Influential factors in patient uptake of influenza vaccination during pregnancy; a survey-based audit in a tertiary hospital setting.

AIM: The aim of this study was to determine the key influential factors for pregnant or recently pregnant women in deciding on influenza vaccination. METHOD: This study was conducted in a single tertiary hospital in New Zealand using an anonymous and voluntary patient survey. Ethnicity, age and stage of pregnancy along with self-reported data on factors that influenced the decision to vaccinate against influenza during pregnancy were recorded. RESULTS: We included 101 participants over the one-week study period, 76% of whom had received the influenza vaccination. The most commonly reported reason for vaccination was the desire for neonatal protection, the common reasons for not being vaccinated were not receiving information on vaccination or safety concerns. CONCLUSION: There are a variety of factors influencing women when deciding on antenatal influenza vaccination. Further studies are needed to expand on the findings of this small local study in order to be able to improve vaccination uptake through empathetic delivery of evidence-based recommendations.

What are women saying about noninvasive prenatal testing? An analysis of online pregnancy discussion forums.

OBJECTIVE: The aim of this study was to explore what women are saying about noninvasive prenatal testing (NIPT) in online discussion forums. METHODS: Inductive thematic analysis of content from 13 open-access discussion forums written in English from 11 popular maternity websites from four different countries (the United Kingdom, United States, New Zealand, and Australia) between 2013 to 2017 (n = 127 women). RESULTS: The forums were a space where women were provided with emotional support and advice in making their decision about NIPT as screening option. Justifications were made for paying for NIPT with terminology echoing commercial advertising "price was high … well worth the peace of mind." Paying for NIPT was referred to as a shopping exercise to find the "best deal." Women in the United States often talked about having to choose between NIPT and a scan because their insurance "won't pay for both." Commercial influence on maternity care providers' preference for different brands of NIPT was evident: "my doctor only uses [brand]. He said it's the best one on the market." CONCLUSION: Our findings highlight women's need for experiential information in prenatal screening counselling and how NIPT commercialization influences both routinized perspectives, and access, which may affect informed choice and best evidence screening practice.

Scorecards for health system performance assessment: the New Zealand example.

OBJECTIVE: To develop a national scorecard for assessing health system performance derived from routine data. METHODS: We drew upon national and international data to develop benchmarks for health system performance, then applied basic ratio scores to compare New Zealand performances to the benchmark. 64 indicators were included in four assessment categories: healthy lives, quality, access, and efficiency. In a fifth category, 27 of these indicators were used to score health system equity. Indicator scores in each category were then averaged to give a health system score out of 100. RESULTS: New Zealand's health system achieved an overall score of 71 out of 100. The system scored relatively well on quality and efficiency, but poorly on equity despite considerable government investment in reducing inequalities. CONCLUSIONS: The scorecard offers a useful method for combining a range of data to give an overall picture of health system performance, highlighting strengths, weaknesses and areas for improvement. This initial study provides a baseline for assessing New Zealand's performance over time and, where data permit, a template for other countries to follow.