Abstract
ObjectiveDespite the recognized importance of person-centered care, very little information exists on how person-centered maternity care (PCMC) impacts newborn health.MethodsBaseline and follow-up data were collected from women who delivered in government health facilities in Nairobi and Kiambu counties in Kenya between August 2016 and February 2017. The final analytic sample included 413 respondents who completed the baseline survey and at least one follow-up survey at 2, 6, 8, and/or 10 weeks. Data were analyzed using descriptive, bivariate, and multivariate statistics. Logistic regression was used to assess the relationship between PCMC scores and outcomes of interest.ResultsIn multivariate analyses, women with high PCMC scores were significantly less likely to report newborn complications than women with low PCMC scores (adjusted odds ratio [aOR] 0.39, 95% confidence interval [CI] 0.16–0.98). Women reporting high PCMC scores also had significantly higher odds of reporting a willingness to return to the facility for their next delivery than women with low PCMC score (aOR 12.72, 95% CI 2.26–71.63). The domains of Respect/Dignity and Supportive Care were associated with fewer newborn complications and willingness to return to a facility.ConclusionPCMC could improve not just the experience of the mother during childbirth, but also the health of her newborn and future health-seeking behavior.
Highlights
Despite major gains in the past decade, maternal and newborn deaths remain unacceptably high
This is the first study to assess the impact of person-centered maternity care (PCMC) on newborn outcomes using a validated scale for person-centered care
PCMC should be considered a right, and provided whether or not it improves outcomes, the finding that receipt of high PCMC is associated with neonatal health will advance advocacy efforts to improve PCMC
Summary
Respondents were recruited from seven government health facilities in Nairobi and Kiambu counties in Kenya. Women with medium and high PCMC scores had significantly higher odds of reporting a willingness to return to the same facility for their delivery than women with low PCMC scores (aOR 2.88, 95% CI 1.46–5.69 and aOR 14.11, 95% CI 3.81– 52.28, respectively). Compared to women with low scores on the Dignity and Respect sub- scale, high scores on the Dignity and Respect sub-scale were associated with significantly lower odds of newborn complications at 2 weeks after delivery (aOR 0.49, 95% CI 0.25–0.94) and significantly higher odds of women reporting a willingness to return to the facility for their delivery (aOR 5.58, 95% CI 2.39–13.01) (Table 5). Medium or high scores in the Supportive Care sub-scale were associated with significantly higher odds of reporting a willingness to return to the facility for their delivery (aOR 2.63, 95% CI 1.35–5.14 and aOR 43.75, 95% CI 5.44–351.59, respectively). None of the PCMC sub-scales were found to be associated with visiting a facility for the newborn's immunizations
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