School of Medicine, University of California, San Francisco, USA.
Kenya Medical Research Institute, Nairobi, Kenya.
Reprod Health. 2017 Dec 29;14(1):180. doi: 10.1186/s12978-017-0446-7.
Sub-Saharan Africa accounts for approximately 66% of global maternal deaths. Poor person-centered maternity care, which emphasizes the quality of patient experience, contributes both directly and indirectly to these poor outcomes. Yet, few studies in low resource settings have examined what is important to women during childbirth from their perspective. The aim of this study is to examine women's facility-based childbirth experiences in a rural county in Kenya, to identify aspects of care that contribute to a positive or negative birth experience.
Data are from eight focus group discussions conducted in a rural county in western Kenya in October and November 2016, with 58 mothers aged 15 to 49 years who gave birth in the preceding nine weeks. We recorded and transcribed the discussions and used a thematic approach for data analysis.
The findings suggest four factors influence women's perceptions of quality of care: responsiveness, supportive care, dignified care, and effective communication. Women had a positive experience when they were received well at the health facility, treated with kindness and respect, and given sufficient information about their care. The reverse led to a negative experience. These experiences were influenced by the behavior of both clinical and support staff and the facility environment.
This study extends the literature on person-centered maternity care in low resource settings. To improve person-centered maternity care, interventions need to address the responsiveness of health facilities, ensure women receive supportive and dignified care, and promote effective patient-provider communication.
撒哈拉以南非洲地区约占全球产妇死亡人数的 66%。以患者体验质量为重点的以人为本的产妇护理，直接和间接地促成了这些较差的结果。然而，在资源匮乏的环境中，很少有研究从女性的角度考察分娩期间对她们来说重要的事情。本研究旨在检查肯尼亚农村县的妇女在医疗机构中的分娩经历，以确定有助于积极或消极分娩体验的护理方面。
数据来自 2016 年 10 月至 11 月在肯尼亚西部农村县进行的八项焦点小组讨论，参与者为 58 名年龄在 15 至 49 岁之间的母亲，她们在过去九周内生了孩子。我们记录并转录了讨论内容，并使用主题方法进行数据分析。
研究结果表明，有四个因素影响了妇女对护理质量的看法：响应性、支持性护理、有尊严的护理和有效的沟通。当妇女在医疗机构受到良好接待、受到友善和尊重的对待，并获得足够的护理信息时，她们会有积极的体验。反之则会产生消极的体验。这些体验受到临床和支持人员的行为以及设施环境的影响。
本研究扩展了关于资源匮乏环境中以人为本的产妇护理的文献。为了改善以人为本的产妇护理，干预措施需要解决医疗机构的响应性问题，确保妇女得到支持性和有尊严的护理，并促进有效的医患沟通。
