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阐明南非北部的医生在孕产妇保健方面发现的挑战和解决方案:一项定性研究。

Elucidating challenges and solutions in the maternal healthcare, identified by medical doctors in northern South Africa: a qualitative study.

机构信息

Department of Health Sciences, Lund University, Södra Förstadsgatan 35, Malmö, Sweden.

Department of Neuroscience, Care and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, Sweden.

出版信息

Pan Afr Med J. 2020 Aug 31;36:376. doi: 10.11604/pamj.2020.36.376.18544. eCollection 2020.

Abstract

INTRODUCTION

as South Africa's maternal mortality ratio increased between 1990 and 2015, the country failed to reach the United Nations millennium development goal 5a. The maternal mortality ratio of Limpopo province is higher than the national average and previous studies report shortages of manpower and medical equipment in Limpopo province. The overall study aim was to elucidate views and experiences of medical doctors regarding maternal healthcare by identifying the challenges they experience and solutions they suggest.

METHODS

a qualitative interview-based study was performed with ten medical doctors as participants. Manifest content analysis was used to analyze the data.

RESULTS

the main findings were categorized as lack of material and human resources, feelings of experienced isolation and solution-focused expressions. The challenges identified included logistical issues, staffing issues, demographic characteristics of the patient population, poor interinstitutional communication and lack of support from the administration. The solutions included revision of resource allocation and improvement of the interinstitutional cooperation. For example, participants suggested that exchange programs between hospitals could be arranged, that the emergency medical service personnel could triage patients and that private practitioners could be contracted to work at public institutions.

CONCLUSION

most identified challenges were related to a lack of resources. Based on their inside experience, the participants suggested several solutions. These firsthand accounts of the local medical doctors highlight the need for intervention and should be taken into account when it comes to improving the provincial healthcare and working toward achieving the healthcare-related sustainable development goals by 2030.

摘要

简介

南非的孕产妇死亡率在 1990 年至 2015 年间上升,未能实现联合国千年发展目标 5a。林波波省的孕产妇死亡率高于全国平均水平,此前的研究报告称该省人力和医疗设备短缺。总体研究目的是通过确定他们所经历的挑战和他们提出的解决方案,阐明医生对孕产妇保健的看法和经验。

方法

采用基于定性访谈的研究方法,选取 10 名医生作为参与者。采用明显内容分析法对数据进行分析。

结果

主要发现可分为缺乏物质和人力资源、感到孤立和以解决方案为导向的表达。确定的挑战包括后勤问题、人员配备问题、患者人群的人口统计学特征、机构间沟通不畅以及管理层缺乏支持。解决方案包括重新分配资源和改善机构间合作。例如,参与者建议可以安排医院之间的交流计划,让急救医疗服务人员对患者进行分诊,还可以与私人执业医生签订合同,让他们在公立机构工作。

结论

大多数确定的挑战都与资源短缺有关。根据他们的内部经验,参与者提出了一些解决方案。这些当地医生的第一手资料突出了干预的必要性,在改善省级医疗保健和努力实现到 2030 年与医疗保健相关的可持续发展目标方面应予以考虑。

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Midwifery workforce profile in Limpopo Province referral hospitals.林波波省转诊医院的助产士劳动力概况。
Afr J Prim Health Care Fam Med. 2014 Apr 25;6(1):E1-4. doi: 10.4102/phcfm.v6i1.573.

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