Hospital Performance Indicators in Provision of  Perinatal Services: A Qualitative Study

Hossein Jabbari Bayrami; Somayae Abdollahi Sabet; Amirreza Naseri; Mohammad-Salar Hosseini

doi:10.18502/jfrh.v19i2.19302

Hossein Jabbari Bayrami Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
Somayae Abdollahi Sabet Department of Community Medicine, Faculty of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
Amirreza Naseri Research Center for Evidence-Based Medicine, Iranian EBM Center: A JBI Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran
Mohammad-Salar Hosseini Research Center for Evidence-Based Medicine, Iranian EBM Center: A JBI Center of Excellence, Tabriz University of Medical Sciences, Tabriz, Iran

DOI: https://doi.org/10.18502/jfrh.v19i2.19302

Keywords: Health Care Delivery; Health Services Research; Maternal Mortality; Neonatal Care; Perinatal Mortality

Abstract

Objective: Perinatal mortality is an indicating factor in social development, and international measures have been taken to reduce maternal and perinatal mortality. This study aims to collect the experts’ opinions about hospitals performance in providing perinatal services and emerge the key indicators for evaluation.

Materials and methods: This is a qualitative study using the Delphi technique and based on the focus group discussion sessions with twelve experts, including pediatricians, perinatologists, neonatologists, neonatal care nurses, and midwives with at least five years of work experience. A coordinator managed the sessions, and the discussions continued until saturation. Thematic analysis was performed to extract the major themes and sub-themes.

Results: Three main themes of input/structure, process, and outcome are extracted. The input/structure theme consists of human resources, physical space, equipment, and technical support and information. In human resources, the number and proficiency of healthcare providers and mental health problems are expressed. In terms of physical space, the areas and infrastructure facilities are discussed. The proper purchase and allocation of equipment are emphasized in the equipment sub-theme. The need to establish a Health Information Service in level-one centers is mentioned in the support sub-theme. The process theme consists of medical staff retraining and empowerment, referral, follow-up, education, and audits. The maternal and neonatal mortality and morbidity indices are cited in the outcome theme.

Conclusion: Our findings provide a wide range of context-specific challenges the healthcare systems face in provision of perinatal health services. As a result of this study, the primary indicators for assessing the hospitals’ performance in providing perinatal services are emerged.