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对提供产前护理的初级医疗保健机构的横断面评估:呼吁改善巴基斯坦旁遮普省的基层医疗单位

A cross-sectional assessment of primary healthcare facilities for provision of antenatal care: calling for improvements in Basic Health Units in Punjab, Pakistan.

作者信息

Majrooh Muhammad Ashraf, Hasnain Seema, Akram Javaid, Siddiqui Arif

机构信息

Professor & HOD Community Medicine, Services Institute of Medical Sciences (SIMS) Lahore, 34-B, Jatala House, Atchison Housing Society Raiwind Road, Lahore, Pakistan.

Allama Iqbal Medical College, Lahore, Pakistan.

出版信息

Health Res Policy Syst. 2015 Nov 25;13 Suppl 1(Suppl 1):59. doi: 10.1186/s12961-015-0046-3.

Abstract

BACKGROUND

There are two types of barriers to the utilisation of maternal health and antenatal care (ANC) services, including the supply-side barriers operating at the health facility level and demand-side, affecting the utilisation ANC services by pregnant women. The purpose of the study was to assess the essential resources required for the provision of ANC services in primary healthcare facilities in Punjab, Pakistan.

METHODS

A cross-sectional facility assessment was conducted in primary healthcare facilities across Punjab. A multi-stage sampling was used to randomly select nine districts from three stratifications and 19 primary healthcare facilities in the public sector (17 Basic Health Units (BHUs) and two Rural Health Centres (RHCs)) from each district. A total of 171 health facilities were included. Data on infrastructure and availability of equipment, essential supplies, medicines, treatment protocols, and infection control items was collected through pre-tested, semi-structured questionnaires. Univariate analysis was carried out to describe the frequency and percentages of facilities across three ratings (good, average, and poor) by type of facility.

RESULTS

Overall, 28% of facilities had poor infrastructure and the availability of equipment was poor in 16% of the health facilities. Essential supply items, such as urine strips for albumin, blood sugar testing strips, and haemoglobin reagents, were particularly poorly stocked. However, infrastructure and the availability of equipment and supplies were generally better in RHCs compared to BHUs.

CONCLUSION

Health facilities lacked the resources required to provide quality ANC services, particularly in terms of infrastructure, equipment, supply items, and medicines. The availability of these resources needs to be urgently addressed.

摘要

背景

孕产妇保健和产前保健(ANC)服务的利用存在两种障碍,包括在卫生机构层面运作的供给侧障碍以及影响孕妇利用ANC服务的需求侧障碍。本研究的目的是评估巴基斯坦旁遮普省初级卫生保健机构提供ANC服务所需的基本资源。

方法

在旁遮普省的初级卫生保健机构进行了一项横断面机构评估。采用多阶段抽样从三个分层中随机选取九个区,并从每个区的公共部门随机选取19个初级卫生保健机构(17个基本卫生单位(BHU)和2个农村卫生中心(RHC))。共纳入171个卫生机构。通过预先测试的半结构化问卷收集有关基础设施、设备、基本用品、药品、治疗方案和感染控制项目的可用性的数据。进行单因素分析以按机构类型描述三个评级(良好、一般和较差)的机构的频率和百分比。

结果

总体而言,28%的机构基础设施较差,16%的卫生机构设备可用性较差。基本供应物品,如白蛋白尿试纸、血糖测试条和血红蛋白试剂,库存尤其不足。然而,与基本卫生单位相比,农村卫生中心的基础设施、设备和用品的可用性总体上更好。

结论

卫生机构缺乏提供高质量ANC服务所需的资源,特别是在基础设施、设备、供应物品和药品方面。这些资源的可用性需要紧急解决。

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本文引用的文献

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PLoS One. 2014 Nov 19;9(11):e113390. doi: 10.1371/journal.pone.0113390. eCollection 2014.
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