Improving maternity care in the Dominican Republic: a pilot study of a community-based participatory research action plan by an international healthcare team.

This article is a report of the process and results of a feasibility pilot study to improve the quality of maternity care in a sample of 31 women and their newborns delivering in a public, tertiary hospital in the Dominican Republic. The pilot study was the first "action step" taken as a result of a formative, community-based participatory research (CBPR) study conducted between 2008 and 2010 by an interdisciplinary, international partnership of U.S. academic researchers, Dominican medical/nursing personnel, and Dominican community health workers. Health personnel and community health workers separately identified indicators most important to measure quality of antepartum maternity care: laboratory and diagnostic studies and respectful, interpersonal communication. At the midpoint and the completion of data collection, the CBPR team evaluated the change in quality indicators to assess improvement in care. The pilot study supports the idea that joint engagement of community health workers, health personnel, and academic researchers with data creation and patient monitoring is motivating for all to continue to improve services in the cultural context of the Dominican Republic.

Community-based participatory research and the challenges of qualitative analysis enacted by lay, nurse, and academic researchers.

There are multiple challenges in adhering to the principles of community-based participatory research (CBPR), especially when there is a wide range of academic preparation within the research team. This is particularly evident in the analysis phase of qualitative research. We describe the process of conducting qualitative analysis of data on community perceptions of public maternity care in the Dominican Republic, in a cross-cultural, CBPR study. Analysis advanced through a process of experiential and conversational learning. Community involvement in analysis provided lay researchers an imperative for improvements in maternity care, nurses a new perspective about humanized care, and academic researchers a deeper understanding of how to create the conditions to enable conversational learning.