Institute of Research and Education Development, University of Health Sciences, Ministry of Health, Samsenthai Street, Pearvath Village, Sisathanark District, Vientiane Capital, Lao PDR, P.O. Box: 7444.
Vrije Universiteit Amsterdam, Athena Institute and Amsterdam Public Health Institute, Amsterdam, The Netherlands.
BMC Pregnancy Childbirth. 2019 Jul 22;19(1):255. doi: 10.1186/s12884-019-2345-0.
The maternal mortality rate in Lao PDR (Laos) is still the highest in Southeast Asia, at 197 per 100,000 live births. Antenatal care (ANC) could contribute to maternal and child mortality reduction. The quality of ANC service remains inadequate and little information is available on the quality of health education and counseling services of health providers in Laos. This study aims to gain insight into the perceptions of stakeholders on both supply and demand sides of public ANC services in Laos and evidence for recommendations to improve the quality of ANC services.
Semi-structured interviews were conducted with 50 participants from different stakeholder groups; on the demand side, couples with a currently pregnant woman and mothers with children under one year of age and a family member; and on the supply side, health providers, managers, policy makers of the Ministry of Health, and development partners. The interviews were voice recorded and transcribed verbatim for analysis by open and thematic coding, using the MAXQDA software program.
All respondents reported that the number of pregnant women who visit ANC services has increased. However, an analysis of the supply side identified issues related to the quality of ANC that need to be improved in the areas of facilities, human resources, privacy and confidentiality, providers' behavior, attitudes, and ineffective communication skills when it comes to providing health education and counseling to pregnant women and their family members. The analysis of the demand side mainly emphasized the issues of providers' behavior, attitude, communication and unequal treatment, and the lack of privacy. Both sides also suggested solutions to the problems, such as training, effective materials, rewarding good role models, and building a feedback system.
The number of public ANC services has increased, but both supply and demand sides experienced challenges with the quality of ANC. All respondents proposed possible solutions to improve quality of ANC service in public health facilities in Laos.
老挝的孕产妇死亡率仍然是东南亚最高的，为每 10 万活产儿 197 例。产前护理 (ANC) 可以有助于降低母婴死亡率。 ANC 服务的质量仍然不足，关于老挝卫生提供者的健康教育和咨询服务质量的信息很少。本研究旨在深入了解利益相关者对老挝公共 ANC 服务供需双方的看法，并为改善 ANC 服务质量提供证据。
对来自不同利益相关者群体的 50 名参与者进行了半结构式访谈；在需求方面，有目前怀孕的夫妇和 1 岁以下儿童及其家庭成员；在供应方面，有卫生提供者、管理人员、卫生部政策制定者和发展伙伴。访谈进行了录音，并逐字转录为分析，使用 MAXQDA 软件程序进行开放式和主题式编码。
所有受访者都报告说，接受 ANC 服务的孕妇人数有所增加。然而，对供应方的分析确定了与 ANC 质量相关的问题，这些问题需要在设施、人力资源、隐私和保密性、提供者行为、态度以及在向孕妇及其家庭成员提供健康教育和咨询方面缺乏有效的沟通技巧等方面得到改善。需求方面的分析主要强调了提供者行为、态度、沟通和不平等对待以及缺乏隐私的问题。供需双方还就培训、有效材料、奖励良好榜样和建立反馈系统等问题提出了解决方案。
公共 ANC 服务的数量有所增加，但供需双方都在 ANC 质量方面面临挑战。所有受访者都提出了改善老挝公共卫生设施 ANC 服务质量的可能解决方案。
