Volume 21, Issue 1 (April 2023)                   Nursing and Midwifery Journal 2023, 21(1): 1-11 | Back to browse issues page

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1- Master's Degree Students, Counseling in Midwifery, Urmia University of Medical Sciences, Urmia, Iran
2- Assistant Professor of Reproductive Health, Urmia University of Medical Sciences, Urmia, Iran (Corresponding Author)
3- Assistant Professor, of Epidemiology, Urmia University of Medical Sciences, Urmia, Iran
4- Instructor of Midwifery, Urmia University of Medical Sciences, Urmia, Iran
Abstract:   (913 Views)
Background & Aim: One of the programs of the health system in Iran is providing services related to pregnancy, which is provided in three areas of pre-pregnancy, pregnancy, and postpartum care. Quality and quantity assessment shows how health care programs are implemented and identifies the inadequacies of the programs to solve the main problems. Therefore, the present study was conducted to investigate the quality and adequacy of pre-pregnancy care from the point of view of women referring to Urmia city hospitals.
Material & Methods: This cross-sectional study was conducted on 765 pregnant women referring to hospitals in Urmia city by Quota sampling method. The data collection tool included demographic and midwifery information as well as a researcher-made questionnaire about the quality and adequacy of pre-pregnancy care. The questionnaires were completed about 2-3 hours before the mother was discharged from the maternity ward. Data analysis was done with descriptive and inferential statistics by SPSS software version 16. Statistical significance was considered at p<0.05.
Results: The mean and standard deviation of the age of women participating in the study was 27.0±4.9 years. Of all the participatrd women, 159 (20.78 percent) had received pre-pregnancy care. The mean and standard deviation of the number of pre-pregnancy cares received by all women participating in the study was 15.8 ± 3.7 cares. The minimum and maximum received cares were 8 and 23, respectively, and the mean number of received cares was 15 cares. The total quality score of pre-pregnancy service was 66.60 ± 11.20. The mean scores of those who refer to private centers for the dimensions of selection, communication, interaction, and total score of service quality were significantly higher than the average scores of those who refer to public centers (p<0.05). The mean and standard deviation of the pre-pregnancy customer quality score was 59.31±11.98. The results showed that the customer quality levels were similar between women referring to public and private centers and there was no significant difference between them (p=0.859).
Conclusion: Despite the low coverage of pre pregnancy care, the adequacy of pre-pregnancy care was optimal, and there was no difference between private and public service providers. Considering the low quality of some aspects of pre-pregnancy care services in public compared to private centers, there is a need for planning and intervention to improve the quality of service delivery, especially in public centers.
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Type of Study: Research | Subject: مامایی

1. Peyman N, Ezzati Rastegar K, Tehrani H, Zarei F. Explanation of unwanted pregnancy from the perspective of family planning service providers: An exploratory study. Iran J Obstet Gynecol Infertil 2016;19(12):18-26. [Google Scholar]
2. Debiec KE, Paul KJ, Mitchell CM, Hitti JE. Inadequate prenatal care and risk of preterm delivery among adolescents: a retrospective study over 10 years. Am J Obstet Gynecol 2010;203(2):122. e1-e6. [DOI:10.1016/j.ajog.2010.03.001] [PMID]
3. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS. Williams obstetrics, 24e: Mcgraw-hill New York, NY, USA; 2014. [URL]
4. Østensen M. Preconception counseling. Rheumatic Disease Clinics. 2017;43(2):189-99. [DOI:10.1016/j.rdc.2016.12.003] [PMID]
5. Farshbaf Khalili A SN. Attitude of midwives', suggested solutions and current problems of preconception care. J Urmia Nurs Midwifery Fac 2017;14(10):783-90. [URL]
6. Jourabchi Z, Sharif S, Lye MS, Saeed A, Khor GL, Tajuddin SHS. Association between preconception care and birth outcomes. Am J Health Promot [Internet]. 2019;33(3):363-71. [DOI:10.1177/0890117118779808] [PMID]
7. Nekouei N, Pakgouhar M, Khakbazan Z, Mahmoodi M. Midwifery students Knowledge of preconception care. J Nurs Midwifery 2004.
8. Corrigan JM. Crossing the quality chasm. Building a better delivery system. 2005;89. [URL]
9. Ferrand YB, Siemens J, Weathers D, Fredendall LD, Choi Y, Pirrallo RG, et al. Patient satisfaction with healthcare services A critical review. Qual Manag J 2016;23(4):6-22. [DOI:10.1080/10686967.2016.11918486]
10. Vaghee S, Yavari M. The effect of communication skills training on the quality of nursing care of patients. Evidence Based Care 2013;2(4):37-46. [URL]
11. Aghlmand S, Akbari F, editors. Method to assess the quality of health services. Sixth International Conference on Quality Management in Iran, Tehran; 2005. [URL]
12. Donabedian A. An introduction to quality assurance in health care: Oxford University Press; 2002. [Google books]
13. Kenagy JW, Berwick DM, Shore MF. Service quality in health care. Jama. 1999;281(7):661-5. [DOI:10.1001/jama.281.7.661] [PMID]
14. Tabrizi JS. Quality of delivered care for people with type 2 diabetes: a new patient-centred model. J Res Health Sci 2009;9(2):1-9. [Google Scholar]
15. Tayebi T, Hamzehgardeshi Z, Shirvani MA, Dayhimi M, Danesh M. Relationship between Revised Graduated Index (R-GINDEX) of prenatal care utilization & preterm labor and low birth weight. Glob J Health Sci 2014;6(3):131. [DOI:10.5539/gjhs.v6n3p131] [PMID] [PMCID]
16. Kotelchuck M. An evaluation of the Kessner adequacy of prenatal care index and a proposed adequacy of Prenatal Care Utilization Index. Am J Public Health 1994;84(9):1414-20. [DOI:10.2105/AJPH.84.9.1414] [PMID] [PMCID]
17. Alexander GR, Kotelchuck M. Quantifying the adequacy of prenatal care: a comparison of indices. Pub Health Rep 1996;111(5):408. [PMCID]
18. Ghaffari F, Jahani Shourab N, Jafarnejad F, Esmaily H. Application of Donabedian quality-of-care framework to assess the outcomes of preconception care in urban health centers, Mashhad, Iran in 2012. J Midwifery Reprod Health 2014;2(1):50-9. [Google Scholar]
19. Campos TP, Carvalho MS, Barcellos CC. Infant mortality in Rio de Janeiro, Brazil: risk areas and distance traveled by patients to get to health care facilities. Rev Panam Salud Publica 2000;8(3):164-71. [DOI:10.1590/S1020-49892000000800003] [PMID]
20. Siko SPL. Evaluations of quality of antenatal care at rural Health centers in Matebelend North Province Central. African J of Med 1996; 17:423-34 [PMID]
21. Ghaffari F, A K. The necessity to determine the indices to surveillance of preconception care. Iran J Obstet Gynecol Infertil 2022;25(4):51-9. [URL]
22. Tabrizi J, Alidoost S, Bahrami A, Asgharijafarabadi M. Service Quality (SQ) in Patients with Type 2 Diabetes. Hospital 2014;13(4):23-30. [URL]
23. Hekari D, Mohammadzadeh R, Velayati A, S Z. A Survey Of Prenatal Care Quality In Tabriz Therapeutic-Health Centers. Woman Stud Fam 2013;5(18):157-78. [URL]
24. Sardasht FG, Keramat A, Motaghi Z. Investigating reproductive life plan in pregnant women referred to teaching hospitals of Mashhad, Iran. Iran J Nurs Midwifery Res 2021;26(2):120. [DOI:10.4103/ijnmr.IJNMR_13_20] [PMID] [PMCID]
25. Lassi ZS, Dean SV, Mallick D, Bhutta ZA. Preconception care: delivery strategies and packages for care. Reprod Health 2014;11(3):1-17. [DOI:10.1186/1742-4755-11-S1-S1] [PMID] [PMCID]
26. Ghaffari F, Keramat A. The need to determine an index to monitor the quality of pre-pregnancy care. Iran J Nurs Midwifery Res 2022;25(4):51-9. [URL]
27. Ghaffari Sardasht F, Jahani Shourab N, Jafarnejad F, Esmaily H. Comparing the quality of preconception care provided in healthcare centers in Mashhad in 2012. Electro Physician 2015;7(2):1039. [PMCID]
28. Barker M, Dombrowski SU, Colbourn T, Fall CH, Kriznik NM, Lawrence WT, et al. Intervention strategies to improve nutrition and health behaviours before conception. Lancet 2018;391(10132):1853-64. [DOI:10.1016/S0140-6736(18)30313-1] [PMID]
29. Sharami S, Zahiri Z, Zendehdel M. Assessment the client satisfaction in prenatal unit of Rasht public hospitals. J Guilan Univ Med Sci 2008;17(66):29-37.. [Google Scholar]
30. Zaky HH, Khattab HA, Galal D. Assessing the quality of reproductive health services in Egypt via exit interviews. Matern Child Health J 2007;11(3):301-6. [DOI:10.1007/s10995-006-0167-y] [PMID]
31. Tabrizi J, Partovi Y, Alidoost S, Alizadeh O, Zariei Gavgani F. Assessment The Quality Of Delivered Care For People With Type 2 Diabetes By Comprehensive Quality Measurement In Healthcare (CQMH) Model. Iran J Diabetes Metab 2015;14(6):431-40. [URL]
32. Tabrizi J, O'Rourke P, Wilson A, Coyne E. Service quality for Type 2 diabetes in Australia: the patient perspective. Diabet Med 2008;25(5):612-7. [DOI:10.1111/j.1464-5491.2008.02420.x] [PMID]
33. Oladapo OT, Iyaniwura CA, Sule-Odu AO. Quality of antenatal services at the primary care level in southwest Nigeria. Afr J Reprod Health. 2008;12(3):71-92. [Google Scholar]
34. Agha Molaei T, Zare S, Poudat A, Kebriaei A. Customers' Perceptions And Expectations Of Primary Healthcare Services Quality In Health Centers Of Bandar Abbas. Med J Hormozgan Univ 2007;11(3):173-9. [URL]

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