gms | German Medical Science

Background: Care for women during pregnancy and after childbirth is provided unequally. Inhabitants of socially disadvantaged neighborhoods have reduced access to midwifery services. At the same time, they face multiple challenges and would therefore particularly benefit from midwifery care. To improve this situation, the state of Bremen has implemented two midwifery centers in socially disadvantaged neighborhoods, with more in planning. This innovative care concept aims to enhance care during pregnancy and after childbirth through needs-based and low-threshold services, while also providing midwives an attractive workplace. To determine the goals that individual stakeholders associate with a midwifery center and the intervention components that contribute to achieving the goal, a process-oriented evaluation is necessary.

Aim/research question: The aim of this Ph.D. project is to develop an effective evaluation concept and, based on this concept conduct an evaluation of the Bremen midwifery centers. The target audience for the evaluation includes the professionals working in the midwifery centers, women during pregnancy and after childbirth, as well as their families in the selected socially disadvantaged neighborhoods.

Methods: The development of the evaluation concept is carried out through participatory methods. This includes conversations with pregnant women and mothers, as well as the establishment of an advisory board. The board comprises various experts in the field of perinatal care (e.g., midwives, stakeholders from the political context and local community representatives). The evaluation concept involves qualitative interviews with professionals at the midwifery centers and stakeholders engaged in the implementation processes or utilization of the midwifery centers. Additionally, an analysis of routinely collected healthcare data from the midwifery centers is planned.

Results: The participatory process allows the identification of the objectives of the care concept, which are then examined through the evaluation. This analysis includes aspects such as access to the care services, an assessment of network and collaboration structures, as well as the satisfaction of professionals with the care concept. This satisfaction could stem from factors like work organization or team dynamics.

Relevancy: There is a specific need for care in socially disadvantaged neighborhoods during pregnancy and after birth, coupled with a shortage of skilled professionals. Therefore, the results of this project will be beneficial for the participants as well as other groups that engage with perinatal care and health inequality.

Recommendations/conclusion: The participatory approach enables the creation of a practical and target group-oriented evaluation concept that can be applied beyond the project’s duration and setting.

Ethics and conflicts of interest: The evaluation concept with its corresponding measurement instruments will be submitted to the Ethics Committee of the University of Bremen. The research was financed by own resources. There are no conflicts of interest.