{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T18:05:46Z","timestamp":1784225146825,"version":"3.55.0"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100015381","name":"Instituto Nacional De Salud P\u00fablica","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015381","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>\n                    Ensuring high-quality care during pregnancy, childbirth, postpartum, and the newborn period is essential for reducing maternal and neonatal morbidity and mortality. In Mexico, a significant gap exists in comprehensive, culturally relevant instruments to assess quality of care (QoC) across these critical stages. This study aimed to develop robust, context-specific instruments to evaluate key dimensions of maternal and neonatal care, including patient experience, clinical processes, and hospital infrastructure. Using a modified Delphi method, we conducted two national workshops with 78 unique national experts, including academic researchers, healthcare decision-makers, and maternal health advocates. In Workshop 1, 45 experts identified 1,162 QoC indicators, which our research team subsequently reduced to 521 through a systematization process. Workshop 2 engaged 62 experts\u2013approximately 20% of whom had also participated in Workshop 1\u2013who discussed and rated the 521 indicators. Based on these expert ratings, our research team conducted a subsequent systematization, which further reduced the list to 489 QoC indicators. The final 489 indicators were categorized into five core QoC domains (i.e.,\n                    <jats:italic>Woman, Care Processes, Health Personnel, Infrastructure, and Supplies and Medications<\/jats:italic>\n                    ) and used to develop three instruments (1) a\n                    <jats:italic>Semi-Structured Interview Guide<\/jats:italic>\n                    to explore women\u2019s care experiences; (2) a\n                    <jats:italic>Childbirth Observation Instrument<\/jats:italic>\n                    to assess QoC during labor and immediate postpartum care, including sociodemographic details, facility characteristics, clinical processes, and adherence to best practices, and (3) a\n                    <jats:italic>Hospital Information Instrument<\/jats:italic>\n                    to gather data on infrastructure, personnel, supplies, medications, and service utilization. These instruments offer a rigorous, context-specific framework for evaluating maternal and neonatal QoC in Mexico, helping identify gaps, guide improvements, and promote health equity. They address a critical need by providing tailored tools with strong potential to inform practice and improve outcomes.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0352347","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T17:31:16Z","timestamp":1784223076000},"page":"e0352347","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Developing comprehensive perinatal quality of care instruments in Mexico: An inclusive, multidisciplinary, and culturally sensitive approach"],"prefix":"10.1371","volume":"21","author":[{"given":"Jimena","family":"Fritz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8437-2113","authenticated-orcid":true,"given":"Pablo","family":"Montero-Zamora","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6183-7750","authenticated-orcid":true,"given":"Cara B.","family":"Safon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Mart\u00ednez-Garrido","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Sachse-Aguilera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hern\u00e1n","family":"Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Sesia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaela","family":"Schiavon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-8399","authenticated-orcid":true,"given":"H\u00e9ctor","family":"Lamadrid-Figueroa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"issue":"8","key":"pone.0352347.ref001","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1111\/1471-0528.13451","article-title":"Quality of care for pregnant women and newborns-the WHO vision","volume":"122","author":"\u04e6 Tun\u00e7alp","year":"2015","journal-title":"BJOG"},{"key":"pone.0352347.ref002","unstructured":"World Health Organization. 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