Colomar Mercedes, Cafferata Maria Luisa, Aleman Alicia, Tomasso Giselle, Betran Ana Pilar
Montevideo Clinical Research Unit (UNICEM), Montevideo, Uruguay.
World Health Organization (WHO), Geneva, Switzerland.
Reprod Health. 2017 Mar 31;14(1):48. doi: 10.1186/s12978-017-0299-0.
Antenatal care reduces maternal and perinatal mortality and morbidity through the detection and treatment of some conditions, but its coverage is less than optimal within certain populations. Supply kits for maternal health were designed to overcome barriers present when providing care during pregnancy and childbirth particularly to women from underserved population.We conducted a mixed-methods systematic review on the use of supply kits. This manuscript presents the findings from qualitative studies that reported barriers, facilitators, and user's recommendation in the adoption and implementation of any type of kit designed to be used during pregnancy or childbirth.This review included eight studies, and seven were implemented in developing countries. Most studies assessed the implementation of clean delivery kits to be used during labour and delivery, and contributed to gain insights into factors that may hinder or foster the use of kits.Clean delivery kits were conceived to cope with barriers related mainly to access. The most important barrier identified were those related to the socio-cultural and the lack of knowledge dimension such as who held the decision-making authority in the household, as well as popular beliefs behind the idea that birth preparation could bring bad luck, may prevent clients from adhering to their use. In addition, financial constraints and limited understanding of the instructions of use were accessibility barriers found. On the other hand, once used, clean delivery kits for maternal health were accepted by women and health workers. Convenience, hygienic components, and avoidance of delays in receiving care were viewed as satisfactory features.Supply kits are mostly affordable and easily deployable. Increasing awareness among the population about the offered kits and providing information on their benefits emerges as a critical step to foster use in settings where kits are available. Implementation of this strategy requires low complexity resources and could make the use of kits an accepted alternative to increase the use of evidence-based interventions and thus improve quality of care during pregnancy, childbirth and neonatal period mainly at the community level in low income countries and remote areas with low access.
产前护理通过对某些病症的检测和治疗降低了孕产妇和围产期的死亡率及发病率，但其在某些人群中的覆盖范围并不理想。孕产妇保健供应包旨在克服在孕期和分娩期间提供护理时遇到的障碍，尤其是为服务不足人群中的妇女提供护理时。我们对供应包的使用进行了一项混合方法的系统评价。本手稿介绍了定性研究的结果，这些研究报告了在采用和实施任何旨在在孕期或分娩期间使用的供应包时存在的障碍、促进因素以及用户的建议。该评价纳入了八项研究，其中七项在发展中国家开展。大多数研究评估了分娩时使用的清洁分娩包的实施情况，并有助于深入了解可能阻碍或促进使用这些包的因素。清洁分娩包旨在应对主要与获取相关的障碍。确定的最重要障碍与社会文化和知识缺乏层面有关，例如家庭中的决策权威是谁，以及认为分娩准备会带来厄运背后的普遍观念，这些可能会阻止服务对象坚持使用。此外，经济限制和对使用说明的理解有限也是发现的获取障碍。另一方面，一旦使用，孕产妇保健清洁分娩包受到了妇女和卫生工作者的认可。便利性、卫生组件以及避免护理延误被视为令人满意的特点。供应包大多价格实惠且易于部署。提高人群对所提供包的认识并提供其益处的信息，成为在有供应包的环境中促进使用的关键一步。实施这一策略所需的资源复杂性较低，并且可以使供应包的使用成为一种被接受的选择，以增加基于证据的干预措施的使用，从而主要在低收入国家的社区层面和获取机会少的偏远地区改善孕期、分娩期和新生儿期的护理质量。
