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乌干达西南部农村地区近期分娩妇女对新生儿危险信号的认知不足:一项社区调查。

Inadequate knowledge of neonatal danger signs among recently delivered women in southwestern rural Uganda: a community survey.

作者信息

Sandberg Jacob, Odberg Pettersson Karen, Asp Gustav, Kabakyenga Jerome, Agardh Anette

机构信息

Social medicine and Global Health, Dept. of Clinical sciences, Lund University, Lund, Sweden.

Social medicine and Global Health, Dept. of Clinical sciences, Lund University, Lund, Sweden; Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.

出版信息

PLoS One. 2014 May 13;9(5):e97253. doi: 10.1371/journal.pone.0097253. eCollection 2014.

Abstract

BACKGROUND

Early detection of neonatal illness is an important step towards improving newborn survival. Every year an estimated 3.07 million children die during their first month of life and about one-third of these deaths occur during the first 24 hours. Ninety-eight percent of all neonatal deaths occur in low- and middle-income countries like Uganda. Inadequate progress has been made globally to reduce the amount of neonatal deaths that would be required to meet Millennium Development Goal 4. Poor knowledge of newborn danger signs delays care seeking. The aim of this study was to explore the knowledge of key newborn danger signs among mothers in southwestern Uganda.

METHODS

Results from a community survey of 765 recently delivered women were analyzed using univariate and multivariate logistic regressions. Six key danger signs were identified, and spontaneous responses were categorized, tabulated, and analyzed.

RESULTS

Knowledge of at least one key danger sign was significantly associated with being birth prepared (adjusted OR 1.7, 95% CI 1.2-2.3). Birth preparedness consisted of saving money, identifying transportation, identifying a skilled birth attendant and buying a delivery kit or materials. Overall, respondents had a poor knowledge of key newborn danger signs: 58.2% could identify one and 14.8% could identify two. We found no association between women attending the recommended number of antenatal care visits and their knowledge of danger signs (adjusted OR 1.0, 95% CI 0.8-1.4), or between women using a skilled birth attendant at delivery and their knowledge of danger signs (adjusted OR 1.2, 95% CI 0.9-1.7).

CONCLUSIONS

Our findings indicate the need to enhance education of mothers in antenatal care as well as those discharged from health facilities after delivery. Further promotion of birth preparedness is encouraged as part of the continuum of maternal care.

摘要

背景

早期发现新生儿疾病是提高新生儿存活率的重要一步。每年估计有307万儿童在出生后的第一个月内死亡,其中约三分之一的死亡发生在出生后的头24小时内。所有新生儿死亡中有98%发生在乌干达等低收入和中等收入国家。全球在减少实现千年发展目标4所需的新生儿死亡数量方面进展不足。对新生儿危险信号的了解不足会延误寻求医疗护理。本研究的目的是探讨乌干达西南部母亲对关键新生儿危险信号的了解情况。

方法

对765名近期分娩妇女进行社区调查的结果采用单变量和多变量逻辑回归进行分析。确定了六个关键危险信号,并对自发回答进行分类、列表和分析。

结果

了解至少一个关键危险信号与做好分娩准备显著相关(调整后的比值比为1.7,95%置信区间为1.2 - 2.3)。分娩准备包括存钱、确定交通方式、确定熟练的助产士以及购买分娩包或材料。总体而言,受访者对关键新生儿危险信号的了解较差:58.2%能识别一个,14.8%能识别两个。我们发现,参加推荐次数产前检查的妇女与其对危险信号的了解之间没有关联(调整后的比值比为1.0,95%置信区间为0.8 - 1.4),在分娩时使用熟练助产士的妇女与其对危险信号的了解之间也没有关联(调整后的比值比为1.2,95%置信区间为0.9 - 1.7)。

结论

我们的研究结果表明,需要加强对产前护理中的母亲以及产后从医疗机构出院的母亲的教育。作为孕产妇护理连续过程的一部分,鼓励进一步推广分娩准备工作。

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