Department of Health, Behavior and Society, Jimma University, P. O. Box 378, Jimma, Ethiopia.
BMC Pediatr. 2020 Jun 20;20(1):303. doi: 10.1186/s12887-020-02211-9.
Globally, possible serious bacterial infection [PSBI] is a cause for about 600,000 newborn deaths per year. To decrease the burden of this infection, a community-based management newborn PSBI when referral to hospital is not possible has been on implementation. Studies showed gaps in the service utilization and this study was aimed at exploring its barriers and facilitators.
A descriptive qualitative study was conducted from March 11- April 7, 2019, in Debre Libanos District, Ethiopia. Study participants were recruited purposively. Women who gave birth within 2 months before data collection, health extension workers [HEW], health workers, religious leader, kebele chairman, and other community members were involved in the study. Five in-depth interviews, seven key informant interviews, and four focused group discussions were conducted with a total of fifty-two participants. The data were audio-recorded, transcribed verbatim and translated, and inductive thematic analysis was done using Atlas ti.7.1 software.
The availability of health workers trained on community-based newborn care [CBNC], Integrated Management of Newborn and Childhood Illness guidelines, availability of medical supplies and job aids, and performance review meetings were identified as facilitators. Communities perception that the newborn illness has no medical treatment, newborn illness is not severe and is self-resolution; the belief in healing power of traditional medicines, socio-cultural and religious beliefs, lack of awareness about service availability at the health post, poor supportive supervision or monitoring, shortage of HEW, the residency of HEWs outside the health post, a poor commitment of health workers and HEWs, and non-functionality of health developmental army were explored as barriers.
The findings provided insight into the facilitators of and barriers to community-based service utilization for newborn PSBI management. There is a need to develop strategies to address the barriers. Therefore, health care providers should have to develop strategies, and conduct a behavioral change communication to change the perception of community members towards newborn illnesses, promote the availability of the service at the health post, and the HEWs provide the service staying at the health post.
在全球范围内，可能的严重细菌感染[PSBI]是导致每年约 60 万新生儿死亡的原因之一。为了减轻这种感染的负担，已经在实施一种基于社区的管理新生儿 PSBI 的方法，即在无法转诊到医院的情况下进行管理。研究表明，该服务的利用存在差距，本研究旨在探讨其障碍和促进因素。
这是一项描述性的定性研究，于 2019 年 3 月 11 日至 4 月 7 日在埃塞俄比亚德布雷利巴诺斯区进行。研究参与者是通过目的性抽样招募的。在数据收集前的 2 个月内分娩的妇女、卫生推广员[HEW]、卫生工作者、宗教领袖、村长和其他社区成员参与了这项研究。共对 52 名参与者进行了 5 次深入访谈、7 次关键人物访谈和 4 次焦点小组讨论。数据以音频记录，逐字转录并翻译，使用 Atlas ti.7.1 软件进行归纳主题分析。
具备社区新生儿护理[CBNC]培训的卫生工作者、《新生儿和儿童疾病综合管理指南》、医疗用品和工作辅助工具的可用性，以及绩效审查会议被认为是促进因素。社区认为新生儿疾病没有治疗方法、疾病不严重且会自行缓解、传统药物具有治疗能力、社会文化和宗教信仰、对卫生站服务可用性缺乏认识、支持性监督或监测不力、卫生推广员人数不足、卫生推广员居住在卫生站之外、卫生工作者和卫生推广员承诺度低、卫生发展军不起作用，这些都被认为是障碍。
研究结果深入了解了社区为管理新生儿 PSBI 提供服务的促进因素和障碍。需要制定策略来解决这些障碍。因此，医疗保健提供者应该制定策略，并开展行为改变沟通，以改变社区成员对新生儿疾病的看法，促进卫生站提供服务，并促使卫生推广员留在卫生站提供服务。
