Browsing by Author "Lazzerini, Marzia"

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    Importance of Quality of Maternal and Newborn Care in Childbirth : Findings over Time of the Imagine Euro Study on 40 WHO Standard-Based Quality Measures During the Covid-19 Pandemic in Latvia
    (2024-02-01) Knoka, Anna Regīna; Pumpure, Elizabete; Matroze, Asnate; Jakovicka, Dārta; Mariani, Ilaria; Vaska, Agnija; Covi, Benedetta; Valente, Emanuelle Pessa; Jansone-Šantare, Gita; Vilcāne, Katrīna Paula; Rezeberga, Dace; Lazzerini, Marzia; Department of Obstetrics and Gynaecology; Rīga Stradiņš University
    The objectives of the study were to investigate the quality of maternal and newborn care (QMNC) from the view of mothers who gave birth in a healthcare facility during the COVID-19 pandemic in Latvia. An online questionnaire survey was conducted in Latvia from 1 March 2020 to 28 October 2021, which was based on 40 World Health Organisation (WHO) Standard-based Quality measures. In addition, descriptive and multivariate quantile regression analyses were performed to compare the years 2020 and 2021. A total of 2079 women participated in the study, of whom 833 gave birth in 2020 — of them, 648 had a vaginal delivery, and 185 had a cesarean section, and 1205 women gave birth in 2021, 979 with a vaginal delivery, and 226 with a cesarean section. A lower QMNC during the COVID-19 pandemic was reported by 29.8% and 24.5% of respondents in 2020 and 2021. The total QMNC Index was notably higher in 2021 compared to 2020. This study showed essential gaps in the QMNC in Latvia perceived by mothers, while observing a slight increase in quality in 2021. Therefore, strategies to improve mothers' and newborns' health care should be introduced as soon as possible.
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    What is the quality of the maternal near-miss case reviews in WHO European Region? Cross-sectional study in Armenia, Georgia, Latvia, Republic of Moldova and Uzbekistan
    (2018-04-01) Bacci, Alberta; Hodorogea, Stelian; Khachatryan, Henrik; Babojonova, Shohida; Irsa, Signe; Jansone, Maira; Dondiuc, Iurie; Matarazde, George; Lazdane, Gunta; Lazzerini, Marzia; Rīga Stradiņš University
    Objectives The maternal near-miss case review (NMCR) cycle is a type of clinical audit aiming at improving quality of maternal healthcare by discussing near-miss cases. In several countries this approach has been introduced and supported by WHO and partners since 2004, but information on the quality of its implementation is missing. This study aimed at evaluating the quality of the NMCR implementation in selected countries within WHO European Region. Design Cross-sectional study. Settings Twenty-three maternity units in Armenia, Georgia, Latvia, Moldova and Uzbekistan. Assessment tools A predefined checklist including 50 items, according to WHO methodology. Quality in the NMCR implementation was defined by summary scores ranging from 0 (totally inappropriate) to 3 (appropriate). Results Quality of the NMCR implementation was heterogeneous among different countries, and within the same country. Overall, the first part of the audit cycle (from case identification to case analysis) was fairly well performed (mean score 2.00, 95% CI 1.94 to 2.06), with the exception of the â € inclusion of users' views' (mean score 0.66, 95% CI 0.11 to 1.22), while the second part (developing recommendations, implementing them and ensuring quality) was poorly performed (mean score 0.66, 95% CI 0.11 to 1.22). Each country had at least one champion facility, where quality of the NMCR cycle was acceptable. Quality of the implementation was not associated with its duration. Gaps in implementation were of technical, organisational and attitudinal nature. Conclusions Ensuring quality in the NMCR may be difficult but achievable. The high heterogeneity in results within the same country suggests that quality of the NMCR implementation depends, to a large extent, from hospital factors, including staff's commitment, managerial support and local coordination. Efforts should be put in preventing and mitigating common barriers that hamper successful NMCR implementation.
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    Women's perspectives on the quality of maternal and newborn care in childbirth during the COVID-19 pandemic in Latvia : Results from the IMAgiNE EURO study on 40 WHO standards-based quality measures
    (2022-12) Pumpure, Elizabete; Jakovicka, Dārta; Mariani, Ilaria; Vaska, Agnija; Covi, Benedetta; Valente, Emanuelle Pessa; Jansone-Šantare, Gita; Knoka, Anna Regīna; Vilcāne, Katrīna Paula; Rezeberga, Dace; Lazzerini, Marzia; IMAgiNE EURO study group; Department of Obstetrics and Gynaecology; Faculty of Medicine
    OBJECTIVE: To investigate women's perspectives on the quality of maternal and newborn care (QMNC) around the time of childbirth during the COVID-19 pandemic in Latvia, comparing the years 2020 and 2021, among women who went into labor or had a prelabor cesarean. METHODS: Women giving birth in healthcare facilities in Latvia from March 1, 2020, to October 28, 2021, answered an online questionnaire including 40 WHO standards-based quality measures. Descriptive and multivariate quantile regression analyses were performed to compare QMNC in 2020 and 2021. RESULTS: 2079 women were included in the analysis: 1860 women who went into labor (group 1) and 219 with prelabor cesarean (group 2). Among group 1, 66.4% (n = 99/149) of women received fundal pressure in an instrumental vaginal birth, 43.5% (n = 810) lacked involvement in choices, 17.4% (n = 317) reported suffering abuse, 32.7% (n = 609) reported inadequate breastfeeding support while 5.2% (n = 96) lack of early breastfeeding. A significant reduction in QMNC due to the COVID-19 pandemic was reported by 29.5% (n = 219) and 25.0% (n = 270) of respondents in 2020 and 2021, respectively (P = 0.045). Multivariate analyses highlighted a significantly lower QMNC index for 2020 compared with 2021 (P < 0.001). CONCLUSION: This first study investigating QMNC in Latvia showed significant gaps in QMNC perceived by respondents, with slightly better results in 2021. Appropriate healthcare strategies to improve health care for women and newborns in Latvia are required. CLINICALTRIALS: gov Identifier:NCT04847336.