Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/29491
Appears in Collections:Management, Work and Organisation eTheses
Title: Labouring for quality: crossing the chasm in maternal health care in Trinidad and Tobago
Author(s): Blaize-La Caille, Charmaine
Supervisor(s): Walsh, Michael
Marshall, Carol
Keywords: quality, health quality, Total Quality Management (TQM), Continuous Quality improvement (CQI), health quality models and frameworks, organisational behaviour, health reform, new public sector management, maternity care models, antenatal health care, reproductive heath care, health care systems, health policy, Trinidad and Tobago, Caribbean, Developing country, Small Island Developing state, middle income economy
Lean methodology, Lean/Six Sigma, Donabedian, STEEEP acronym, Model for improvement, PDSA, IHI Rapid cycle for change,SERVQUAL, Chronic Care Model,European Foundation of Quality Management (EFQM), Malcolm Baldrige Quality Award (MBQA), ISO 9001:2015
Quality in Maternal Care,universal health access, WHO vision on quality of care for maternal and newborn health
midwifery model, medical model
Issue Date: Nov-2018
Publisher: University of Stirling
Abstract: Trinidad and Tobago is a Caribbean country which is striving towards achieving developed country status in the global economic sphere. However, this is against a backdrop of a medical care system which is in a state of flux, and, in particular, has a high maternal mortality rate. The aim of this study was to investigate the quality deficit in maternal health care utilising an adapted version of a maternity quality model. This acted as a conceptual framework in order to explain the gaps in maternal health care and diagnose its weaknesses. This study adopted a mixed method approach using a combination of semi-structured interviews and a small-scale quantitative survey with key stakeholders within the public health system. Two principal themes emerged: firstly, that the women who accessed maternity services were passive, with them mainly being receivers of the service provided and not using their agency to act within the system and exercise their right to choose. Secondly, health care professionals were passionate and devoted to their professions. However, they tended to be constrained by a health system that has been weakened by competing political, social, generational and cultural agendas, maldistribution, staff shortages, ageing workforce, facilities and equipment deficits. The study concludes by suggesting that quality has been used as the vehicle to drive health sector reforms and has led to multi-sector alliances and partnerships. However, these alliances would be more effective with better cohesion of activities at all levels within the health system. Despite this, quality is perceived by the users as new and young and in a growth stage as it continues to grapple with the friction and fuzziness of logic of medical, managerial and administrative professionalism. Key concepts explored: definitions of quality, health quality, Total Quality Management (TQM), Continuous Quality improvement (CQI), health quality models and frameworks, organisational behaviour, health reform, new public sector management, maternity care models, health and health care systems and health policy.
Type: Thesis or Dissertation
URI: http://hdl.handle.net/1893/29491

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File Description SizeFormat 
FINAL MAY 2019 Charmaine BlaizeLaCaille PhdSubmission (1)cblc.pdfFull thesis3.4 MBAdobe PDFView/Open
list of tables and figuresof PHDcblc.pdfList of tables and figures99.97 kBAdobe PDFView/Open
Table of ContentsofPHDcblc.pdfTable of contents287.81 kBAdobe PDFView/Open
AbstractofThesiscblc.pdfAbstract62.92 kBAdobe PDFView/Open
1stpageofPHDcblc.pdfFirst page of thesis19.22 kBAdobe PDFView/Open



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