- Title
- Caring for Pregnant Women with Rheumatic Heart Disease: A Qualitative Study of Health Service Provider Perspectives
- Creator
- Vaughan, Geraldine; Dawson, Angela; Peek, Michael; Carapetis, Jonathan; Wade, Vicki; Sullivan, Elizabeth
- Relation
- Global Heart Vol. 16, Issue 1, no. 88
- Publisher Link
- http://dx.doi.org/10.5334/gh.1086
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2021
- Description
- Background: Rheumatic heart disease (RHD) persists in low-middle-income countries and in high-income countries where there are health inequities. RHD in pregnancy (RHD-P) is associated with poorer maternal and perinatal outcomes. Our study examines models of care for women with RHD-P from the perspectives of health care providers. Methods: A descriptive qualitative study exploring Australian health professionals’ perspectives of care pathways for women with RHD-P. Thematic analysis of semi-structured interviews with nineteen participants from maternal health and other clinical and non-clinical domains related to RHD-P.Results: A constellation of factors challenged the provision of integrated women-centred care, related to health systems, workforces and culture. Themes that impacted on the provision of quality woman-centred care included conduits of care – helping to break down silos of information, processes and access; ‘layers on layers’ – reflecting the complexity of care issues; and shared understandings – factors that contributed to improved understandings of disease and informed decision-making.Conclusions: Pregnancy for women with RHD provides an opportunity to strengthen health system responses, improve care pathways and address whole-of-life health. To respond effectively, structural and cultural changes are required including enhanced investment in education and capacity building – particularly in maternal health – to support a better informed and skilled workforce. Aboriginal Mothers and Babies programs provide useful exemplars to guide respectful effective models of care for women with RHD, with relevance for non-Indigenous women in high-risk RHD communities.For key goals to be met in the context of RHD, maternal health must be better integrated into RHD strategies and RHD better addressed in maternal health.
- Subject
- rheumatic heart disease; pregnancy; health services; qualitative research; SDG 3; SDG 5; SDG 10; SDG 17; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1474060
- Identifier
- uon:49199
- Identifier
- ISSN:2211-8160
- Rights
- © 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.
- Language
- eng
- Full Text
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Goal 5: Gender Equality
Goal 10: Reduced Inequalities
Goal 3: Good Health and Well-Being
Goal 17: Partnerships for the Goals
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