Terkawi Abdullah Sulieman, Bakri Basil, Alsadek Amena S, Alsibaee Rawaa H, Alasfar Esraa M, Albakour Amna H, Aljouja Abdulhannan Y, Alshaikhwais Nour A, Fares Feras A, Flood Pamela D, Jnaid Hussam, Najib Amina A, Saloom Diaa A, Zahra Noran A, Altirkawi Khalid A
Syrian Expatriate Medical Association (SEMA), SEMA-US, Charlottesville, VA, USA.
Department of Anaesthesiology, University of Virginia, Charlottesville, VA, USA.
Avicenna J Med. 2019 Jul-Sep;9(3):94-106. doi: 10.4103/ajm.AJM_190_18.
Since the uprising in 2011, there have been limited health-care data from inside Syria regarding women's health. This study aimed to provide an updated account of women's health, including pregnancy, perinatal care, childbirth, and other conditions to identify obstacles and challenges to health-care delivery in Northwestern Syria.
This is a prospective data registry study, using a medical electronic records system that builds on the () codes. We collected data from one medical center in Northwestern Syria during 2017. We conducted a survey to understand patients' knowledge of and barriers limiting antenatal care (ANC).
We studied 7213 patients' health status and surveyed 134 regarding ANC. Prenatal care, delivery, and miscarriage treatment represented the most common (70%) reasons for women's health-care visits, followed by menstrual disorders (17%). From 2057 delivery records, 70% delivered vaginally and 30% required cesarean delivery. Our findings showed that 1169 (24%) of the pregnant women (4936) in 2017 were adolescents, of them 22 (0.44%) were 14 years old. Regarding ANC visits, 85% of respondents did not have a single ANC visit in the first trimester, 82% had no visits in the second trimester, and 44% had no visits in the third trimester. Thirty-one percent had no ANC visit throughout the entire pregnancy. Only 13% had postnatal care (PNC) visits. Women who live in the refugee camp are 2.7 times less likely to meet the World Health Organization (WHO) criteria for focused ANC (FANC = 4 visits) compared to those who reside in town ( < 0.001), with only 14% having met the FANC. The major barrier to ANC is related to transportation (34%), followed by factors related to the study center (29%) and knowledge and education (19%). We estimated the number of obstetrics-gynecology doctors per 1000 populations to be 0.02.
We found a huge deficiency in ANC and PNC visits, a high adolescent birth rate, and a higher cesarean-to-vaginal delivery ratio than what is recommended by the WHO. We also found a severe shortage in the number of obstetrician-gynecologists serving this population.
自2011年起义以来，叙利亚境内关于妇女健康的医疗保健数据有限。本研究旨在提供一份关于妇女健康的最新情况报告，包括怀孕、围产期护理、分娩及其他情况，以确定叙利亚西北部医疗保健服务提供过程中的障碍和挑战。
这是一项前瞻性数据登记研究，使用基于（）编码的医学电子记录系统。2017年，我们从叙利亚西北部的一个医疗中心收集数据。我们进行了一项调查，以了解患者对产前护理（ANC）的了解情况以及限制产前护理的障碍。
我们研究了7213名患者的健康状况，并对134名患者进行了关于产前护理的调查。产前护理、分娩和流产治疗是妇女进行医疗保健就诊的最常见原因（70%），其次是月经紊乱（17%）。从2057份分娩记录来看，70%为阴道分娩，30%需要剖宫产。我们的研究结果显示，2017年4936名孕妇中有1169名（24%）为青少年，其中22名（0.44%）年龄为14岁。关于产前护理就诊情况，85%的受访者在孕早期没有进行过一次产前护理就诊，82%在孕中期没有就诊，44%在孕晚期没有就诊。31%的孕妇在整个孕期都没有进行产前护理就诊。只有13%的孕妇进行了产后护理（PNC）就诊。与居住在城镇的妇女相比，居住在难民营的妇女达到世界卫生组织（WHO）集中产前护理标准（FANC = 4次就诊）的可能性要低2.7倍（< 0.001），只有14%的人达到了集中产前护理标准。产前护理的主要障碍与交通有关（34%），其次是与研究中心相关的因素（29%）以及知识和教育方面的因素（19%）。我们估计每1000人口中妇产科医生的数量为0.02。
我们发现产前护理和产后护理就诊存在巨大不足，青少年出生率高，剖宫产与阴道分娩的比例高于世界卫生组织的建议。我们还发现为该人群服务的妇产科医生数量严重短缺。
