PowerPointpresentatie

1
The Future of Primary Health Care in Europe
(II)Promoting co-operation, collaboration and
organisation Southampton, 15-17 September 2008
Maternity care assistants (MCA) in the
Netherlands
Therese A. Wiegers, PhD.
2
Structure of this presentation

• Some international data
• Birth in the Netherlands
• Professionals in maternity care
• Maternity care assistance

3
Infant mortality rate, deaths per 1,000 live
births in 1970 and 2006 ( 2005, 2004)
Source OECD Health Data 2008
4
Cesarean section ratein 1990 and latest
available year
Source OECD Health Data 2006, 2008
5
Number of home births and hospital births in the
Netherlands since 1965
Source CBS / TNO
6

• Professionals involved in obstetrics and
  maternity care
• Midwives (primary and secondary care)
• Gynaecologists
• General practitioners
• Paediatricians
• Maternity care assistants

7
What is maternity care assistance

• Care for the mother and the new baby
• during and after the birth
• for up to eight consecutive days
• for an average of 5 hours a day

8
What is maternity care assistance

• Tasks during and immediately after birth
• Assisting the midwife or GP during birth
• Supporting the woman during birth
• Giving nursing care immediately afterwards
• Cleaning the bedroom / bathroom

9
What is maternity care assistance

• Tasks in the days following the birth
• Taking care of the new mother, making sure she
  gets
• enough rest
• Taking care of the newborn infant
• Giving information and instruction on
  (breast)feeding
• Giving information and instruction on baby
  care
• Guaranteeing hygiene during the postpartum
  period
• Doing (some) household tasks

10
Who receives maternity care assistance

• Women giving birth at home, assisted by
  a midwife or GP
• Women giving birth in hospital,
  assisted by a midwife or GP, returning home the
  same day or the next
• Women giving birth in hospital,
  assisted by a gynaecologist or hospital midwife,
  and returning home within 8 days

All pregnant women can apply for and are
entitled to maternity care assistance
11

• The advantages of the MCA being present in the
  household are
• The MCA can make sure the mother gets enough rest
• The MCA can observe the interaction between the
  mother and her baby and react immediately
• The MCA can give information and instruction on
  (breast)feeding and baby care at relevant moments
• The MCA can observe the physical and
  psychological condition of the mother and baby
  and report to the midwife or GP

12
Vocational training of the maternity care
assistant

• Many different routes to become MCA
• 3-year course to become a care worker,
  only specialising in maternity care assistance
  during the last year
• 3-year in-service training as care worker, with
  special training in maternity care assistance
• abbreviated course for maternity care assistant,
  12-18 months
• re-training course for care workers from other
  fields

13
Who is maternity care assistant

• Profile
• average age of MCA is 44,5 years
• average age at qualification was 28
  years
• average work experience is 12.6 years
• one in three stopped working for an
  average duration of 11 years
• most prominent reasons to stop working
  pregnancy, raising children or marriage

14
Age distribution of MCA
15
Age distribution of MCA at the time they filled
in the questionnaire, at the time they started
working as MCA and at the time they stopped
working as MCA
16
Work arrangements of MCA
17
MCAs opinion about their work
18
Plans to keep working or stop working, for all
respondents and for different age groups
on average 60 years
19
Summary

• The job of an MCA is
• highly satisfactory
• but
• mostly part time
• often insecure
• at irregular times
• Making it less appealing to young women, who
  prefer a full time, secure job.

20
Conclusion

• the profession of MCA is relatively old, leading
  to a large number leaving the coming years
• almost a third of MCAs have contracts without
  fixed working hours
• the way the work is organized is not very
  attractive to young people
• this will lead to a new shortage of maternity
  care assistants
• which will ultimately threaten the maternity care
  system in the Netherlands.