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A change laboratory for maternity care in Brazil: Pilot implementation of Mother Baby Friendly Birthing Initiative.
Diniz, Carmen Simone Grilo; Bussadori, Jamile Claro de Castro; Lemes, Luana Beatriz; Moisés, Elaine Christine Dantas; Prado, Caio Antonio de Campos; McCourt, Christine.
Afiliação
  • Diniz CSG; School of Public Health, University of São Paulo, São Paulo, Brazil.
  • Bussadori JCC; Department of Nursing, Universidade Federal de São Carlos (Federal University of Sao Carlos), São Carlos, Brazil.
  • Lemes LB; School of Public Health, University of Sao Paulo, São Paulo, Brazil.
  • Moisés ECD; Department of Gynecology & Obstetrics, Ribeirão Preto School of Medicine (FMRP), University of São Paulo, Ribeirão Preto, Brazil.
  • Prado CAC; Women's Health Reference Centre of Ribeirão Preto (MATER), São Paulo, Brazil.
  • McCourt C; School of Health Sciences, City, University of London, London, UK.
Med Teach ; 43(1): 19-26, 2021 01.
Article em En | MEDLINE | ID: mdl-32672483
Disrespectful and abusive treatment of women during childbirth is a worldwide problem. This research aimed to develop and implement a Mother Baby-Friendly Hospital Initiative (MBFHI) in an academic maternity hospital in Brazil and evaluate how change could be sustained. Change Laboratory principles guided a process of action research, which was conducted between 2017 and 2019. Clinicians and managers joined the researchers in discussion sessions to redesign routines and care pathways. Observation, interviews, focus groups, and historical and documentary analysis provided information about the existing activity system, which we analysed qualitatively using MBFHI criteria to identify themes. Evidence of inappropriate obstetric interventions and impersonal interactions between clinicians and patients stimulated us to devise innovative solutions. The challenges identified by this exercise included: poor infrastructure and ambience; difficulty adhering to evidence-based protocols; social and professional hierarchies; and clinicians being poorly educated about women's rights. Although challenges remained, positive changes included a friendlier environment, improved patient privacy, and fewer unnecessary procedures. Resources released by these changes allowed us, collaboratively, to track the further implementation and sustainability of change. We conclude that the Change Laboratory can help motivated clinicians and managers humanise patients' experiences, make care more evidence-based, and expand learning of mother-friendly maternity care. Tensions and contradictions between education and patient care reported here may resonate in settings other than maternity care.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Serviços de Saúde Materna / Mães Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research Limite: Female / Humans / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: Med Teach Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Serviços de Saúde Materna / Mães Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research Limite: Female / Humans / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Revista: Med Teach Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido