Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/23932
Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Midwifery-led antenatal care models: Mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care
Authors: Symon, Andrew
Pringle, Jan E C
Cheyne, Helen
Downe, Soo
Hundley, Vanora
Lee, Elaine
Lynn, Fiona
McFadden, Alison
McNeill, Jennifer
Renfrew, Mary J
Ross-Davie, Mary
van, Teijlingen Edwin
Whitford, Heather M
Alderdice, Fiona
Contact Email: h.l.cheyne@stir.ac.uk
Keywords: Care model
Characteristics of care
Maternity care
Midwifery-led
Outcomes
Pregnancy
Quality
Randomised controlled trial
Issue Date: 2016
Publisher: BioMed Central
Citation: Symon A, Pringle JEC, Cheyne H, Downe S, Hundley V, Lee E, Lynn F, McFadden A, McNeill J, Renfrew MJ, Ross-Davie M, van Teijlingen E, Whitford HM & Alderdice F (2016) Midwifery-led antenatal care models: Mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care, BMC Pregnancy and Childbirth, 16, p. 168.
Abstract: BACKGROUND: Implementing effective antenatal care models is a key global policy goal. However, the mechanisms of action of these multi-faceted models that would allow widespread implementation are seldom examined and poorly understood. In existing care model analyses there is little distinction between what is done, how it is done, and who does it. A new evidence-informed quality maternal and newborn care (QMNC) framework identifies key characteristics of quality care. This offers the opportunity to identify systematically the characteristics of care delivery that may be generalizable across contexts, thereby enhancing implementation.Our objective was to map the characteristics of antenatal care models tested in Randomised Controlled Trials (RCTs) to a new evidence-based framework for quality maternal and newborn care; thus facilitating the identification of characteristics of effective care. METHODS:   A systematic review of RCTs of midwifery-led antenatal care models. Mapping and evaluation of these models' characteristics to the QMNC framework using data extraction and scoring forms derived from the five framework components. Paired team members independently extracted data and conducted quality assessment using the QMNC framework and standard RCT criteria. RESULTS: From 13,050 citations initially retrieved we identified 17 RCTs of midwifery-led antenatal care models from Australia (7), the UK (4), China (2), and Sweden, Ireland, Mexico and Canada (1 each). QMNC framework scores ranged from 9 to 25 (possible range 0-32), with most models reporting fewer than half the characteristics associated with quality maternity care. Description of care model characteristics was lacking in many studies, but was better reported for the intervention arms. Organisation of care was the best-described component. Underlying values and philosophy of care were poorly reported. CONCLUSIONS: The QMNC framework facilitates assessment of the characteristics of antenatal care models. It is vital to understand all the characteristics of multi-faceted interventions such as care models; not only what is done but why it is done, by whom, and how this differed from the standard care package. By applying the QMNC framework we have established a foundation for future reports of intervention studies so that the characteristics of individual models can be evaluated, and the impact of any differences appraised.
Type: Journal Article
URI: http://hdl.handle.net/1893/23932
DOI Link: http://dx.doi.org/10.1186/s12884-016-0944-6
Rights: Publisher is open-access. Open access publishing allows free access to and distribution of published articles where the author retains copyright of their work by employing a Creative Commons attribution licence. Proper attribution of authorship and correct citation details should be given. http://dx.doi.org/10.1186/s12884-016-0944-6
Affiliation: University of Dundee
University of Dundee
NMAHP Research
University of Central Lancashire
Bournemouth University
University of Dundee
Queen's University Belfast
University of Dundee
Queen's University Belfast
University of Dundee
NHS Education for Scotland
Bournemouth University
University of Dundee
Queen's University Belfast

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