Measurement of maternal functioning during pregnancy and postpartum: findings from the cross-sectional WHO pilot study i
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(2020) 20:518
RESEARCH ARTICLE
Open Access
Measurement of maternal functioning during pregnancy and postpartum: findings from the cross-sectional WHO pilot study in Jamaica, Kenya, and Malawi Jenny A. Cresswell1*, Kelli D. Barbour2, Doris Chou1, Affette McCaw-Binns3, Veronique Filippi4, Jose Guilherme Cecatti5, Maria Barreix1, Max Petzold6, Nenad Kostanjsek7, Sara Cottler-Casanova8,9 and Lale Say1
Abstract Background: The World Health Organization’s definition of maternal morbidity refers to “a negative impact on the woman’s wellbeing and/or functioning”. Many studies have documented the, mostly negative, effects of maternal ill-health on functioning. Although conceptually important, measurement of functioning remains underdeveloped, and the best way to measure functioning in pregnant and postpartum populations is unknown. Methods: A cross-sectional study among women presenting for antenatal (N = 750) and postpartum (N = 740) care in Jamaica, Kenya and Malawi took place in 2015–2016. Functioning was measured through the World Health Organization Disability Assessment Schedule (WHODAS-12). Data on health conditions and socio-demographic characteristics were collected through structured interview, medical record review, and clinical examination. This paper presents descriptive data on the distribution of functioning status among pregnant and postpartum women and examines the relationship between functioning and health conditions. Results: Women attending antenatal care had a lower level of functioning than those attending postpartum care. Women with a health condition or associated demographic risk factor were more likely to have a lower level of functioning than those with no health condition. However, the absolute difference in functioning scores typically remained modest. Conclusions: Functioning is an important concept which integrates a woman-centered approach to examining how a health condition affects her life, and ultimately her return to functioning after delivery. However, the WHODAS-12 may not be the optimal tool for use in this population and additional components to capture pregnancy-specific issues may be needed. Challenges remain in how to integrate functioning outcomes into routine maternal healthcare at-scale and across diverse settings. Keywords: WHODAS, maternal health, health-related functioning, health-related quality of life, activities of daily living
* Correspondence: [email protected] 1 Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, UNDP UNFPA UNICEF WHO World Bank Special Programme of Research, World Health Organization, Geneva, Switzerland Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide
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