in MLBCs from low and middle-income countries (LMIC) is limited. AIM: This study aimed to explore the perceptions of women and midwives regarding the quality of care in four MLBCs in Uganda. METHODS: A qualitative study was conducted in four MLBCs in Uganda. We conducted interviews with women and midwives in the MLBCs to explore their perceptions and experiences related to care in the MLBCs. The study obtained ethical approval. Deductive thematic analysis was used for data analysis. RESULTS: Three key themes were identified regarding the perceptions of women and midwives about the quality of care in the MLBCs: providing respectful, and dignified care; a focus on woman-centred care; and reasons for choosing care in the MLBC. Women valued the respectful and humane care characterised by dignified and non-discriminatory care, non-abandonment, privacy, and consented care. The woman-centred care in the MLBC involved individualised holistic care, providing autonomy and empowerment, continuity of care, promoting positive birth experience, confidence in the woman's own abilities, and responsive providers. Women chose MLBCs because the services were perceived to be available, accessible, affordable, with comprehensive and effective referral mechanisms. CONCLUSION: Women perceived care to be respectful, woman-centred, and of good quality. Global attention should be directed to scaling up the establishment of MLBCs, especially in LMIC, to improve the positive childbirth experience and increase access to care.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER
dc.relation.ispartof	Women Birth
dc.relation.isbasedon	10.1016/j.wombi.2024.101612
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	11 Medical and Health Sciences
dc.subject.classification	Obstetrics & Reproductive Medicine
dc.subject.classification	3215 Reproductive medicine
dc.subject.classification	4204 Midwifery
dc.subject.mesh	Humans
dc.subject.mesh	Female
dc.subject.mesh	Uganda
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Pregnancy
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Adult
dc.subject.mesh	Midwifery
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Patient Satisfaction
dc.subject.mesh	Perception
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Interviews as Topic
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Nurse Midwives
dc.subject.mesh	Humans
dc.subject.mesh	Delivery, Obstetric
dc.subject.mesh	Attitude of Health Personnel
dc.subject.mesh	Perception
dc.subject.mesh	Midwifery
dc.subject.mesh	Pregnancy
dc.subject.mesh	Qualitative Research
dc.subject.mesh	Adult
dc.subject.mesh	Nurse Midwives
dc.subject.mesh	Birthing Centers
dc.subject.mesh	Maternal Health Services
dc.subject.mesh	Patient Satisfaction
dc.subject.mesh	Quality of Health Care
dc.subject.mesh	Uganda
dc.subject.mesh	Female
dc.subject.mesh	Interviews as Topic
dc.title	Perceptions of quality of care in Midwife-led Birth Centres (MLBCs) in Uganda: Why do women choose MLBCs over other options?
dc.type	Journal Article
utslib.citation.volume	37
utslib.location.activity	Netherlands
utslib.for	11 Medical and Health Sciences
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	University of Technology Sydney/Strength - WHO CC
pubs.organisational-group	University of Technology Sydney/Faculty of Health/Midwifery
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-08-21T03:39:41Z
pubs.issue	4
pubs.publication-status	Published
pubs.volume	37
utslib.citation.issue	4

Abstract:

BACKGROUND: Midwife-led birth centres (MLBCs) are associated with reduced childbirth interventions, higher satisfaction rates, and improved birth outcomes. The evidence on quality of care in MLBCs from low and middle-income countries (LMIC) is limited. AIM: This study aimed to explore the perceptions of women and midwives regarding the quality of care in four MLBCs in Uganda. METHODS: A qualitative study was conducted in four MLBCs in Uganda. We conducted interviews with women and midwives in the MLBCs to explore their perceptions and experiences related to care in the MLBCs. The study obtained ethical approval. Deductive thematic analysis was used for data analysis. RESULTS: Three key themes were identified regarding the perceptions of women and midwives about the quality of care in the MLBCs: providing respectful, and dignified care; a focus on woman-centred care; and reasons for choosing care in the MLBC. Women valued the respectful and humane care characterised by dignified and non-discriminatory care, non-abandonment, privacy, and consented care. The woman-centred care in the MLBC involved individualised holistic care, providing autonomy and empowerment, continuity of care, promoting positive birth experience, confidence in the woman's own abilities, and responsive providers. Women chose MLBCs because the services were perceived to be available, accessible, affordable, with comprehensive and effective referral mechanisms. CONCLUSION: Women perceived care to be respectful, woman-centred, and of good quality. Global attention should be directed to scaling up the establishment of MLBCs, especially in LMIC, to improve the positive childbirth experience and increase access to care.

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http://hdl.handle.net/10453/180438