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利益相关者对智利人性化分娩实践和产科暴力的看法:范围综述。

Stakeholders' perceptions of humanized birth practices and obstetric violence in Chile: A scoping review.

机构信息

Centro Interdisciplinario de Estudios en Salud (CIESAL), School of Obstetrics, Faculty of Medicine, San Felipe Campus, Universidad de Valparaíso, San Felipe, Chile. ORCID: 0000-0002-9858-4125.

School of Obstetrics, Faculty of Medicine, San Felipe Campus, Universidad de Valparaíso, San Felipe, Chile. ORCID: 0000-0002-6682-7815.

出版信息

Medwave. 2020 Oct 21;20(9):e8047. doi: 10.5867/medwave.2020.09.8047.

Abstract

INTRODUCTION

Chile has an incipient policy regarding humanized birth practices. Obstetric violence is becoming an issue in the public discussion, as brought up by women. Despite this advancement, no initiatives were observed to overcome the conflict. Questions arise from the different points of view of the main stakeholders involved. These questions help identify strategies contributing to the development of health policies that consider influencing actors.

OBJECTIVES

To identify stakeholders' perceptions of humanized care in childbirth and obstetric violence.

METHODS

We conducted a scoping review that included articles and analysis of texts reflecting the scientific communities' point of view. We included statements from governmental, social, professional, and political actors as expressed in institutional websites. Moreover, we performed a qualitative inductive, thematic content analysis.

RESULTS

We included seventy documents. The scientific community is visualized as aligned with ministerial recommendations for personalized childbirth. Several researchers analyze the difficulties for its improvement due to the historical, socio-cultural, and economic construction of the predominantly biomedical model for birthing. Convergence is observed among the scientific community and other stakeholders in recognition of humanized birth benefits and the need to overcome institutional obstacles within the health sector. However, the progress of the proposed change is slow, and health professionals' resistance to address women's complaints towards obstetric violence and claim of quality care is observed. This discussion finds its reflection in a parliamentary discussion.

CONCLUSIONS

The stakeholders' analysis reflects areas of conflict and consensus, as well as the diverse interacting dimensions that hinder the advance of humanized care in childbirth. This broad analysis strategy contributes to identifying critical aspects to be addressed in the development of integral and effective health policies.

摘要

简介

智利在人性化分娩实践方面制定了初步政策。由于女性提出,产科暴力已成为公众讨论的问题。尽管取得了这一进展,但仍未观察到任何举措来解决这一冲突。不同利益相关者的观点引发了问题。这些问题有助于确定有助于制定考虑到影响因素的卫生政策的策略。

目的

识别利益相关者对分娩人性化护理和产科暴力的看法。

方法

我们进行了一项范围综述,其中包括反映科学界观点的文章和文本分析。我们纳入了政府、社会、专业和政治行为者在机构网站上发表的声明。此外,我们进行了定性归纳、主题内容分析。

结果

我们纳入了 70 份文件。科学界被视为与部长级个性化分娩建议一致。一些研究人员分析了由于历史、社会文化和经济上对主要的生物医学分娩模式的构建,其改善所面临的困难。科学界和其他利益相关者在承认人性化分娩的益处以及需要克服卫生部门内机构障碍方面达成了共识。然而,所提议变革的进展缓慢,观察到卫生专业人员对处理女性对产科暴力的投诉和要求提供优质护理的抵制。这一讨论在议会讨论中得到了反映。

结论

利益相关者的分析反映了冲突和共识的领域,以及阻碍人性化分娩发展的多样化相互作用的维度。这种广泛的分析策略有助于确定在制定综合有效的卫生政策方面需要解决的关键问题。

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