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尼日利亚在妇幼保健中利用传统助产士的进展与挑战

Progresses and challenges of utilizing traditional birth attendants in maternal and child health in Nigeria.

作者信息

Amutah-Onukagha Ndidiamaka, Rodriguez Monica, Opara Ijeoma, Gardner Michelle, Assan Maame Araba, Hammond Rodney, Plata Jesus, Pierre Kimberly, Farag Ehsan

机构信息

Department of Public Health and Community Medicine, Tufts University, School of Medicine, 136 Harrison Avenue Boston, MA 02111, USA.

Department of Public Health, Montclair State University, 1 Normal Avenue, University Hall Room 4162, Montclair NJ 07043, USA.

出版信息

Int J MCH AIDS. 2017;6(2):130-138. doi: 10.21106/ijma.204.

Abstract

BACKGROUND AND OBJECTIVES

Despite advances in modern healthcare, Traditional Birth Attendants (TBA) have continued to be heavily utilized in rural communities in Nigeria. Major disparities in maternal health care in Nigeria remain present despite the goal of the United Nations Millennium Development Goal to reduce maternal mortality by 2015. The objective of this study is to review the contribution of TBAs in the birthing process in Nigeria, and to examine barriers and opportunities for utilizing TBAs in improving maternal and child health outcomes in Nigeria.

METHODS

A literature review of two major electronic databases was conducted using the PRISMA framework to identify English language studies conducted between 2006 and 2016. Inclusion criteria included articles that examined the role of traditional birth attendants as a factor influencing maternal health in Nigeria.

RESULTS

The value of TBAs has not been fully examined as few studies have aimed to examine its potential role in reducing maternal mortality with proper training. Eight manuscripts that were examined highlighted the role of TBAs in maternal health including outcomes of utilizing trained versus non-trained TBAs.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

Specific areas of training for TBAs that were identified and recommended in review including: recognizing delivery complications, community support for TBA practices through policy, evaluation of TBA training programs and increasing collaboration between healthcare facilities and TBAs. Policies focused on improving access to health services and importantly, formal health education training to TBAs, are required to improve maternal health outcomes and underserved communities.

摘要

背景与目标

尽管现代医疗有所进步,但在尼日利亚农村社区,传统接生员(TBA)仍被大量使用。尽管联合国千年发展目标旨在到2015年降低孕产妇死亡率,但尼日利亚孕产妇保健方面的重大差距依然存在。本研究的目的是回顾传统接生员在尼日利亚分娩过程中的贡献,并探讨在尼日利亚利用传统接生员改善母婴健康结果的障碍与机遇。

方法

使用PRISMA框架对两个主要电子数据库进行文献综述,以识别2006年至2016年期间开展的英文研究。纳入标准包括考察传统接生员作为影响尼日利亚孕产妇健康因素的作用的文章。

结果

由于很少有研究旨在通过适当培训来考察传统接生员在降低孕产妇死亡率方面的潜在作用,其价值尚未得到充分研究。所考察的八篇手稿强调了传统接生员在孕产妇健康中的作用,包括使用经过培训与未经培训的传统接生员的结果。

结论与全球健康影响

综述中确定并推荐的传统接生员具体培训领域包括:识别分娩并发症、通过政策为传统接生员的做法提供社区支持、评估传统接生员培训项目以及加强医疗机构与传统接生员之间的合作。需要制定侧重于改善获得医疗服务机会的政策,重要的是,要为传统接生员提供正规健康教育培训,以改善孕产妇健康结果和服务不足的社区。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ff59/5777388/56e25d52078a/IJMA-6-130-g001.jpg

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