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结合任务转移和基于社区的护理改善孕产妇健康:实用方法和患者认知。

Combining task shifting and community-based care to improve maternal health: Practical approaches and patient perceptions.

机构信息

University of Maryland, Baltimore County, Department of Psychology, 1000 Hilltop Cir, Baltimore, MD, 21250, USA.

出版信息

Soc Sci Med. 2018 Nov;216:26-32. doi: 10.1016/j.socscimed.2018.09.018. Epub 2018 Sep 16.

Abstract

Globally, community-based care and task shifting strategies are used to address maternal healthcare shortages in low-income countries. Limited research exists on models that combine these strategies. Using a qualitative approach, we explored Haitian women's perceptions of the Midwives for Haiti model, which unites task shifting and community-based care by training nurses as skilled birth attendants and offering healthcare via rotating, mobile clinics. Eight focus groups (N = 52) were conducted in rural Haiti in March 2017. Thematic analysis of data indicated that perceptions of care were universally positive. Participants cited accessible patient-centred care, affordable services, and health education as primary motivators to attend. Results illustrated the importance of women's perceptions on the future use of mobile clinic sites or other formal care. Future efforts to address maternal healthcare shortages should consider the Midwives for Haiti model, combining task shifting and community-based care to address common social, topographical, or financial barriers to maternal healthcare.

摘要

在全球范围内,社区为基础的护理和任务转移策略被用于解决低收入国家的产妇保健短缺问题。关于结合这些策略的模式的研究有限。本研究采用定性方法,探讨了海地妇女对海地助产士模式的看法,该模式通过培训护士成为熟练的接生员,并通过流动诊所提供医疗服务,将任务转移和社区为基础的护理结合在一起。2017 年 3 月,在海地农村地区进行了 8 个焦点小组(N=52)。对数据的主题分析表明,对护理的看法普遍是积极的。参与者提到了可及的以患者为中心的护理、负担得起的服务和健康教育,这些是促使她们就诊的主要动机。结果表明,妇女对未来使用流动诊所或其他正规护理的看法很重要。未来解决产妇保健短缺问题的工作应考虑海地助产士模式,将任务转移和社区为基础的护理结合起来,以解决产妇保健方面常见的社会、地形或经济障碍。

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