PMID- 32620403
OWN - NLM
STAT- MEDLINE
DCOM- 20210728
LR  - 20210728
IS  - 1872-6054 (Electronic)
IS  - 0168-8510 (Linking)
VI  - 124
IP  - 11
DP  - 2020 Nov
TI  - The rising impact of civic activism on health policy: The analysis of the closure 
      of smaller obstetric units in Estonia.
PG  - 1239-1244
LID - S0168-8510(20)30165-2 [pii]
LID - 10.1016/j.healthpol.2020.06.011 [doi]
AB  - In 2017, the Estonian government performed an administrative reform with the 
      promise to keep vital services available for people. In March 2018, the closure 
      of two smaller obstetrics units (OU) was announced, thereby raising resistance by 
      community members. The aim of the research is to identify public perceptions and 
      information needs during the closure process of smaller maternity units, and 
      examine it in the context of recently performed administrative reform. Data was 
      collected from 226 respondents via a web-based questionnaire. To evaluate the 
      level of information seeking activity for pregnancy- and birth-giving-related 
      information, new aggregated index variables were constructed. For authorities and 
      lay-people "near home" and "safety" had different meanings in the context of 
      childbirth. Findings revealed strong correlations between perceived information 
      availability and sufficiency (for pregnancy, birth-giving and transfer to the 
      hospital). The subjective lack of information appeared in recognition of the 
      start of the labour and how, when, and where to go. Respondents considered both 
      the medical capability and personal aspects to be equally important. Considering 
      the lack of knowledge and hesitancy among Estonians, the arguments of civic 
      activists presented in the debate were well-grounded. To conclude, public 
      communication must be consistent and people need clearer instructions for 
      activities related to labour-period and security that necessary features of 
      medical help and personal approach to be both available.
CI  - Copyright (c) 2020 The Authors. Published by Elsevier B.V. All rights reserved.
FAU - Lubi, Kadi
AU  - Lubi K
AD  - Tallinn Health Care College, Health Education Center, Kannu 67, 13418 Tallinn, 
      Estonia. Electronic address: kadi.lubi@ttk.ee.
FAU - Uibu, Marko
AU  - Uibu M
AD  - University of Tartu, Institute of Social Studies, Lossi 36, 51003 Tartu, Estonia. 
      Electronic address: marko.uibu@ut.ee.
FAU - Koppel, Katre
AU  - Koppel K
AD  - University of Tartu, Institute of Cultural Research, Ulikooli 16, 51003 Tartu, 
      Estonia. Electronic address: katre.koppel@ut.ee.
FAU - Mets-Oja, Silja
AU  - Mets-Oja S
AD  - Tallinn Health Care College, Health Education Center, Kannu 67, 13418 Tallinn, 
      Estonia.
LA  - eng
PT  - Journal Article
DEP - 20200627
PL  - Ireland
TA  - Health Policy
JT  - Health policy (Amsterdam, Netherlands)
JID - 8409431
MH  - Delivery, Obstetric
MH  - Estonia
MH  - Female
MH  - Health Policy
MH  - Hospitals
MH  - Humans
MH  - *Maternal Health Services
MH  - *Obstetrics
MH  - Pregnancy
OTO - NOTNLM
OT  - Access
OT  - Civic activism
OT  - Estonia
OT  - Information needs
OT  - Maternal care
OT  - Obstetric unit centralization
COIS- Declaration of Competing Interest The authors declare that they have no competing 
      interests.
EDAT- 2020/07/06 06:00
MHDA- 2021/07/29 06:00
CRDT- 2020/07/05 06:00
PHST- 2019/06/06 00:00 [received]
PHST- 2020/02/18 00:00 [revised]
PHST- 2020/06/19 00:00 [accepted]
PHST- 2020/07/06 06:00 [pubmed]
PHST- 2021/07/29 06:00 [medline]
PHST- 2020/07/05 06:00 [entrez]
AID - S0168-8510(20)30165-2 [pii]
AID - 10.1016/j.healthpol.2020.06.011 [doi]
PST - ppublish
SO  - Health Policy. 2020 Nov;124(11):1239-1244. doi: 10.1016/j.healthpol.2020.06.011. 
      Epub 2020 Jun 27.