Background
Midwifery in Belgium
Planning for healthcare professionals in Belgium
Methods
The Robust Workforce Planning Framework
Application of the Robust Workforce Planning Framework for the simulation of demand for the Belgian midwifery
Horizon scanning
Scenario generation
Generation of narrative scenarios for the future midwifery practice
Quantification of all parameters included in the scenarios
Results
Horizon scanning
Narrative scenarios for the future midwifery practice
Impact of the scenarios on demand for midwifery care
2011 | 2016 | 2021 | 2026 | 2031 | 2036 | 2041 | 2011–2016 Source | Projection |
---|---|---|---|---|---|---|---|---|
Number of hospital stays involving childbirth | ||||||||
125,150 | 122,458 | 124,867 | 126,487 | 125,726 | 127,864 | 129,434 | ||
Proportion of moderate- to high-risk pregnancies | ||||||||
17.5% | 23.3% | 28.7% | 34.1% | 34.1% | 34.1% | 34.1% | IMA-AIM | Linear until 2026 then constant |
Proportion of the population living in a household with an equivalent disposable income below the poverty threshold | ||||||||
15.3% | 15.9% | 16.0% | 16.4% | 16.4% | 16.4% | 16.4% | Linear until 2026 then constant | |
Proportion of multiparous pregnancies | ||||||||
55.2% | 56.3% | 58.4% | 60.0% | 60.0% | 60.0% | 60.0% | Linear until 2026 then constant | |
Length of the first individual obstetrical session (all risk levels) | ||||||||
52 min | Elicitation | Constant | ||||||
Length of the following individual obstetrical sessions for low-risk pregnancies | ||||||||
30 min | Elicitation | Constant | ||||||
Length of the following individual obstetrical sessions for moderate- to high-risk pregnancies (including sessions specific to at-risk pregnancies) | ||||||||
35 min | Elicitation | Constant | ||||||
Additional length of the individual obstetrical sessions in the event of socioeconomic vulnerability | ||||||||
15 min | Elicitation | Constant | ||||||
Average number of additional sessions of preparation for birth and parenthood education in the case of socioeconomic vulnerability | ||||||||
1.0 | 2.0 | 2.0 | 2.0 | 2.0 | Elicitation | Elicitation | ||
Length of the individual sessions of birth preparation and parenthood education | ||||||||
60 min | Elicitation | Constant | ||||||
Length of the group sessions of birth preparation and parenthood education | ||||||||
120 min | Elicitation | Constant | ||||||
Average number of participants in the group sessions | ||||||||
7 | Elicitation | Elicitation | ||||||
Weighting coefficient applied to the days of hospitalisation (severity level 1) | ||||||||
Day 1: 155; day 2: 129; day 3: 92; day 4: 84; day 5 and following: 77 | ULB, School of Public Health (PACHA) [20] | Constant | ||||||
Weighting coefficient applied to the days of hospitalisation (severity level 2) | ||||||||
Day 1: 140; day 2: 144; day 3: 97; day 4: 86; day 5 and following: 82 | ULB, School of Public Health (PACHA) [20] | Constant | ||||||
Weighting coefficient applied to the days of hospitalisation (severity levels 3 and 4) | ||||||||
Day 1: 172; day 2: 156; day 3: 118; day 4: 108; day 5 and following: 105 | ULB, School of Public Health (PACHA) [20] | Constant | ||||||
Average number of postnatal follow-up and care services until the 5th day postpartum | ||||||||
0.3 | 0.8 | 1/day | Econodat and IMA-AIM | Elicitation | ||||
Average number of postnatal follow-up and care services due to complication | ||||||||
0.1 | 0.1 | 0.1 | Econodat and IMA-AIM | Constant | ||||
Average number of breastfeeding consultations | ||||||||
0.2 | 0.4 | 0.4 | Econodat and IMA-AIM | Constant |
2011 | 2016 | 2021 | 2026 | 2031 | 2036 | 2041 | 2011–2016 Source | Projection | |
---|---|---|---|---|---|---|---|---|---|
Average number of individual obstetrical sessions per pregnancy (low-risk) | 1.0 | 1.4 | IMA-AIM | ||||||
• Baseline | 1.4 | 1.4 | 1.4 | 1.4 | 1.4 | Constant | |||
• Scenario A multiparous | 1.6 | 1.8 | 2.2 | 2.6 | 3.0 | Elicitation | |||
Primiparous | 1.8 | 2.2 | 3.0 | 3.4 | 5.0 | Elicitation | |||
• Scenarios B and C multiparous | 1.9 | 2.4 | 3.4 | 4.5 | 6.0 | Elicitation | |||
Primiparous | 2.0 | 2.6 | 4.0 | 5.7 | 8.0 | Elicitation | |||
Average number of individual obstetrical sessions per pregnancy (moderate- to high-risk) | 0.8 | 3.4 | Econodat and IMA-AIM | ||||||
• Baseline and Scenario A | 3.4 | 3.4 | 3.4 | 3.4 | 3.4 | Constant | |||
• Scenarios B and C | 3.0 | 2.7 | 2.3 | 1.9 | 1.6 | Elicitation | |||
Average number of individual sessions on preparation for birth and parenthood education per pregnancy | 0.3 | 0.6 | Econodat and IMA-AIM | ||||||
• Baseline | 0.6 | 0.6 | 0.6 | 0.6 | 0.6 | Constant | |||
• Scenarios A, B and C – Multiparous | 0.7 | 0.7 | 0.8 | 0.9 | 1.0 | Elicitation | |||
– Primiparous | 0.8 | 1.1 | 1.6 | 2.2 | 3.0 | Elicitation | |||
Average number of group sessions of preparation for birth and parenting per pregnancy | 0.3 | 0.4 | Econodat and IMA-AIM | ||||||
• Baseline | 0.4 | 0.3 | 0.4 | 0.4 | 0.4 | Constant | |||
• Scenarios A, B and C – Multiparous | 0.2 | 0.2 | 0.2 | 0.2 | 0.2 | Elicitation | |||
– Primiparous | 0.5 | 0.6 | 0.7 | 0.8 | 0.9 | Elicitation | |||
Average length of stay (number of days) | |||||||||
• Baseline, scenario A and scenario B—examples | |||||||||
o APR-DRG 540 (caesarean) – SOI 1 – 25–34 y | 5.7 | 5.0 | 4.4 | 4.0 | 4.0 | 4.0 | 4.0 | ||
– 35–39 y | 5.7 | 5.1 | 4.5 | 4.1 | 4.1 | 4.1 | 4.1 | ||
o APR-DRG 560 (vaginal) – SOI 1 – 25–34 y | 4.1 | 3.7 | 3.3 | 3.0 | 3.0 | 3.0 | 3.0 | ||
– 35–39 y | 4.0 | 3.6 | 3.3 | 3.0 | 3.0 | 3.0 | 3.0 | ||
• Scenario C | |||||||||
o APR-DRG 560 – SOI 1: for all age groups | 3.0 | 2.0 | 2.0 | 2.0 | 2.0 | ||||
– SOI 2: for all age groups | 3.7 | 2.5 | 2.5 | 2.5 | 2.5 | ||||
o APR-DRG 540 – SOI 1: for all age groups | 4.4 | 3.0 | 3.0 | 3.0 | 3.0 | ||||
– SOI 2: for all age groups | 5.4 | 4.0 | 4.0 | 4.0 | 4.0 | ||||
Average number of postnatal monitoring and care services as of the 6th day postpartum | 0.9 | 1.7 | Econodat and IMA-AIM | ||||||
Baseline, Scenario A, and Scenario B - Multiparous | 2.0 | 2.0 | 2.0 | 2.0 | 2.0 | Elicitation | |||
- Primiparous | 4.0 | 4.0 | 4.0 | 4.0 | 4.0 | Elicitation | |||
Scenario C - Multiparous | 4.0 | 4.0 | 4.0 | 4.0 | 4.0 | Elicitation | |||
- Primiparous | 7.0 | 7.0 | 7.0 | 7.0 | 7.0 | Elicitation | |||
Inclusion of coordination tasks via an increase in the length of the prenatal and postnatal consultations (%) | 20% | Elicitation | |||||||
Baseline and scenario A | 20% | 20% | 20% | 20% | 20% | Elicitation | |||
Scenarios B and C | 21% | 22% | 23% | 24% | 25% | Elicitation |
Initial allocation key
2016 (%) | |
---|---|
Outpatient settings | 20.0 |
Prenatal follow-up | 5.4 |
Preparation for birth and parenting | 2.7 |
Postnatal follow-up | 11.9 |
Hospital setting | 80.0 |
Postpartum follow-up | 48.0 |
Other activities | 32.0 |
2021 (%) | 2026 (%) | 2031 (%) | 2036 (%) | 2041 (%) | |
---|---|---|---|---|---|
Baseline | + 5.9 | + 7.1 | + 6.4 | + 8.2 | + 9.6 |
Scenario A | + 7.9 | + 11.4 | + 12.3 | + 16.3 | + 20.5 |
Scenario B | + 8.1 | + 12.0 | + 13.6 | + 18.7 | + 24.6 |
Scenario C | + 17.6 | + 17.4 | + 19.0 | + 24.3 | + 30.4 |