Sudhinaraset May, Afulani Patience, Diamond-Smith Nadia, Bhattacharyya Sanghita, Donnay France, Montagu Dominic
Global Health Sciences, University of California, San Francisco, San Francisco, CA, 94105, USA.
Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Gates Open Res. 2017 Nov 6;1:1. doi: 10.12688/gatesopenres.12756.1.
Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.
在全球范围内，孕产妇、新生儿和生殖健康方面存在严重的健康不平等现象。在诸多层面上，无法获得高质量的医疗服务是导致这些不平等现象的关键因素。全球为提高孕产妇和生殖健康机构内的医疗服务质量做出了重大努力。然而，质量改进活动中一个严重被忽视的方面是以患者为中心的医疗服务。本文的目的是回顾与以患者为中心的生殖健康医疗服务相关的现有文献和理论，以制定一个提高生殖健康质量的框架，特别是在低收入和中等收入国家。本文提出了生殖健康公平的以患者为中心的医疗服务框架，该框架描述了女性生殖健康的三个相互依存的背景层面：健康公平的社会和社区决定因素、女性的就医行为以及机构内的医疗服务质量。它列出了孕产妇和生殖健康以患者为中心的医疗服务的八个领域。以患者为中心的医疗服务已被证明能改善治疗效果；然而，在女性生殖健康医疗服务领域，对于定义和衡量标准尚无共识。拟议的框架回顾了以患者为中心的生殖健康医疗服务的基本方面。
