Tlebere Pulani, Jackson Debra, Loveday Marian, Matizirofa Lyness, Mbombo Nomafrench, Doherty Tanya, Wigton Alyssa, Treger Latasha, Chopra Mickey
United Nations Population Fund (UNFPA) Regional Directors Team, South Africa.
J Midwifery Womens Health. 2007 Jul-Aug;52(4):342-50. doi: 10.1016/j.jmwh.2007.03.016.
This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies of women with no antenatal care and/or home birth, and verbal/social autopsies of maternal and infant deaths, conducted in three diverse sites across the country. Data analysis used quantitative statistics for the semistructured interviews and a qualitative thematic content approach for the case studies and verbal/social autopsies. Each component was analyzed separately and then triangulated. The following themes emerged: 1) transport and distance to care were the biggest problems, particularly in rural areas; 2) providers' communication with families was very poor; 3) health-seeking behavior was better than anticipated; 4) treatment by health providers and quality of care showed mixed results; 5) HIV/AIDS is a major issue; however, basic maternity and neonatal service quality cannot be overlooked; and 6) families and communities are an untapped resource for improving maternal and neonatal health. Implications for maternal and infant health care in developing countries are discussed, with a particular focus on barriers to utilization and involvement of communities and families in maternity care.
这项社区情况分析确定了影响南非孕产妇保健服务利用情况的因素。研究采用了定量和定性研究方法,包括在全国三个不同地点进行的半结构化家庭访谈、对未接受产前护理和/或在家分娩妇女的案例研究,以及对孕产妇和婴儿死亡的口头/社会尸检。数据分析对半结构化访谈采用定量统计方法,对案例研究和口头/社会尸检采用定性主题内容分析法。每个部分分别进行分析,然后进行三角互证。出现了以下主题:1)交通和就医距离是最大的问题,尤其是在农村地区;2)医护人员与家庭的沟通非常差;3)寻求医疗行为比预期的要好;4)医护人员的治疗和护理质量参差不齐;5)艾滋病毒/艾滋病是一个主要问题;然而,基本的孕产妇和新生儿服务质量也不容忽视;6)家庭和社区是改善孕产妇和新生儿健康的未开发资源。文中讨论了对发展中国家孕产妇和婴儿保健的影响,特别关注了利用服务的障碍以及社区和家庭参与孕产妇保健的情况。