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Developing contrace...
Developing contraceptive services for immigrant women postpartum : a case study of a quality improvement collaborative in Sweden
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- Kilander, Helena (author)
- Linköpings universitet,Jönköping University,The Jönköping Academy for Improvement of Health and Welfare,Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare Jönköping University, Jönköping, Sweden; Department of Women’s and Children’s Health, Karolinska Institutet, Solna, Sweden; Division of Nursing Sciences and Reproductive Health, Department of Health, Medicine and Caring Sciences and Department of Obstetrics and Gynaecology, Region Jönköping County, Linköping University, Linköping, Sweden,Sch Hlth & Welf Jönköping Univ, Jönköping Acad Improvement Hlth & Welf, Jönköping, Sweden.;Karolinska Inst, Dept Womens & Childrens Hlth, Solna, Sweden.;Linköping Univ, Div Nursing Sci & Reprod Hlth, Dept Hlth Med & Caring Sci, Linköping, Sweden.;Linköping Univ, Region Jönköping Cty, Dept Obstet & Gynaecol, Linköping, Sweden.,Avdelningen för omvårdnad och reproduktiv hälsa,Medicinska fakulteten
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- Weinryb, Maja (author)
- Department of Women’s and Children’s Health, Karolinska Institutet, Solna, Sweden; Health Care Services, Stockholm Region, Stockholm, Sweden,Karolinska Inst, Dept Womens & Childrens Hlth, Solna, Sweden.;Hlth Care Serv, Stockholm Reg, Stockholm, Sweden.
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- Vikström, Malin (author)
- Maternal Healthcare Unit, Stockholm South General Hospital, The Health and Medical Care Administration, Region Stockholm County, Stockholm, Sweden,Stockholm South Gen Hosp, Hlth & Med Care Adm, Maternal Healthcare Unit, Reg Stockholm Cty, Stockholm, Sweden.
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- Petersson, Kerstin (author)
- Umeå universitet,Obstetrik och gynekologi,Maternal Healthcare Unit, Stockholm South General Hospital, The Health and Medical Care Administration, Region Stockholm County, Stockholm, Sweden,Stockholm South Gen Hosp, Hlth & Med Care Adm, Maternal Healthcare Unit, Reg Stockholm Cty, Stockholm, Sweden.;Umeå Univ, Dept Clin Sci Obstet & Gynaecol, Umeå, Sweden.
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- Larsson, Elin C. (author)
- Uppsala universitet,Karolinska Institutet,Internationell kvinno- och mödrahälsovård och migration,Karolinska Inst, Dept Womens & Childrens Hlth, Solna, Sweden.;Karolinska Inst, Dept Global Publ Hlth, Widerstromskahuset Floor 3,Tomtebodavagen 18A, SE-17177 Stockholm, Sweden.,Karolinska Inst, Sweden; Karolinska Inst, Sweden; Uppsala Univ, Sweden
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(creator_code:org_t)
- 2022-04-26
- 2022
- English.
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In: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 22:1
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Abstract
Subject headings
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- Background: Immigrant women use less effective contraceptive methods and have a higher risk of unintended pregnancies. Maternal health care services offer a central opportunity to strengthen contraceptive services, especially among immigrants. This study aimed to evaluate a Quality Improvement Collaborative QIC. Its objective was to improve contraceptive services for immigrant women postpartum, through health care professionals’ (HCPs) counselling and a more effective choice of contraceptive methods.Methods: The pilot study was designed as an organisational case study including both qualitative and quantitative data collection and analysis. Midwives at three maternal health clinics (MHCs) in Stockholm, Sweden participated in a QIC during 2018–2019. In addition, two recently pregnant women and a couple contributed user feedback. Data on women’s choice of contraceptive method at the postpartum visit were registered in the Swedish Pregnancy Register over 1 year.Results: The participating midwives decided that increasing the proportion of immigrant women choosing a more effective contraceptive method postpartum would be the goal of the QIC. Evidence-based changes in contraceptive services, supported by user feedback, were tested in clinical practice during three action periods. During the QIC, the proportion of women choosing a more effective contraceptive method postpartum increased at an early stage of the QIC. Among immigrant women, the choice of a more effective contraception increased from 30 to 47% during the study period. Midwives reported that their counselling skills had developed due to participation in the QIC, and they found using a register beneficial for evaluating women’s choice of contraceptive methods.Conclusions: The QIC, supported by a register and user feedback, helped midwives to improve their contraceptive services during the pregnancy and postpartum periods. Immigrant women’s choice of a more effective contraceptive method postpartum increased during the QIC. This implies that a QIC could increase the choice of a more effective contraception of postpartum contraception among immigrants.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Health Care Service and Management, Health Policy and Services and Health Economy (hsv//eng)
Keyword
- Contraception
- Coproduction
- Counselling
- Family planning
- Maternal health care
- Postpartum
- Quality improvement
- System performance
Publication and Content Type
- ref (subject category)
- art (subject category)
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