Kuupiel Desmond, Tlou Boikhutso, Bawontuo Vitalis, Mashamba-Thompson Tivani P
Department of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
Faculty of Health and Allied Sciences, Catholic University College of Ghana, Fiapre, Sunyani, Ghana.
Heliyon. 2019 Feb 19;5(2):e01236. doi: 10.1016/j.heliyon.2019.e01236. eCollection 2019 Feb.
Improving access to maternal healthcare in resource-limited settings plays a critical role in improving maternal health outcomes and reducing maternal deaths. However barriers and challenges may exist in rural clinics and could affect successful implementation. This study assessed the current accessibility of pregnancy-related point-of-care (POC) diagnostic tests for maternal healthcare in rural primary healthcare (PHC) clinics in northern Ghana.
We randomly selected 100 PHC clinics providing maternal healthcare from a total list of 356 PHC clinicss obtained from the Regional Health Directorate. Selected clinics were surveyed from February to March 2018, using an adopted survey tool. We obtained data for clinic-level staffing, availability, usage, and desired POC diagnostic tests. Stata 14 was used for data analysis.
Majority (64%) of the respondents were midwives. The mean ± standard deviation (SD) years of work experience and working hours per week were estimated at 5.6 years ± 0.4 and 122 hours ± 5.2 respectively. Average antenatal clinic attendance (clinic census) per month was 65 ± 67 pregnant women (Range: 3-360). The mean ± SD POC tests available and use was 4.9 tests ± 2.2. POC tests for malaria, HIV, urine pregnancy, and blood pressure monitoring devices were available in most clinics. POC tests requested by the clinics to assist them care for pregnant women included: Glucose-6-phosphate dehydrogenase (95%); hepatitis C (94%); sickling (91%); tuberculosis, blood glucose and blood type (89%) each; urinary tract infection (87%); urine protein (81%); hepatitis B (78%); haemoglobin (76%); and syphilis (76%).
There is poor accessibility to pregnancy-related POC diagnostic tests for maternal healthcare due to low availability (≤5 tests per PHC clinic) of POC tests in rural PHC clinics in northern Ghana.
在资源有限的环境中改善孕产妇保健服务的可及性，对改善孕产妇健康结局和降低孕产妇死亡起着关键作用。然而，农村诊所可能存在障碍和挑战，这可能会影响实施的成功。本研究评估了加纳北部农村初级卫生保健（PHC）诊所中与妊娠相关的即时检验（POC）诊断测试在孕产妇保健方面的当前可及性。
我们从地区卫生局提供的356家初级卫生保健诊所的总名单中随机选择了100家提供孕产妇保健服务的初级卫生保健诊所。2018年2月至3月，使用一种经过改编的调查工具对选定的诊所进行了调查。我们获取了诊所层面的人员配备、可用性、使用情况以及所需的即时检验诊断测试的数据。使用Stata 14进行数据分析。
大多数（64%）受访者为助产士。工作经验的平均±标准差（SD）年数和每周工作小时数分别估计为5.6年±0.4年和122小时±5.2小时。每月平均产前诊所就诊人数（诊所普查）为65±67名孕妇（范围：3 - 360）。可用和使用的即时检验测试的平均±标准差为4.9项测试±2.2项。大多数诊所都有疟疾、艾滋病毒、尿妊娠和血压监测设备的即时检验测试。诊所要求的用于协助照顾孕妇的即时检验测试包括：葡萄糖-6-磷酸脱氢酶（95%）；丙型肝炎（94%）；镰状细胞病（91%）；结核病、血糖和血型（各89%）；尿路感染（87%）；尿蛋白（81%）；乙型肝炎（78%）；血红蛋白（76%）；以及梅毒（76%）。
由于加纳北部农村初级卫生保健诊所中即时检验测试的可用性较低（每个初级卫生保健诊所≤5项测试），与妊娠相关的即时检验诊断测试在孕产妇保健方面的可及性较差。
