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成功实施“帮助婴儿存活”和“帮助母亲存活”项目——新生儿和孕产妇生存的乌斯坦模式

Successful implementation of Helping Babies Survive and Helping Mothers Survive programs-An Utstein formula for newborn and maternal survival.

作者信息

Ersdal Hege L, Singhal Nalini, Msemo Georgina, Kc Ashish, Data Santorino, Moyo Nester T, Evans Cherrie L, Smith Jeffrey, Perlman Jeffrey M, Niermeyer Susan

机构信息

Department of Anaesthesiology and Intensive Care, Stavanger University Hospital, Stavanger, Norway.

Division of Neonatology, University of Calgary, Calgary, Canada.

出版信息

PLoS One. 2017 Jun 7;12(6):e0178073. doi: 10.1371/journal.pone.0178073. eCollection 2017.

Abstract

Globally, the burden of deaths and illness is still unacceptably high at the day of birth. Annually, approximately 300.000 women die related to childbirth, 2.7 million babies die within their first month of life, and 2.6 million babies are stillborn. Many of these fatalities could be avoided by basic, but prompt care, if birth attendants around the world had the necessary skills and competencies to manage life-threatening complications around the time of birth. Thus, the innovative Helping Babies Survive (HBS) and Helping Mothers Survive (HMS) programs emerged to meet the need for more practical, low-cost, and low-tech simulation-based training. This paper provides users of HBS and HMS programs a 10-point list of key implementation steps to create sustained impact, leading to increased survival of mothers and babies. The list evolved through an Utstein consensus process, involving a broad spectrum of international experts within the field, and can be used as a means to guide processes in low-resourced countries. Successful implementation of HBS and HMS training programs require country-led commitment, readiness, and follow-up to create local accountability and ownership. Each country has to identify its own gaps and define realistic service delivery standards and patient outcome goals depending on available financial resources for dissemination and sustainment.

摘要

在全球范围内,出生时的死亡和疾病负担仍然高得令人无法接受。每年,约有30万名妇女死于分娩相关原因,270万婴儿在出生后的第一个月内死亡,260万婴儿为死产。如果世界各地的助产人员具备处理出生时危及生命并发症的必要技能和能力,许多此类死亡是可以通过基本但及时的护理避免的。因此,创新性的“帮助婴儿存活”(HBS)和“帮助母亲存活”(HMS)项目应运而生,以满足对更实用、低成本和低技术的模拟培训的需求。本文为HBS和HMS项目的使用者提供了一份包含10个要点的关键实施步骤清单,以产生持续影响,从而提高母婴存活率。这份清单是通过一个类似于乌特斯坦共识的过程制定的,该过程涉及该领域广泛的国际专家,可作为指导资源匮乏国家相关工作流程的一种手段。成功实施HBS和HMS培训项目需要国家主导的承诺、准备工作和后续跟进,以建立地方问责制和自主权。每个国家都必须根据自身可用的传播和维持资金,找出自身差距并确定现实的服务提供标准和患者结果目标。

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