Exploring the meaning of value of maternal care among healthcare professionals and patients: application of value-based healthcare at the Mowbray Maternity Hospital in Cape Town , South Africa
1
Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht University, Maastricht, Netherlands
2
SAMRC/Wits Centre for Health Economics and Decision Science – PRICELESS SA, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
3
Western Cape Department: Health and wellness, Western Cape Province, Cape Town, South Africa
4
Health Economics Unit, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
5
Research Centre for Health through Physical Activity, Lifestyle and Sport, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A2325
ABSTRACT
BACKGROUND:
Mowbray Maternity Hospital (MMH), strives to deliver high-quality, person-centered care despite constrained human and financial resources. Transitioning from a supply-driven to a value-driven care model offers potential to optimize limited resources, improve maternal health outcomes, and align care experiences with what matters most to women1. However, applying value-based healthcare (VBHC) requires adaptation to the hospital’s internal and external context. A critical first step is to investigate what “value” means to stakeholders.
METHODS:
Using a VBHC framework, we explored the meaning of value among key stakeholders in MMH: women receiving care, maternal care providers, and hospital management. We defined VBHC as a concept built on four value-pillars: personal, technical , allocative and societal value2. A qualitative, exploratory phenomenological case study approach was employed. We conducted in-depth interviews with 20 women and 19 healthcare professionals in April and May of 2024. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed thematically.
RESULTS:
Findings revealed strong alignment between stakeholder perspectives the four pillars of VBHC. Both women and providers emphasized similar priorities. Under personal value, participants highlighted the importance of respectful maternity care, interpersonal relationships, effective communication, and shared decision-making. Technical value was reflected in trust in clinical competence, access to care, efficiency of service delivery, and health outcomes achieved. Allocative value encompassed resource availability and adequate staff-to-patient ratios. Societal value incorporated social support structures and broader socio-economic issues.
CONCLUSIONS:
This study demonstrates convergence between women receiving care and providers’ perspectives on what constitutes value in maternal care. Respectful and efficient care, supported by adequate resources and responsiveness to socio-economic realities, defines value in this context. Adapting VBHC to local realities can strengthen maternal health systems and ensure care resonates with women’s priorities.
Mowbray Maternity Hospital (MMH), strives to deliver high-quality, person-centered care despite constrained human and financial resources. Transitioning from a supply-driven to a value-driven care model offers potential to optimize limited resources, improve maternal health outcomes, and align care experiences with what matters most to women1. However, applying value-based healthcare (VBHC) requires adaptation to the hospital’s internal and external context. A critical first step is to investigate what “value” means to stakeholders.
METHODS:
Using a VBHC framework, we explored the meaning of value among key stakeholders in MMH: women receiving care, maternal care providers, and hospital management. We defined VBHC as a concept built on four value-pillars: personal, technical , allocative and societal value2. A qualitative, exploratory phenomenological case study approach was employed. We conducted in-depth interviews with 20 women and 19 healthcare professionals in April and May of 2024. Interviews were audio-recorded, transcribed verbatim, coded, and analyzed thematically.
RESULTS:
Findings revealed strong alignment between stakeholder perspectives the four pillars of VBHC. Both women and providers emphasized similar priorities. Under personal value, participants highlighted the importance of respectful maternity care, interpersonal relationships, effective communication, and shared decision-making. Technical value was reflected in trust in clinical competence, access to care, efficiency of service delivery, and health outcomes achieved. Allocative value encompassed resource availability and adequate staff-to-patient ratios. Societal value incorporated social support structures and broader socio-economic issues.
CONCLUSIONS:
This study demonstrates convergence between women receiving care and providers’ perspectives on what constitutes value in maternal care. Respectful and efficient care, supported by adequate resources and responsiveness to socio-economic realities, defines value in this context. Adapting VBHC to local realities can strengthen maternal health systems and ensure care resonates with women’s priorities.
| eISSN: | 2654-1459 |
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