Original Research

CLEVER maternity care: A before-and-after study of women’s experience of childbirth in Tshwane, South Africa

Sarie J. Oosthuizen, Anne-Marie Bergh, Jackie Grimbeek, Robert C. Pattinson
African Journal of Primary Health Care & Family Medicine | Vol 12, No 1 | a2560 | DOI: https://doi.org/10.4102/phcfm.v12i1.2560 | © 2020 Sarie J. Oosthuizen, Anne-Marie Bergh, Jackie Grimbeek, Robert C. Pattinson | This work is licensed under CC Attribution 4.0
Submitted: 20 May 2020 | Published: 15 October 2020

About the author(s)

Sarie J. Oosthuizen, Tshwane District Health and Department of Family Medicine, University of Pretoria, Pretoria, South Africa; and, Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, UP/SAMRC Unit for Maternal and Infant Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Anne-Marie Bergh, Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, UP/SAMRC Unit for Maternal and Infant Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Jackie Grimbeek, Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, UP/SAMRC Unit for Maternal and Infant Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Robert C. Pattinson, Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; and, UP/SAMRC Unit for Maternal and Infant Health Care Strategies, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa


Share this article

Bookmark and Share

Abstract

Background: Birthing care matters to women and some women experience mistreatment during childbirth.

Aim: To determine the effect the ‘CLEVER Maternity Care’ package, a multi-faceted intervention to improve respectful, quality obstetric care.

Setting: Ten midwife-led obstetric units in Tshwane health district, South Africa; five intervention and five control units.

Methods: We conducted an anonymous baseline and end-line survey to measure the change in women’s perceptions and experiences of childbirth care after the implementation of the CLEVER package. A convenience sample of women returning for a postnatal follow-up visit was obtained at baseline (n = 653) and after implementation of CLEVER (n = 679).

Results: Six survey items were selected as proxies for respectful clinical care. There was no significant change in proportions of responses regarding one question, and with regard to patients receiving attention within 15 min of arrival, both the intervention and control group units showed a significant increase in positive responses (odds ratios of 8.4 and 6.1, respectively, and p values of 0.0001 and 0.0007). For the remaining four items (asking permission before doing an examination, positive communication, respectful treatment and overall satisfaction), only the intervention group showed a significant positive change (odds ratios ranging from 2.4 to 4.3; p ≤ 0.0018), with no significant change for the control group (odds ratios between 1.0 and 1.8; p ≥ 0.0736).

Conclusion: After the implementation of CLEVER Maternity Care, women reported a more positive experience of childbirth. The CLEVER intervention is a potential strategy for addressing respectful, quality obstetric care that warrants further investigation.


Keywords

respectful maternal care; obstetric care; childbirth; quality improvement

Metrics

Total abstract views: 125
Total article views: 66


Crossref Citations

No related citations found.