abstract: 'BackgroundQuality maternal and newborn care is essential for improving

  the health of mothers and babies. Low- and middle-income countries, such

  as Papua New Guinea (PNG), face many barriers to achieving quality care

  for all. Efforts to improve the quality of maternal and newborn care

  must involve community in the design, implementation, and evaluation of

  initiatives to ensure that interventions are appropriate and relevant

  for the target community. We aimed to describe community members''

  perspectives and experiences of maternal and newborn care, and their

  ideas for improvement in one province, East New Britain, in

  PNG.MethodsWe undertook a qualitative descriptive study in partnership

  with and alongside five local health facilities, health care workers and

  community members, using a Partnership Defined Quality Approach. We

  conducted ten focus group discussions with 68 community members

  (identified through church, market and other community-based groups) in

  East New Britain PNG to explore perspectives and experiences of maternal

  and newborn care, identify enablers and barriers to quality care and

  interventions to improve care. Discussions were transcribed verbatim. A

  mixed inductive and deductive analysis was conducted including

  application of the World Health Organisation (WHO) Quality Maternal and

  Newborn Care framework.ResultsUsing the WHO framework, we present the

  findings in accordance with the five experience of care domains. We

  found that the community reported multiple challenges in accessing care

  and facilities were described as under-staffed and under resourced.

  Community members emphasised the importance of good communication and

  competent, caring and respectful healthcare workers. Both women and men

  expressed a strong desire for companionship during labor and birth.

  Several changes were suggested by the community that could immediately

  improve the quality of care.ConclusionsCommunity perspectives and

  experiences are critical for informing effective and sustainable

  interventions to improve the quality of maternal and newborn care and

  increasing facility-based births in PNG. A greater understanding of the

  care experience as a key component of quality care is needed and any

  quality improvement initiatives must include the user experience as a

  key outcome measure.

  Plain English summaryImproving the care provided to, and experienced by,

  women and their families during pregnancy and childbirth is important

  for improving the health of mothers and babies. Community members should

  be involved in thinking about appropriate ways to improve care. Papua

  New Guinea (PNG) is a country in the Pacific which faces multiple

  challenges to improving care during pregnancy and birth. We aimed to

  understand what community members think about care provided and

  experienced during labour and birth in East New Britain, a rural

  province of PNG. We worked with five health facilities, health workers

  and community members in East New Britain to develop a qualitative

  research project. We carried out 10 focus group discussions with

  community members in East New Britain to understand what the provision

  and experience of care was like during labour and birth, and ways that

  it could be improved. We found that community members identified

  multiple challenges in getting to facilities and many facilities were

  found to have not enough supplies, equipment, or staff. Community

  members wanted staff that were good at their work but also caring and

  respectful. Women wanted to have support people present during labour

  and birth and many men wanted to be present too. Our results show that

  it is important to understand what the community thinks about the

  quality of care during labour and birth and this information is helpful

  to design effective activities to improve the care provided and

  experienced.'
affiliation: 'Wilson, AN (Corresponding Author), Burnet Inst, Maternal Child \& Adolescent
  Hlth Program, Melbourne, Australia.

  Wilson, AN (Corresponding Author), Univ Melbourne, Nossal Inst Global Hlth, Sch
  Populat \& Global Hlth, Melbourne, Australia.

  Wilson, Alyce N.; Melepia, Pele; Suruka, Rose; Hezeri, Priscah; Kabiu, Dukduk; Vogel,
  Joshua P.; Beeson, James; Scoullar, Michelle J. L.; Kennedy, Elissa; Homer, Caroline
  S. E., Burnet Inst, Maternal Child \& Adolescent Hlth Program, Melbourne, Australia.

  Wilson, Alyce N., Univ Melbourne, Nossal Inst Global Hlth, Sch Populat \& Global
  Hlth, Melbourne, Australia.

  Melepia, Pele; Suruka, Rose; Hezeri, Priscah; Kabiu, Dukduk, Burnet Inst, Hlth Mothers,
  Hlth Babies, Kokopo, Papua N Guinea.

  Babona, Delly, St Marys Hosp, Kokopo, Papua N Guinea.

  Wapi, Pinip, Nonga Gen Hosp, Rabaul, Papua N Guinea.

  Morgan, Alison, World Bank, Global Financing Facil, Washington, DC USA.

  Beeson, James; Scoullar, Michelle J. L., Univ Melbourne, Dept Med, Melbourne, Australia.

  Morgan, Christopher, Johns Hopkins Univ, Immunizat Program, JHPIEGO, Baltimore,
  MD USA.

  Kelly-Hanku, Angela; Nosi, Somu; Vallely, Lisa M., Papua New Guinea Inst Med Res,
  Goroka, Papua N Guinea.

  Kelly-Hanku, Angela; Vallely, Lisa M., Univ New South Wales, Kirby Inst, Kensington,
  Australia.

  Bohren, Meghan A., Univ Melbourne, Ctr Hlth Equity, Sch Populat \& Global Hlth,
  Gender \& Womens Hlth Unit, Melbourne, Australia.'
article-number: '780'
author: Wilson, Alyce N. and Melepia, Pele and Suruka, Rose and Hezeri, Priscah and
  Kabiu, Dukduk and Babona, Delly and Wapi, Pinip and Morgan, Alison and Vogel, Joshua
  P. and Beeson, James and Morgan, Christopher and Kelly-Hanku, Angela and Scoullar,
  Michelle J. L. and Nosi, Somu and Vallely, Lisa M. and Kennedy, Elissa and Bohren,
  Meghan A. and Homer, Caroline S. E.
author-email: alyce.wilson@burnet.edu.au
author_list:
- family: Wilson
  given: Alyce N.
- family: Melepia
  given: Pele
- family: Suruka
  given: Rose
- family: Hezeri
  given: Priscah
- family: Kabiu
  given: Dukduk
- family: Babona
  given: Delly
- family: Wapi
  given: Pinip
- family: Morgan
  given: Alison
- family: Vogel
  given: Joshua P.
- family: Beeson
  given: James
- family: Morgan
  given: Christopher
- family: Kelly-Hanku
  given: Angela
- family: Scoullar
  given: Michelle J. L.
- family: Nosi
  given: Somu
- family: Vallely
  given: Lisa M.
- family: Kennedy
  given: Elissa
- family: Bohren
  given: Meghan A.
- family: Homer
  given: Caroline S. E.
da: '2023-09-28'
doi: 10.1186/s12913-023-09723-x
eissn: 1472-6963
files: []
journal: BMC HEALTH SERVICES RESEARCH
keywords: 'Quality Care; Maternal and Newborn Health; Papua New Guinea; Quality

  Improvement; Community'
keywords-plus: 'CHILDBIRTH; HEALTH; PERCEPTIONS; WOMEN; MORTALITY; PATIENT; DEATHS;

  ACCESS'
language: English
month: JUL 20
number: '1'
number-of-cited-references: '83'
orcid-numbers: 'Vogel, Joshua/0000-0002-3214-7096

  Beeson, James/0000-0002-1018-7898'
papis_id: fc0b8ca5fc4d2be48689f6dbb90b0c87
ref: Wilson2023communityperspective
researcherid-numbers: 'Vogel, Joshua/K-7649-2019

  '
times-cited: '0'
title: Community perspectives and experiences of quality maternal and newborn care
  in East New Britain, Papua New Guinea
type: article
unique-id: WOS:001032984300001
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '23'
web-of-science-categories: Health Care Sciences \& Services
year: '2023'