Buser Julie M, Munro-Kramer Michelle L, Veliz Philip T, Zhang Xingyu, Lockhart Nancy, Biemba Godfrey, Ngoma Thandiwe, Scott Nancy, Lori Jody R
Michigan Medicine, University of Michigan, Ann Arbor, Michigan, United States of America.
Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, United States of America.
PLoS One. 2021 Jan 22;16(1):e0245893. doi: 10.1371/journal.pone.0245893. eCollection 2021.
As highlighted in the International Year of the Nurse and the Midwife, access to quality nursing and midwifery care is essential to promote maternal-newborn health and improve survival. One intervention aimed at improving maternal-newborn health and reducing underutilization of pregnancy services is the construction of maternity waiting homes (MWHs). The purpose of this study was to assess whether there was a significant change in antenatal care (ANC) and postnatal care (PNC) attendance, family planning use, and vaccination rates before and after implementation of the Core MWH Model in rural Zambia. A quasi-experimental controlled before-and-after design was used to evaluate the impact of the Core MWH Model by assessing associations between ANC and PNC attendance, family planning use, and vaccination rates for mothers who gave birth to a child in the past 13 months. Twenty health care facilities received the Core MWH Model and 20 were identified as comparison facilities. Before-and-after community surveys were carried out. Multivariable logistic regression were used to assess the association between Core MWH Model use and ANC and PNC attendance. The total sample includes 4711 mothers. Mothers who used the Core MWH Model had better ANC and PNC attendance, family planning use, and vaccination rates than mothers who did not use a MWH. All mothers appeared to fare better across these outcomes at endline. We found an association between Core MWH Model use and better ANC and PNC attendance, family planning use, and newborn vaccination outcomes. Maternity waiting homes may serve as a catalyst to improve use of facility services for vulnerable mothers.
正如“国际护士和助产士年”所强调的,获得高质量的护理和助产服务对于促进孕产妇和新生儿健康以及提高存活率至关重要。旨在改善孕产妇和新生儿健康并减少妊娠服务利用不足的一项干预措施是建造孕产妇候产之家(MWHs)。本研究的目的是评估在赞比亚农村实施核心MWH模式前后,产前护理(ANC)和产后护理(PNC)的就诊率、计划生育的使用情况以及疫苗接种率是否有显著变化。采用准实验性前后对照设计,通过评估在过去13个月内生育孩子的母亲的ANC和PNC就诊率、计划生育的使用情况以及疫苗接种率之间的关联,来评估核心MWH模式的影响。20个医疗保健机构接受了核心MWH模式,另外20个被确定为对照机构。开展了前后社区调查。使用多变量逻辑回归来评估核心MWH模式的使用与ANC和PNC就诊率之间的关联。总样本包括4711名母亲。使用核心MWH模式的母亲在ANC和PNC就诊率、计划生育的使用情况以及疫苗接种率方面比未使用MWH的母亲更好。在终点时,所有母亲在这些结果方面似乎都表现得更好。我们发现核心MWH模式的使用与更好的ANC和PNC就诊率、计划生育的使用情况以及新生儿疫苗接种结果之间存在关联。孕产妇候产之家可能成为改善弱势母亲利用设施服务的一个催化剂。