Nguyen My H Ng, Gammeltoft Tine, Rasch Vibeke
Scientific Institute for Population, Family and Children, Viet Nam Commission of Population, Family and Children, Hanoi, Viet Nam.
Reprod Health Matters. 2007 May;15(29):172-82. doi: 10.1016/S0968-8080(07)29283-3.
Six months after a Comprehensive Abortion Care project was implemented in Phu-San Hospital, the main maternity hospital in Hai Phòng, northern Viet Nam, a study of quality of abortion services was carried out. The study explored the interaction between providers and women seeking abortion and how cultural values influenced quality of care. A quantitative and qualitative approach was employed: a three-part structured survey with 748 women before and after they had an abortion, 20 in-depth interviews with women just after abortion, seven informal interviews with health care staff and 100 participant observations. Both the women and the staff equated quality of care mainly with improved technical performance of abortion. Insufficient knowledge and skills had a negative impact on provision of information and good quality counselling in relation to understanding and uptake of contraception, treating reproductive tract infection and preventing post-abortion infection. To further improve abortion care in hospitals such as Phu-San, training programmes are needed that integrate counselling and clinical skills and address the cultural factors that hinder health staff and women from interacting in an equitable manner. A supportive supervisory system that holds health staff accountable for conducting high quality information and counselling sessions should also be established.
在越南北方海防市的主要妇产医院富山医院实施全面堕胎护理项目六个月后,开展了一项堕胎服务质量研究。该研究探讨了提供者与寻求堕胎的女性之间的互动,以及文化价值观如何影响护理质量。采用了定量和定性方法:对748名女性在堕胎前后进行了三部分的结构化调查,对刚堕胎后的女性进行了20次深入访谈,对医护人员进行了7次非正式访谈,并进行了100次参与观察。女性和工作人员都将护理质量主要等同于堕胎技术性能的提高。知识和技能不足对提供与理解和采用避孕措施、治疗生殖道感染以及预防堕胎后感染相关的信息和高质量咨询产生了负面影响。为了进一步改善富山等医院的堕胎护理,需要开展将咨询和临床技能相结合并解决阻碍医护人员和女性以公平方式互动的文化因素的培训项目。还应建立一个支持性监督系统,要求医护人员对开展高质量的信息和咨询会议负责。