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Background <p>High-quality postnatal care (PNC), including Person-centered postnatal care (PCPNC), is essential to achieving optimal maternal and neonatal outcomes. PCPNC refers to postnatal care that is respectful of and responsive to postpartum women’s preferences, needs, and values. While interest in person-centered care across the reproductive health continuum has increased, there are no validated tools to comprehensively measure PCPNC. This study aimed to develop and validate a tool to comprehensively measure PCPNC that is relevant to the experiences of women in low- and middle-income countries (LMICs).</p> Methods <p>The adaptation and validation process included a literature review to define the construct and develop the scale items. This was followed by expert reviews with maternal health experts, healthcare providers, and women with past postnatal care experience to assess content validity. We then conducted cognitive interviews with postpartum women to ensure the questions were relevant, clear, and understandable. We iteratively revised the questions at each stage and surveyed 268 postpartum women (who gave birth within the last six months) in the Upper East Region of Ghana for initial analysis. We then analyzed the data, which informed additional edits to the questions. The final questions were administered in a survey to 1,394 women in Ghana and Kenya who had received postnatal care within 12 weeks postpartum. Psychometric analysis was employed for item reduction and to assess construct and criterion validity, as well as internal consistency reliability.</p> Results <p>Following iterative factor analysis, we developed a 38-item PCPNC scale. The 38 items load onto one dominant factor, with three factors having eigenvalues greater than one and a Cronbach’s alpha of 0.93. We grouped the items into three conceptual domains, representing the “dignity and respect,” “communication and autonomy,” and “responsive and supportive care” subscales, each of which has a Cronbach’s alpha &gt; 0.7. PCPNC scores are associated with satisfaction with PNC and intent to receive PNC in the same health facility in the future, suggesting good criterion validity.</p> Conclusions <p>The PCPNC scale is a valid and reliable tool for measuring respectful and responsive PNC, and will thus facilitate efforts to monitor and improve the experiences of mothers and their babies during PNC.</p>

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Development and validation of the person-centered postnatal care scale for low- and middle-income countries

  • 期刊论文

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  • 发表日期：

    2026年4月11日

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  • Patience A. Afulani,
  • Anthony Gerald Akanlu,
  • Hawa Malechi,
  • Moro Ali,
  • Osamuedeme J. Odiase,
  • Jaffer Okiring,
  • Beryl Ogolla,
  • Joyceline Kinyua,
  • Linnet Ongeri,
  • Özge Tunçalp,
  • Raymond A. Aborigo

摘要

Background

High-quality postnatal care (PNC), including Person-centered postnatal care (PCPNC), is essential to achieving optimal maternal and neonatal outcomes. PCPNC refers to postnatal care that is respectful of and responsive to postpartum women’s preferences, needs, and values. While interest in person-centered care across the reproductive health continuum has increased, there are no validated tools to comprehensively measure PCPNC. This study aimed to develop and validate a tool to comprehensively measure PCPNC that is relevant to the experiences of women in low- and middle-income countries (LMICs).

Methods

The adaptation and validation process included a literature review to define the construct and develop the scale items. This was followed by expert reviews with maternal health experts, healthcare providers, and women with past postnatal care experience to assess content validity. We then conducted cognitive interviews with postpartum women to ensure the questions were relevant, clear, and understandable. We iteratively revised the questions at each stage and surveyed 268 postpartum women (who gave birth within the last six months) in the Upper East Region of Ghana for initial analysis. We then analyzed the data, which informed additional edits to the questions. The final questions were administered in a survey to 1,394 women in Ghana and Kenya who had received postnatal care within 12 weeks postpartum. Psychometric analysis was employed for item reduction and to assess construct and criterion validity, as well as internal consistency reliability.

Results

Following iterative factor analysis, we developed a 38-item PCPNC scale. The 38 items load onto one dominant factor, with three factors having eigenvalues greater than one and a Cronbach’s alpha of 0.93. We grouped the items into three conceptual domains, representing the “dignity and respect,” “communication and autonomy,” and “responsive and supportive care” subscales, each of which has a Cronbach’s alpha > 0.7. PCPNC scores are associated with satisfaction with PNC and intent to receive PNC in the same health facility in the future, suggesting good criterion validity.

Conclusions

The PCPNC scale is a valid and reliable tool for measuring respectful and responsive PNC, and will thus facilitate efforts to monitor and improve the experiences of mothers and their babies during PNC.