Improving apgar scores and reducing perineal injuries through midwife-led quality improvements: an observational study in Uganda.

Background: Globally, the quality of maternal and newborn care remains inadequate, as seen through indicators like perineal injuries and low Apgar scores. While midwifery practices have the potential to improve care quality and health outcomes, there is a lack of evidence on how midwife-led initiatives, particularly those aimed at improving the use of dynamic birth positions, intrapartum support, and perineal protection, affect these outcomes.

Objective: To explore how the use of dynamic birth positions, intrapartum support, and perineal protection impact the incidence of perineal injuries and the 5-min Apgar score within the context of a midwife-led quality improvement intervention.

The understanding of dynamic birth positions for women in labor and childbirth - A hybrid concept analysis.

Problem And Background: The assessment of advantages and drawbacks associated with varying birthing positions has predominantly centered around medical or technical considerations and few studies have accounted for a woman's ability to attune to her bodily instincts during labor and birth. The objective of this study was to define the concept of dynamic birth positions and its significance within the birthing process.

Methods: This hybrid concept analysis consisted of three phases: theoretical, fieldwork, and analytical.

Midwife-led quality improvement: Increasing the use of evidence-based birth practices in Uganda.

Background: Addressing the evidence-to-practice gap in midwifery is vital for improving maternal and newborn health outcomes. Despite the potential of involving midwives in quality improvement interventions to address this gap, such interventions are understudied. In a Ugandan urban hospital, midwifery practices with a significant evidence-to-practice gap have been identified as areas for clinical improvement.

Municipality-level differences in disability retirement in Finland: The contribution of local social characteristics.

Aims: Large differences exist in the risk of disability retirement between Finnish municipalities. This study examined whether individual-level and municipality-level characteristics explain these differences and which municipality-level characteristics are particularly important for the risk of disability retirement.

Methods: Individual-level register data were supplemented with 10 municipality-level characteristics from various databases.

Putting co-creation into practice: lessons learned from developing a midwife-led quality improvement intervention.

Background: Integrating evidence-based midwifery practices improves healthcare quality for women and newborns, but an evidence-to-practice gap exists. Co-created quality improvement initiatives led by midwives could bridge this gap, prevent resource waste and ensure intervention relevance. However, how to co-create a midwife-led quality improvement intervention has not been scientifically explored.

Identifying user profiles of healthcare, social and employment services in a working-age population: A cluster analysis with linked individual-level register data from Finland.

A thorough understanding of the use of services in the population is important in order to comprehend the varying service needs of different groups. This explorative study aimed to find distinct user profiles in a working-age population based on individuals' annual use of healthcare, social and employment services and to explore socio-demographic and morbidity-related predictors of the user groups. Administrative register data on the use of various services and individual-level covariates from year 2018 were linked for all residents aged 18-64 of the municipality of Oulu, Finland (N = 119,740).

Labour market trajectories after part-time sickness absence: a nationwide cohort study from Finland.

Objectives: The use of part-time sickness absence (pSA) enables return to part-time work from full sickness absence. However, subsequent labour market outcomes of pSA users depend on various individual and work-related characteristics. We investigated labour market paths of private and public sector employees after having a pSA spell.

Impact of a Finnish reform adding new sickness absence checkpoints on rehabilitation and labor market outcomes: an interrupted time series analysis.

Objectives: In 2012, new checkpoints were introduced in the Finnish sickness absence system to improve early detection of long-term work disability and hasten return to work after illness. We examined whether the reform affected participation in rehabilitation and labor market outcomes over a one-year period.

Methods: We used interrupted time series analysis among persons who started receiving sickness allowance up to three years before and up to two years after the reform.

Costs and intermediate outcomes for the implementation of evidence-based practices of midwifery under a MIDWIZE framework in an urban health facility in Nairobi, Kenya.

Background: Three evidence-based midwife-led care practices: dynamic birth positions (DBP), immediate skin-to-skin contact (SSC) with zero separation between mother and newborn, and delayed cord clamping (DCC), were implemented in four sub-Saharan African countries after an internet-based capacity building program for midwifery leadership in quality improvement (QI). Knowledge on costs of this QI initiative can inform resource mobilization for scale up and sustainability.

Methods: We estimated the costs and intermediate outcomes from the implementation of the three evidence-based practices under the midwife-led care (MIDWIZE) framework in a single facility in Kenya through a pre- and post-test implementation design.

Use of outpatient healthcare services before and after the onset of unemployment: A register-based propensity score matched study from Finland.

Aims: The aim was to examine the use of outpatient healthcare services in different sectors of healthcare before and after the onset of unemployment and to study whether job loss affected the use of these services.

Methods: Longitudinal individual-level register-based data was utilized on all individuals living in the City of Oulu, Finland, who became unemployed in 2017 (N = 1,999), their propensity matched controls (N = 1,999), and unmatched controls (N = 58,459) in a quasi-experimental design. Use of outpatient healthcare services was examined in one-month periods from 12 months before to 12 months after the onset of unemployment.

Maternal health leaders' perceptions of barriers to midwife-led care in Ethiopia, Kenya, Malawi, Somalia, and Uganda.

Objective: To identify and examine barriers to midwife-led care in Eastern Africa and how these barriers can be reduced DESIGN: A qualitative inductive study with online focus group discussions and semi-structured interviews using content analysis SETTING: The study examines midwife-led care in Ethiopia, Malawi, Kenya, Somalia, and Uganda -five African countries with an unmet need for midwives and a need to improve maternal and neonatal health outcomes.

Participants: Twenty-five participants with a health care profession background and current position as a maternal and child health leader from one of the five study countries.

Findings: The findings demonstrate barriers to midwife-led care connected to organisational structures, traditional hierarchies, gender disparities, and inadequate leadership.

Use of Health Services and Rehabilitation before and after the Beginning of Long-Term Sickness Absence-Comparing the Use by Employment and Disability Pension Transition after the Sickness Absence in Finland.

The objective of the study was to follow the health care and rehabilitation use before, during and after long-term sickness absence (LTSA), and to compare the use by post-LTSA labour market situation in terms of disability pension and employment. Individuals aged 18-58 with a ≥30-day LTSA spell in 2015 ( = 2427) were included from the total population of the city of Oulu, Finland. Register data included LTSA spells, outpatient health care visits, inpatient care spells and rehabilitation spells, disability pensions (DP), employment dates, and demographic, socioeconomic and disability-related covariates.

Use of outpatient and inpatient health care services by occupation-a register study of employees in Oulu, Finland.

Background: The aim of this study was to examine how the use of outpatient and inpatient health services differs by occupational groups, and whether the differences are explained by sociodemographic factors and health status.

Methods: We used register-based data on 25-64-year-old employees living in the city of Oulu, Finland, in 2018 (N = 61,848). Use of outpatient health care services (public, private and occupational health care) among men and women was analysed with negative binomial regression models, and use of inpatient health care with logistic regression models, using two occupational classifications: occupational group (1-digit level) and more detailed occupation (2-digit level).

Outpatient healthcare use before and during a long-term sickness absence spell: a register-based follow-up study comparing healthcare use by the length of sickness absence and transition to disability pension in Finland.

Objectives: The objective of the study was to examine outpatient healthcare use before and during a long-term sickness absence (LTSA), and to compare the development of healthcare use between groups defined through LTSA lengths and disability pension (DP) transition.

Design: Register-based longitudinal study with five 6-month periods before and after the start of the LTSA spell in early 2016.LTSA groups 1 (N=210) and 2 (N=187) went on to reach the statutory maximum LTSA length, with group 1 transitioning to DP.

Associations of Medical Visits with Dentist Visits: A Register-Linkage Study of a Working-Age Population in Finland.

Studies have usually addressed the utilization of either medical or dental services, and less is known about how medical and dentist visits are associated. As oral health is linked to systemic health, knowledge on care coordination between dental and medical services is important to gain understanding of the overall functioning of health care. Register data on 25-64-year-old residents of the city of Oulu, Finland, were used for the years 2017-2018 (N = 91,060).

Implementing an internet-based capacity building program for interdisciplinary midwifery-lead teams in Ethiopia, Kenya Malawi and Somalia.

Unlabelled: The Swedish care model MIDWIZE defined as midwife-led interdisciplinary care and zero separation between mother and newborn, was implemented in 2020-21 in Ethiopia, Kenya, Malawi, and Somalia in a capacity building programme funded by the Swedish Institute.

Objective: To determine the feasibility of using an internet-based capacity building programme contributing to effective midwifery practices in the labour rooms through implementation of dynamic birthing positions, delayed umbilical cord clamping and skin-to-skin care of newborns in the immediate postnatal period.

Methods: The design is inspired by process evaluation.

Socioeconomic differences in utilization of public and private dental care in Finland: Register-based evidence on a population aged 25 and over.

Dental care utilization is known to have a strong socioeconomic gradient, with lower socioeconomic groups utilizing less of these services despite having poorer dental health. However, less is known about the utilization of dental services in the population concurrently in the public and private sectors in different socioeconomic groups. Additionally, evidence on how different sectors contribute to the overall socioeconomic gradient in dental care utilization is scarce.

Changes in Unemployment Affect Sickness Absence and Disability Retirement Rates: A Municipality-Level Panel Study.

To enhance understanding of the interplay between unemployment and sickness absence and disability retirement, the aim of this study was to examine how changes in area-level unemployment rates are associated with changes in sickness absence and disability retirement rates in a longitudinal setting. Municipality-level time-series data were collected on unemployment, sickness absence, disability retirement and covariates from databases for Finnish municipalities for years 2003-2017 ( = 4425 municipality-year observations). Fixed effects panel regression models were used to analyse how changes in unemployment rates predict changes in sickness absence and disability retirement rates when comparing consecutive years.

Frequent attenders of three outpatient health care schemes in Finland: characteristics and association with long-term sickness absences, 2016-2018.

Objectives: Frequent attenders (FAs) impose a significant burden on service capacity and public health funding. Although the characteristics of the group and their risk for sickness absences (SA) have been studied, an understanding of FAs in different health care schemes is lacking. The aim of the study was to investigate FAs and their SA risk in the working-age population in public care, occupational health services (OHS) and private care schemes.

Increase in sickness absence due to mental disorders in Finland: trends by gender, age and diagnostic group in 2005-2019.

Aims: Mental disorders are among the key public health challenges and cause a significant share of sickness absence. The aim of this study was to examine gender and age-specific trends in sickness absence in Finland among non-retired persons aged 16-67 years during 2005-2019 by main diagnostic groups. Special focus was put on the development of sickness absence due to mental and behavioural disorders.