Tulane University School of Public Health and Tropical Medicine, New Orleans, United States.
Glob Health Promot. 2012 Sep;19(3):42-9. doi: 10.1177/1757975912453185.
Skin-to-skin contact (STSC) for low birth weight newborns in community settings may greatly improve survival, especially where access to health facilities is limited. Community STSC has been implemented in large-scale trials in Asia and is recommended by WHO and UNICEF. In countries where the practice is entirely new, such as Ghana, STSC may need special educational approaches.
The dual aims of this study were to understand the acceptance and barriers to STSC in an African community setting and to use in-depth formative research to contribute to the success of a behavior-based health intervention.
A rapid qualitative study with an intentionally small sample.
Kintampo, Ghana, a predominately rural, agrarian area in the center of the country with diverse ethnic groups in a forest-savannah transition zone.
Key informants were consulted through in-depth interviews and focus group discussions to develop the pilot. Five mothers participated in pilot instruction (four refused), which included counseling and used a trials-of-improved-practices methodology; data from group discussion with traditional birth attendants were also included.
It was difficult to overcome barriers to the practice (post partum pain, fear of harming the umbilicus), and less intractable barriers (traditional carrying practices, fear of causing harm, lack of back support, time constraints, breast feeding issues) were reported.
Some study participants tried STSC but none did it continuously. As promotion of STSC could be vital for improving newborn survival in low resource settings, tackling perceived barriers may be an important way to increase acceptability of this practice.
在社区环境中,对低出生体重新生儿进行皮肤接触(STSC)可能会极大地提高生存率,尤其是在获得医疗设施有限的情况下。社区 STSC 已在亚洲的大规模试验中实施,并得到世卫组织和儿基会的推荐。在加纳等完全采用这种做法的国家,STSC 可能需要特殊的教育方法。
本研究的双重目的是了解在非洲社区环境中对 STSC 的接受程度和障碍,并利用深入的形成性研究为基于行为的健康干预措施的成功做出贡献。
一项快速定性研究,样本量小。
加纳的金塔蓬,这是该国中部一个以农业为主的农村地区,位于森林草原过渡带,有不同的种族群体。
通过深入访谈和焦点小组讨论咨询关键信息提供者,以制定试点方案。五名母亲参加了试点指导(四人拒绝),包括咨询和采用试验改进实践方法;还包括传统助产士小组讨论的数据。
很难克服实践的障碍(产后疼痛、害怕伤害脐带),报道的障碍较少(传统的携带做法、害怕造成伤害、缺乏背部支撑、时间限制、母乳喂养问题)。
一些研究参与者尝试了 STSC,但没有人持续这样做。由于促进 STSC 对于改善低资源环境中新生儿的生存率至关重要,解决感知到的障碍可能是提高对这种做法的接受度的重要途径。