Bazzano Alessandra N, Stolow Jeni A, Duggal Ryan, Oberhelman Richard A, Sun Yaoyao, Var Chivorn
Department of Global Community Health and Behavioral Sciences, Tulane School Public Health and Tropical Medicine, New Orleans, 70112 LA, USA.
School of Medicine, Tulane University, New Orleans, 70112 LA, USA.
Healthcare (Basel). 2020 Jun 26;8(2):187. doi: 10.3390/healthcare8020187.
Maternal and under five-year-old mortality rates have reduced in the last two decades globally due to concerted effort, yet newborn deaths remain unacceptably prevalent. Behavior change is an important component of interventions to address newborn health problems in low-income countries. In Cambodia, maternal and newborn mortality has markedly decreased, and continued improvements will allow the country to achieve further reduction in newborn morbidity. The results of an implementation study of the Newborn Care and Infection Control Initiative using process evaluation are presented to provide insight into the trial implementation and context of the program that may have contributed to intervention results. The study utilized a mixed method process to explore the context, mechanisms, and implementation of intervention components: training of village health support group volunteers to provide home visits, training of midwives on infection prevention and control around the perinatal period, counseling on newborn care, and provision of training materials for counseling and intervention. Implementation was evaluated through quantitative and qualitative data collection including surveys, observation, semi-structured interviews, focus groups, and visual media. Descriptive statistics summarized the quantitative data and thematic analysis was used to explore the qualitative data. The evaluation identified several factors that might have influenced the outcomes of the trial: continuity of health center staff communication, timing and ability to complete home visits, and training quality. Additional support for parents in the perinatal period, preferably provided at the community level, will contribute to further improvement in health outcomes for newborns in this area. Researchers in this context should consider mechanisms to improve the coordination of health facility staff counseling while providing support and resources to ensure home visits to families with newborns are made on time. Attention to staffing, training, and quality of newborn health interventions is critical in planning for the scaling-up of newborn health programming.
在过去二十年里，由于各方共同努力，全球孕产妇和五岁以下儿童死亡率有所下降，但新生儿死亡仍然普遍存在，令人无法接受。行为改变是低收入国家解决新生儿健康问题干预措施的重要组成部分。在柬埔寨，孕产妇和新生儿死亡率显著下降，持续改善将使该国进一步降低新生儿发病率。本文介绍了一项使用过程评估的新生儿护理与感染控制倡议实施研究的结果，以深入了解该试验的实施情况以及可能促成干预结果的项目背景。该研究采用混合方法探讨干预措施的背景、机制和实施情况：培训乡村卫生支持小组志愿者进行家访，对助产士进行围产期感染预防和控制培训，提供新生儿护理咨询，并提供咨询和干预培训材料。通过定量和定性数据收集进行实施评估，包括调查、观察、半结构化访谈、焦点小组和视觉媒体。描述性统计总结定量数据，主题分析用于探索定性数据。评估确定了几个可能影响试验结果的因素：卫生中心工作人员沟通的连续性、完成家访的时间和能力以及培训质量。在围产期为父母提供更多支持，最好在社区层面提供，将有助于进一步改善该地区新生儿的健康结果。在这种情况下，研究人员应考虑改进卫生机构工作人员咨询协调的机制，同时提供支持和资源以确保及时对有新生儿的家庭进行家访。在规划扩大新生儿健康项目时，关注人员配备、培训和新生儿健康干预质量至关重要。
