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      The impact of COVID-19 on the provision of respectful maternity care: Findings from a global survey of health workers

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          Abstract

          Background

          Significant adjustments to maternity care in response to the COVID-19 pandemic and the direct impacts of COVID-19 can compromise the quality of maternal and newborn care.

          Aim

          To explore how the COVID-19 pandemic negatively affected frontline health workers’ ability to provide respectful maternity care globally.

          Methods

          We conducted a global online survey of health workers to assess the provision of maternal and newborn healthcare during the COVID-19 pandemic. We collected qualitative data between July and December 2020 among a subset of respondents and conducted a qualitative content analysis to explore open-ended responses.

          Findings

          Health workers (n = 1127) from 71 countries participated; and 120 participants from 33 countries provided qualitative data. The COVID-19 pandemic negatively affected the provision of respectful maternity care in multiple ways. Six central themes were identified: less family involvement, reduced emotional and physical support for women, compromised standards of care, increased exposure to medically unjustified caesarean section, and staff overwhelmed by rapidly changing guidelines and enhanced infection prevention measures. Further, respectful care provided to women and newborns with suspected or confirmed COVID-19 infection was severely affected due to health workers’ fear of getting infected and measures taken to minimise COVID-19 transmission.

          Discussion

          Multidimensional and contextually-adapted actions are urgently needed to mitigate the impacts of the COVID-19 pandemic on the provision and continued promotion of respectful maternity care globally in the long-term.

          Conclusions

          The measures taken during the COVID-19 pandemic had the capacity to disrupt the provision of respectful maternity care and therefore the quality of maternity care.

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          Most cited references26

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          Using thematic analysis in psychology

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            Standards for reporting qualitative research: a synthesis of recommendations.

            Standards for reporting exist for many types of quantitative research, but currently none exist for the broad spectrum of qualitative research. The purpose of the present study was to formulate and define standards for reporting qualitative research while preserving the requisite flexibility to accommodate various paradigms, approaches, and methods.
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              Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.

              Qualitative content analysis and thematic analysis are two commonly used approaches in data analysis of nursing research, but boundaries between the two have not been clearly specified. In other words, they are being used interchangeably and it seems difficult for the researcher to choose between them. In this respect, this paper describes and discusses the boundaries between qualitative content analysis and thematic analysis and presents implications to improve the consistency between the purpose of related studies and the method of data analyses. This is a discussion paper, comprising an analytical overview and discussion of the definitions, aims, philosophical background, data gathering, and analysis of content analysis and thematic analysis, and addressing their methodological subtleties. It is concluded that in spite of many similarities between the approaches, including cutting across data and searching for patterns and themes, their main difference lies in the opportunity for quantification of data. It means that measuring the frequency of different categories and themes is possible in content analysis with caution as a proxy for significance. © 2013 Wiley Publishing Asia Pty Ltd.
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                Author and article information

                Journal
                Women Birth
                Women Birth
                Women and Birth
                The Author(s). Published by Elsevier Ltd on behalf of Australian College of Midwives.
                1871-5192
                1878-1799
                10 September 2021
                July 2022
                10 September 2021
                : 35
                : 4
                : 378-386
                Affiliations
                [a ]Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
                [b ]Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
                [c ]Department of International Health, Johns Hopkins School of Public Health, MD, USA
                [d ]Gender and Women’s Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Australia
                [e ]Global Financing Facility, The World Bank Group, USA
                [f ]Faculty of Liberal Arts, Universidad Adolfo Ibáñez, Santiago, Chile
                [g ]Birth Place Lab, University of British Columbia, Vancouver, Canada
                Author notes
                [* ]Corresponding author.
                Article
                S1871-5192(21)00154-2
                10.1016/j.wombi.2021.09.003
                9179099
                34531166
                13d2bb81-9c03-4311-bec1-762aa7243164
                © 2021 The Author(s)

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 5 May 2021
                : 6 September 2021
                : 6 September 2021
                Categories
                Article

                maternal health,quality of care,labour,childbirth,newborn health,intrapartum care,antenatal care,postnatal care

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