Bakibinga Pauline, Ettarh Remare, Ziraba Abdhalah K, Kyobutungi Catherine, Kamande Eva, Ngomi Nicholas, Osindo Jane
Health Challenges and Systems Research Program, African Population & Health Research Center, Nairobi, Kenya.
BMJ Open. 2014 Oct 23;4(10):e006608. doi: 10.1136/bmjopen-2014-006608.
Rapid urbanisation in Kenya has resulted in growth of slums in urban centres, characterised by poverty, inadequate social services and poor health outcomes. The government's initiatives to improve access to quality healthcare for mothers and children are largely limited to public health facilities, which are few and/or inaccessible in underserved areas such as the slums. The 'Partnership for Maternal, Newborn and Child Health' (PAMANECH) project is being implemented in two Nairobi slums, Viwandani and Korogocho, to assess the impact of strengthening public-private partnerships for the delivery of healthcare on the health of mothers, newborns and young children in two informal settlements in Kenya.
This is a quasi-experimental study; our approach is to support private as well as public health providers and the community to enhance access to and demand for quality healthcare services. Key activities include: infrastructural upgrade of selected Private Not-For-Profit health facilities operating in the two slums, building capacity for healthcare providers as well as the Health Management Teams in Nairobi, facilitating provision of supportive supervision by the local health authorities and forming networks of Community Health Volunteers (CHVs) to create demand for health services. To assess the impact of the intervention, the study is utilising multiple data sources using a combination of qualitative and quantitative methods. A baseline survey was conducted in 2013 and an end-line survey will be conducted at least 1 year after full implementation of the intervention. Systematic monitoring and documentation of the intervention is on-going to strengthen the case for causal inference.
Ethical approval for the study was obtained from the Kenya Medical Research Institute. Key messages from the results will be packaged and widely disseminated through workshops, conference presentations, reports, factsheets and academic publications to facilitate uptake by policymakers.
KEMRI- NON-SSC-PROTOCOL No. 393.
肯尼亚的快速城市化导致城市中心贫民窟不断增多,其特点是贫困、社会服务不足且健康状况不佳。政府为改善母婴获得优质医疗服务的举措主要局限于公共卫生设施,而在贫民窟等服务欠缺地区,此类设施数量稀少且难以到达。“孕产妇、新生儿和儿童健康伙伴关系”(PAMANECH)项目正在内罗毕的两个贫民窟——维万达尼和科罗戈乔实施,以评估加强公私伙伴关系提供医疗服务对肯尼亚两个非正规住区的母亲、新生儿和幼儿健康的影响。
这是一项准实验研究;我们的方法是支持私立和公立医疗服务提供者以及社区,以增加获得优质医疗服务的机会并提高对此类服务的需求。主要活动包括:对在两个贫民窟运营的选定非营利性私立医疗机构进行基础设施升级,为内罗毕的医疗服务提供者以及健康管理团队建设能力,促进地方卫生当局提供支持性监督,并组建社区健康志愿者网络以创造对医疗服务的需求。为评估干预措施的影响,该研究使用定性和定量方法相结合的多种数据来源。2013年进行了基线调查,干预措施全面实施至少1年后将进行终线调查。对干预措施的系统监测和记录正在进行中,以加强因果推断的依据。
该研究已获得肯尼亚医学研究所的伦理批准。研究结果的关键信息将进行整理,并通过研讨会、会议报告、报告、情况说明书和学术出版物广泛传播,以促进政策制定者采用。
KEMRI - NON - SSC - PROTOCOL No. 393。