Owen Medge D, Colburn Elizabeth, Tetteh Cecilia, Srofenyoh Emmanuel K
Department of Anesthesiology, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157-1009, USA.
Kybele, Inc, Lewisville, NC, USA.
BMC Pregnancy Childbirth. 2020 Nov 4;20(1):664. doi: 10.1186/s12884-020-03365-1.
The recent use of antenatal care (ANC) has steadily improved in low- and middle-income countries (LMIC), but postnatal care (PNC) has been widely underutilized. Most maternal and newborn deaths occur during the critical postnatal period, but PNC does not receive adequate attention or support, particularly in Sub-Saharan Africa. In Ghana, the majority of mothers attend four ANC assessments, but far fewer receive the four recommended PNC visits. This study sought to understand perceptions toward PNC counselling administered prior to discharge among both mothers and healthcare providers in the Greater Accra Region of Ghana.
Facility assessments were conducted among 13 health facilities to determine the number and type of deliveries, staffing, timing of discharge following delivery and the PNC schedule. Structured interviews were conducted for 172 mothers over four-months in facilities, which included one regional hospital, four district hospitals, and eight sub-district level hospitals. Additionally, healthcare providers from 12 of the 13 facilities were interviewed. Data were analyzed with Chi-square or students t-test, as appropriate, with p < 0.05 considered statistically significant.
Ninety-nine percent of mothers received PNC instructions prior to hospital discharge, the majority of which were given in a group format. Mothers in the regional hospital were significantly more likely to have been informed about maternal danger signs but were less likely to know the PNC schedule than were mothers in district and sub-district facilities. No mother recalled more than four maternal or five newborn danger signs. Thirty-eight percent of facilities did not have PNC guidelines. Most patient and providers reported positive attitudes toward the level of PNC education, however, knowledge was inconsistent regarding the number and timing of PNC visits as well as other critical information. Only 23% of patients reported having a contact number to call for concerns.
Despite overall positive feelings toward PNC among Ghanaian mothers and providers, there are significant gaps in PNC education that must be addressed in order to recognize problems and to prevent serious complications. Improvements in pre-discharge PNC counseling should be provided in Ghana to give mothers and babies a better chance at survival in the critical postnatal period.
在低收入和中等收入国家（LMIC），近期产前护理（ANC）的利用率稳步提高，但产后护理（PNC）却未得到充分利用。大多数孕产妇和新生儿死亡发生在关键的产后时期，但产后护理并未得到足够的关注或支持，尤其是在撒哈拉以南非洲地区。在加纳，大多数母亲会进行四次产前评估，但接受四次推荐的产后护理访视的母亲要少得多。本研究旨在了解加纳大阿克拉地区母亲和医疗保健提供者对出院前进行的产后护理咨询的看法。
对13家医疗机构进行了设施评估，以确定分娩数量和类型、人员配备、分娩后出院时间以及产后护理时间表。在四个月内，对172名母亲在医疗机构进行了结构化访谈，这些医疗机构包括一家区域医院、四家 district 医院和八家 sub-district 级医院。此外，还对13家医疗机构中的12家的医疗保健提供者进行了访谈。数据采用卡方检验或学生t检验进行分析，以p < 0.05为具有统计学意义。
99%的母亲在出院前接受了产后护理指导，其中大部分是以小组形式进行的。区域医院的母亲比 district 和 sub-district 设施的母亲更有可能了解孕产妇危险信号，但了解产后护理时间表的可能性较小。没有母亲能回忆起超过四个孕产妇或五个新生儿危险信号。38%的设施没有产后护理指南。大多数患者和提供者对产后护理教育水平持积极态度，然而，关于产后护理访视的次数和时间以及其他关键信息的知识并不一致。只有23%的患者报告有可拨打咨询的联系电话。
尽管加纳母亲和提供者对产后护理总体上有积极感受，但产后护理教育仍存在重大差距，必须加以解决，以便识别问题并预防严重并发症。加纳应改善出院前的产后护理咨询，以便母亲和婴儿在关键的产后时期有更好的生存机会。
