Department of Nursing Science, University of Calabar, Calabar, Nigeria.
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
J Clin Nurs. 2018 Apr;27(7-8):e1600-e1611. doi: 10.1111/jocn.14244. Epub 2018 Mar 25.
To facilitate the empowerment of members of a rural community to plan to take action to prevent maternal mortality.
Globally, about 300,000 maternal deaths occur yearly. Sub-Saharan Africa and Southern Asia regions account for almost all the deaths. Within those regions, India and Nigeria account for over a third of the global maternal deaths. Problem of maternal mortality in Nigeria is multifaceted. About 80% of maternal deaths are avoidable, given strategies which include skilled attendants, emergency obstetric care and community mobilisation. In this article, a strategy of community empowerment to plan to take action to prevent maternal mortality is discussed.
Participatory action research was used.
Twelve volunteers were recruited as coresearchers into the study through purposive and snowball sampling who, following an orientation workshop, undertook participatory qualitative data collection with an additional 29 community members. Participatory thematic analysis of the data was undertaken which formed the basis of the plan of action.
Community members attributed maternal morbidities and deaths to superstitious causes, delayed referrals by traditional birth attendants, poor transportation and poor resourcing of health facilities. Following critical reflection, actions were planned to empower the people to prevent maternal deaths through community education and advocacy meetings with stakeholders to improve health and transportation infrastructures; training of existing traditional birth attendants in the interim and initiating their collaboration with skilled birth attendants.
The community is a resource which if mobilised through the process of participatory action research can be empowered to plan to take action in collaboration with skilled birth attendants to prevent maternal mortality.
Interventions to prevent maternal deaths should include community empowerment to have better understanding of their circumstances as well as their collaboration with health professionals.
促进农村社区成员赋权,计划采取行动预防产妇死亡。
全球每年约有 30 万例产妇死亡。撒哈拉以南非洲和南亚地区占所有死亡人数的近 90%。在这些地区中,印度和尼日利亚占全球产妇死亡人数的三分之一以上。尼日利亚的产妇死亡问题是多方面的。如果采取包括熟练助产士、紧急产科护理和社区动员在内的策略,大约 80%的产妇死亡是可以避免的。在本文中,讨论了一种通过社区赋权来计划采取行动预防产妇死亡的策略。
使用参与式行动研究。
通过有目的和滚雪球抽样方法,招募了 12 名志愿者作为核心研究人员参与研究,他们在参加了一个定向研讨会后,与另外 29 名社区成员一起进行了参与式定性数据收集。对数据进行了参与式主题分析,这是行动计划的基础。
社区成员将产妇病残和死亡归因于迷信原因、传统助产妇的延迟转诊、交通条件差和卫生设施资源匮乏。在进行批判性反思后,计划采取行动,通过与利益相关者举行社区教育和宣传会议来增强人民的权能,以改善卫生和交通基础设施;在临时培训现有传统助产妇的同时,启动他们与熟练助产士的合作。
如果通过参与式行动研究的过程来动员社区,社区可以获得赋权,与熟练的助产士合作,共同制定预防产妇死亡的行动计划。
预防产妇死亡的干预措施应包括社区赋权,使他们更好地了解自己的情况,并与卫生专业人员合作。