Gondwe Austrida, Munthali Alister, Ashorn Per, Ashorn Ulla
iLiNS Project, College of Medicine-Mangochi, University of Malawi, Zomba, Malawi.
Department of International Health, University of Tampere, Tampere, Finland.
Matern Child Health J. 2016 Jul;20(7):1441-7. doi: 10.1007/s10995-016-1942-z.
Objectives Malawi is estimated to have one of the highest preterm birth rates in the world. However, care of preterm infants at facility level in Malawi has not been explored. We aimed to explore the views of health stakeholders about the care of preterm infants in health facilities and the existence of any policy protocol documents guiding the delivery of care to these infants. Methods We conducted 16 in-depth interviews with health stakeholders (11 service providers and 5 policy makers) using an interview guide and asked for any existing policy protocol documents guiding care for preterm infants in the health facilities in Malawi. The collected documents were reviewed and all the interviews were digitally recorded, transcribed and translated. All data were analysed using content analysis approach. Results We identified four policy protocol documents and out of these, one had detailed information explaining the care of preterm infants. Policy makers reported that policy protocol documents to guide care for preterm infants were available in the health facilities but majority (63.6 %) of the service providers lacked knowledge about the existence of these documents. Health stakeholders reported several challenges in caring for preterm infants including lack of trained staff in preterm infant care, antibiotics, space, supervision and poor referral system. Conclusions Our study highlights that improving health care service provider knowledge of preterm infant care is an integral part in preterm child birth. Our findings suggests that policy makers and health decision makers should retain those trained in preterm new born care in the health facility's preterm unit.
目标 据估计，马拉维的早产率是世界上最高的之一。然而，尚未对马拉维医疗机构中早产儿的护理情况进行研究。我们旨在探讨卫生利益相关者对医疗机构中早产儿护理的看法，以及是否存在指导为这些婴儿提供护理的政策协议文件。方法 我们使用访谈指南对16名卫生利益相关者（11名服务提供者和5名政策制定者）进行了深入访谈，并询问了马拉维医疗机构中指导早产儿护理的现有政策协议文件。对收集到的文件进行了审查，所有访谈都进行了数字录音、转录和翻译。所有数据均采用内容分析法进行分析。结果 我们识别出了四份政策协议文件，其中一份有关于解释早产儿护理的详细信息。政策制定者报告称，医疗机构中有指导早产儿护理的政策协议文件，但大多数（63.6%）服务提供者对这些文件的存在缺乏了解。卫生利益相关者报告了在护理早产儿方面的几个挑战，包括缺乏早产儿护理方面的训练有素的工作人员、抗生素、空间、监督以及转诊系统不完善。结论 我们的研究强调，提高医疗服务提供者对早产儿护理的认识是早产护理的一个重要组成部分。我们的研究结果表明，政策制定者和卫生决策者应在医疗机构的早产病房保留经过早产儿护理培训的人员。
