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Transforming maternity care: obstetric partnerships as a policy instrument for integration


  • Lips, S.R.
  • Molenaar, J.M.
  • Schuitmaker-Warnaar, T.J.


Increasing continuity in Dutch maternity care is considered pivotal to improve safety and client-centeredness. Closer collaboration between the historically relatively autonomous professionals and organizations in maternity care is deemed conditional to reach this goal, both by maternity care professionals and policy makers. Governmental policy therefore strives for organizational and financial integration. One of the policy measures has been to stimulate interprofessional and interorganizational collaboration through local obstetric partnerships. This study aimed to gain insight into whether this policy measure supported professionals in reaching the policy aim of increasing integration in the maternity care system. We therefore conducted 73 semistructured interviews with maternity care professionals in the region Northwest Netherlands, from 2014 to 2016. Respondents expressed much willingness to intensify interprofessional and interorganizational collaboration and experienced obstetric partnerships as contributing to this. As such, stimulating integration through obstetric partnerships can be considered a suitable policy measure. However, collaborating within the partnerships simultaneously highlighted deep-rooted dividing structures (organizational, educational, legal, financial) in the maternity care system, especially at the systemic level. These were experienced to hinder collaboration, but difficult for the professionals to influence, as they lacked knowledge, skills, resources and mandate. A lack of clear and timely guidance and support from policy, counterbalancing these barriers, limited partnerships' potential to unify professionals and integrate their services.

Suggested Citation

  • Lips, S.R. & Molenaar, J.M. & Schuitmaker-Warnaar, T.J., 2020. "Transforming maternity care: obstetric partnerships as a policy instrument for integration," Health Policy, Elsevier, vol. 124(11), pages 1245-1253.
  • Handle: RePEc:eee:hepoli:v:124:y:2020:i:11:p:1245-1253
    DOI: 10.1016/j.healthpol.2020.05.019

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    References listed on IDEAS

    1. Schuitmaker, Tjerk Jan, 2012. "Identifying and unravelling persistent problems," Technological Forecasting and Social Change, Elsevier, vol. 79(6), pages 1021-1031.
    2. de Vries, Eline F. & Drewes, Hanneke W. & Struijs, Jeroen N. & Heijink, Richard & Baan, Caroline A., 2019. "Barriers to payment reform: Experiences from nine Dutch population health management sites," Health Policy, Elsevier, vol. 123(11), pages 1100-1107.
    3. Mur-Veeman, Ingrid & van Raak, Arno & Paulus, Aggie, 2008. "Comparing integrated care policy in Europe: Does policy matter," Health Policy, Elsevier, vol. 85(2), pages 172-183, February.
    4. Schut, Frederik T. & Varkevisser, Marco, 2017. "Competition policy for health care provision in the Netherlands," Health Policy, Elsevier, vol. 121(2), pages 126-133.
    5. Exworthy, Mark & Powell, Martin & Glasby, Jon, 2017. "The governance of integrated health and social care in England since 2010: great expectations not met once again?," Health Policy, Elsevier, vol. 121(11), pages 1124-1130.
    6. Stokes, Jonathan & Struckmann, Verena & Kristensen, Søren Rud & Fuchs, Sabine & van Ginneken, Ewout & Tsiachristas, Apostolos & Rutten van Mölken, Maureen & Sutton, Matt, 2018. "Towards incentivising integration: A typology of payments for integrated care," Health Policy, Elsevier, vol. 122(9), pages 963-969.
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    Cited by:

    1. Tjerk Jan Schuitmaker-Warnaar & Callum J. Gunn & Barbara J. Regeer & Jacqueline E. W. Broerse, 2021. "Institutionalizing Reflexivity for Sustainability: Two Cases in Health Care," Sustainability, MDPI, vol. 13(21), pages 1-19, October.

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