This study aims at documenting the frequency of reported abuse, stigma and discrimination and exploring the perspectives for improving the quality of maternal-newborn care (QMNC) of migrant mothers’ reporting abuse, stigma or discrimination.

Mixed methods multicentre cross-sectional study.

All maternal facilities (tertiary and secondary levels of care, n=9) from Friuli-Venezia Giulia region, Northeast Italy, between November 2019 and January 2022 in Northeast Italy.

874 migrant and 3968 non-migrant women answering a validated WHO Standard-based questionnaire after birth.

Frequency of reported abuse, stigma and discrimination during facility-based childbirth was calculated and compared with those of non-migrant mothers. Thematic analysis was conducted on eight open questions, using WHO Standards as a framework for the analysis.

Among migrant women, 84 (9.6%) reported some type of abuse, stigma and discrimination, a frequency similar to non-migrant women (9.8%, p=0.880). The most frequently reported was verbal abuse (87.7%), followed by stigma and discrimination (15.1%). Most women (86.9%) provided at least one comment, with a frequency comparable to non-migrant women (p=0.076). Among a total of 327 comments, 104 (31.8%) were practical suggestions for improving QMNC. Experience of care was the domain with the highest frequency both of negative (64.9% of negative comments) and positive comments (51.7% of positive comments) and with the highest frequency of suggestions for improving QMNC (52.9% of suggestions). Overall, suggestions mainly focused on strengthening healthcare professionals’ communication skills, allowing companionship during childbirth, increasing healthcare professionals’ availability and timely support.

This study shows that both migrant and non-migrant mothers are exposed to abuse, stigma and discrimination during childbirth, and that both are willing to provide practical suggestions, which should be used for planning actions to improve QMNC.

To determine the quality of drug manufacturers’ fact sheets for patients for COVID-19 therapeutics for baricitinib, convalescent plasma, anakinra, molnupiravir, nirmatrelvir/ritonavir, remdesivir, tocilizumab and vilobelimab, and fact sheet readability.

Cross-sectional document analysis.

Fact sheets on COVID-19 drugs approved by the US Food and Drug Administration from 2020 to 2023.

Quality assessments with the 16-item DISCERN tool scored 16–80 points and 36-item Ensuring Quality of Information for Patients (EQIP) tool scored 0–36, where lower scores indicate low-quality information. We assessed readability with Flesch-Kincaid Reading Ease (ranges from 0 to 100 where higher scores correspond to reading ease). Higher grades indicated hard-to-read information: Flesch-Kincaid grade level (ranges from grades 0 to 18 (college graduate)), Gunning-Fog score (ranges from grades 0 to 20 (college graduate)), Coleman-Liau index (ranges from grade 4 to college graduate), automated readability index (ranging from grades 5 to 22 (college graduate)), Dale-Chall Readability (ranges from grade 4 to college graduate) and simple measure of gobbledygook (ranges from grade 3 to college graduate). Secondary outcomes were word, syllable and sentence counts. We reported percentages and the median (IQR).

We found 18 fact sheets that described 11 (63.5%) anti-virals (remdesivir (n=4), molnupiravir (n=4) and nirmatrelvir/ritonavir (n=3)) and 7 (37.5%) immune modulators (tocilizumab (n=2), baricitinib (n=2), convalescent plasma (n=1), anakinra (n=1) and vilobelimab (n=1)). DISCERN (median (IQR)) reliability was 4 (IQR 3–4) and 5 (1–5), while DISCERN treatment information was 3 (1–5) and 5 (1–5) for anti-virals and immune modulators, respectively. EQIP (median (IQR)) content was 12 (11–13) and 11 (11–13), identification of information was 4 (3–4) and 3 (3–3) and structure was 9 (8–9) and 9 (9–9) for anti-virals and immune modulators, respectively. Overall, fact sheets had median readability grade levels that ranged from 6.2 to 12.4. Anti-viral and immune modulator fact sheets had median readability grade levels from 6.1 to 12.5. Median (IQR) word, >4 syllable words and sentence counts were 1646.5 (1318.3–1934.8), 25.0 (21.3–29.8) and 118.0 (92.0–152.5) overall; 1758.00 (1200.0–2181.0), 23.0 (15.0–27.0) and 134.0 (82.0–185.0) for anti-virals; and 1461.0 (1341.0–1776.0), 29.0 (23.0–46.0) and 107.0 (105.0–122.0) for immune modulators, respectively.

Although of fair quality, the fact sheet reading level was high, and the transparency of sources used was low. Regulatory officials should enforce readable resources from drug manufacturers to guide patients’ decision-making surrounding COVID-19 therapeutics.