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Research article
Semira Manaseki-Holland
University of Birmingham Institute of Applied Health Research
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Women-held documents are a basic component of continuity of maternity care. The use and completion of women-held documents following discharge could improve treatment and care for postnatal women. Using a mixed-methods study design, we aimed to assess content, quality and completeness of women-held discharge documents and identify factors contributing to the effective use and handover of these documents.
Methods: Documents given to women at discharge from all three hospitals in the Greater Banjul Area, The Gambia, were reviewed for content and quality. Poisson regression was used to estimate factors predicting completion of the documents. Semi-structured interviews (n=21) and two focus groups were carried out with healthcare professionals (HCPs).
Results: From the 212 women included in the study, nearly all (n=211; 99%) were given a document to take home. The maternal record was the most common (n=207; 98%) and the most complete (17/26 items completed on average; 65%). None of the women’s sociodemographic or clinical characteristics were associated with the completeness of the documents. Themes identified from the interviews include HCPs completing and handing over the documents to women and the ability of women to understand and use the documents. Facilitators and barriers identified from both themes were synthesised alongside the quantitative results.
Conclusions: The government-issued maternal record is well established in The Gambia and has potential to be more effective. We recommend a national protocol be established to improve consistent completion and use of the maternal record and to reduce the number of documents HCPs must complete. Training and monitoring of HCPs would ensure the document is complete, given to all women and explained to the women clearly and thoroughly.
Keywords
Maternity care, women-held documents, discharge, continuity of care, The Gambia, low-income country, mixed-methods, handover
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Figure 2
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This is a list of supplementary files associated with this preprint. Click to download.
- Additionalfile1.pdf
ISSM_COREQ_Checklist Completed COREQ checklist for the qualitative component of the study.
- Additionalfile2.docx
Hospital background information Additional information on the hospitals used for the setting of this study
- Additionalfile3.docx
Questionnaire Questionnaire used to collect data on women’s characteristics, the documents they held and their opinion of the documents
- Additionalfile4.docx
Definition of complicated birth The criteria used to define a complicated birth in this study
- Additionalfile5.docx
Interview topic guide for FGDs and SSIs Topic guide for focus discussion groups and semi-structured interviews used for collecting the qualitative data in this study
- Additionalfile6.docx
Women’s background and pregnancy characteristics; figures presented as N (%) Baseline figures for the women included in this study including demographics
- Additionalfile7.docx
Content quality and completeness of documents; figures presented as N (%) Results from the assessment of women-held documents
- Additionalfile8.docx
Questionnaire responses Results from the questionnaire each woman completed
- Additionalfile9.docx
Qualitative participant demographics Demographic data of the healthcare professionals that participated in the focus group discussions and semi-structured interviews
- Additionalfile10.docx
Barriers and facilitators for effective handover of information from HCPs to other HCPs and women Results from the focus groups discussions and semi-structured interviews
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Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 01 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 20 Apr, 2021
Review #3 received
Received 17 Mar, 2021
Review #2 received
Received 28 Feb, 2021
Reviewer #3 agreed
On 24 Feb, 2021
Reviewer #2 agreed
On 06 Feb, 2021
Review #1 received
Received 01 Feb, 2021
Reviewer #1 agreed
On 17 Jan, 2021
Reviewers invited
Invitations sent on 27 Nov, 2020
Editor assigned
On 25 Nov, 2020
Submission checks complete
On 23 Nov, 2020
Editor invited
On 22 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Semira Manaseki-Holland
University of Birmingham Institute of Applied Health Research
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 01 Dec, 2020
No community comments so far
Editorial decision: Major revision
On 20 Apr, 2021
Review #3 received
Received 17 Mar, 2021
Review #2 received
Received 28 Feb, 2021
Reviewer #3 agreed
On 24 Feb, 2021
Reviewer #2 agreed
On 06 Feb, 2021
Review #1 received
Received 01 Feb, 2021
Reviewer #1 agreed
On 17 Jan, 2021
Reviewers invited
Invitations sent on 27 Nov, 2020
Editor assigned
On 25 Nov, 2020
Submission checks complete
On 23 Nov, 2020
Editor invited
On 22 Nov, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Maternal & Fetal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Women-held documents are a basic component of continuity of maternity care. The use and completion of women-held documents following discharge could improve treatment and care for postnatal women. Using a mixed-methods study design, we aimed to assess content, quality and completeness of women-held discharge documents and identify factors contributing to the effective use and handover of these documents.
Methods: Documents given to women at discharge from all three hospitals in the Greater Banjul Area, The Gambia, were reviewed for content and quality. Poisson regression was used to estimate factors predicting completion of the documents. Semi-structured interviews (n=21) and two focus groups were carried out with healthcare professionals (HCPs).
Results: From the 212 women included in the study, nearly all (n=211; 99%) were given a document to take home. The maternal record was the most common (n=207; 98%) and the most complete (17/26 items completed on average; 65%). None of the women’s sociodemographic or clinical characteristics were associated with the completeness of the documents. Themes identified from the interviews include HCPs completing and handing over the documents to women and the ability of women to understand and use the documents. Facilitators and barriers identified from both themes were synthesised alongside the quantitative results.
Conclusions: The government-issued maternal record is well established in The Gambia and has potential to be more effective. We recommend a national protocol be established to improve consistent completion and use of the maternal record and to reduce the number of documents HCPs must complete. Training and monitoring of HCPs would ensure the document is complete, given to all women and explained to the women clearly and thoroughly.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
- Additionalfile1.pdf
ISSM_COREQ_Checklist Completed COREQ checklist for the qualitative component of the study.
- Additionalfile2.docx
Hospital background information Additional information on the hospitals used for the setting of this study
- Additionalfile3.docx
Questionnaire Questionnaire used to collect data on women’s characteristics, the documents they held and their opinion of the documents
- Additionalfile4.docx
Definition of complicated birth The criteria used to define a complicated birth in this study
- Additionalfile5.docx
Interview topic guide for FGDs and SSIs Topic guide for focus discussion groups and semi-structured interviews used for collecting the qualitative data in this study
- Additionalfile6.docx
Women’s background and pregnancy characteristics; figures presented as N (%) Baseline figures for the women included in this study including demographics
- Additionalfile7.docx
Content quality and completeness of documents; figures presented as N (%) Results from the assessment of women-held documents
- Additionalfile8.docx
Questionnaire responses Results from the questionnaire each woman completed
- Additionalfile9.docx
Qualitative participant demographics Demographic data of the healthcare professionals that participated in the focus group discussions and semi-structured interviews
- Additionalfile10.docx
Barriers and facilitators for effective handover of information from HCPs to other HCPs and women Results from the focus groups discussions and semi-structured interviews
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