埃塞俄比亚卫生系统为早产儿、低出生体重儿和患病新生儿护理提供支持设施的准备情况：定性评估。
Health system readiness to support facilities for care of preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment.
机构信息
Madda Walabu University, Bale Robe, Ethiopia.
Wolaita Sodo University, Wolaita Sodo, Ethiopia.
出版信息
BMC Health Serv Res. 2019 Nov 21;19(1):860. doi: 10.1186/s12913-019-4672-2.
BACKGROUND
Preterm birth is a worldwide challenge with the highest burden in low- and middle-income countries. Despite availability of low-cost interventions to decrease mortality of preterm, low birth weight, and sick newborns, these interventions are not well integrated in the health systems of low- and middle-income countries. The aim of this study was to assess, from the perspective of key stakeholders comprising leaders in the public health system, the health system readiness to support health care facilities in the care provided to preterm, low birth weight, and sick newborns in different regions of Ethiopia.
METHODS
A qualitative assessment using in-depth interviews with health facility leaders was conducted in health facilities in 3 regions of Ethiopia from December 2017 to February 2018. The interview guide was developed using a modified version of the World Health Organization health system building blocks.
RESULTS
Across the public health system, adequate and reliable space, power, and water were problematic. Human resource issues (training, staffing, and retention) were critical to being able to properly care for preterm, low birth weight, and sick newborns. Problems with functional equipment and equipment distribution systems were widespread. Funds were lacking to support preterm, low birth weight, and sick newborn needs in facilities. Data collection practices, data quality, and data utilization were all problematic. There were gaps in the availability of guidelines and protocols, specifically targeting preterm, low birth weight, and sick newborn care. Key facilitators, information disseminators, and influencers identified in the study were the Health Development Army, community and religious leaders, and mothers and families who had had positive experiences or outcomes of care.
CONCLUSIONS
The Ethiopian health system has opportunities across all 7 World Health Organization health system building blocks to strengthen readiness to support health facilities to provide quality care and improve outcomes for preterm, low birth weight, and sick newborns.
背景
早产是一个全球性挑战，中低收入国家的负担最重。尽管有降低早产儿、低出生体重儿和患病新生儿死亡率的低成本干预措施，但这些干预措施并未很好地融入中低收入国家的卫生系统。本研究旨在从公共卫生系统的主要利益攸关方（包括公共卫生系统的领导者）的角度评估卫生系统在支持卫生保健机构为埃塞俄比亚不同地区的早产儿、低出生体重儿和患病新生儿提供护理方面的准备情况。
方法
2017 年 12 月至 2018 年 2 月，在埃塞俄比亚的 3 个地区的卫生机构中，采用深入访谈的方法对卫生机构的领导进行了定性评估。访谈指南是使用世界卫生组织卫生系统组成部分的修改版本制定的。
结果
在整个公共卫生系统中，充足和可靠的空间、电力和水都是有问题的。人力资源问题（培训、人员配置和留用）对于能够正确照顾早产儿、低出生体重儿和患病新生儿至关重要。功能性设备和设备分配系统的问题普遍存在。缺乏资金来支持设施中早产儿、低出生体重儿和患病新生儿的需求。数据收集做法、数据质量和数据利用都存在问题。在针对早产儿、低出生体重儿和患病新生儿护理的指南和方案的可用性方面存在差距。在本研究中确定的关键促进因素、信息传播者和影响者是卫生发展军、社区和宗教领袖以及有过积极护理体验或结果的母亲和家庭。
结论
埃塞俄比亚卫生系统在所有 7 个世界卫生组织卫生系统组成部分都有机会加强准备，以支持卫生保健机构提供优质护理，并改善早产儿、低出生体重儿和患病新生儿的结局。
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