撒哈拉以南非洲地区男性伴侣参与分娩准备、并发症应对及产科紧急情况处理的研究:一项范围综述

Male partner involvement in birth preparedness, complication readiness and obstetric emergencies in Sub-Saharan Africa: a scoping review.

作者信息

Forbes Faye, Wynter Karen, Zeleke Berihun M, Fisher Jane

机构信息

Global and Women's Health, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd, Melbourne, Victoria, 3004, Australia.

Deakin University School of Nursing and Midwifery, Geelong, Victoria, Australia.

出版信息

BMC Pregnancy Childbirth. 2021 Feb 12;21(1):128. doi: 10.1186/s12884-021-03606-x.

Abstract

BACKGROUND

Maternal mortality remains a pressing concern across Sub-Sahara Africa. The 'Three Delays Model' suggests that maternal deaths are a consequence of delays in: seeking care, reaching medical care and receiving care. Birth Preparedness and Complication Readiness (BPCR) refers to a plan organised during pregnancy in preparation for a normal birth and in case of complications. Male partners in many Sub-Saharan African communities could play a pivotal role in a woman's ability to prepare for birth and respond to obstetric complications. This review aimed identify: the extent and quality of research performed on the topic of male partner involvement in BPCR in Sub-Saharan Africa; the degree to which populations and geographic areas are represented; how male partner involvement has been conceptualized; how male partners response to obstetric complications has been conceptualised; how the variation in male partners involvement has been measured and if any interventions have been performed.

METHODS

In this scoping review, articles were identified through a systematic search of databases MEDLINE, EMBASE and Maternity and Infant Care and a manual scan of relevant papers, journals and websites. All authors contributed to the screening process and a quality assessment using the Kmet checklist. The PRISMA checking list for Scoping Reviews was used to guide the search, data charting and reporting of the review The protocol was registered with PROSPERO (ID: CRD42019126263).

RESULTS

Thirty-five articles met inclusion criteria, reporting: 13 qualitative, 13 cross-sectional, 5 mixed method and 4 intervention studies. Data were contributed by approximately 14,550 participants (numbers were not always reported for focus groups) including: women who were pregnant or who had experienced pregnancy or childbirth within the previous 3 years, their male partners and key informants such as health workers and community leaders.

CONCLUSIONS

The diversity of study designs, aims and source countries in this body of literature reflects an emerging stage of research; as a result, the review yielded strong evidence in some areas and gaps in others. Male partner's involvement in BPCR and responding to obstetric emergencies can be conceptualised as being centrally involved in responding to complications and having some role in preparing for birth through their position in the chain of decisions and provision of logistic support. However, their knowledge of pregnancy complications and level of preparation for birth is low, suggesting they are making decisions without being fully informed. There is limited evidence on interventions to improve their knowledge. Future research efforts should be focused on producing standardised, culturally appropriate, higher level evidence.

摘要

背景

孕产妇死亡率仍是撒哈拉以南非洲地区的一个紧迫问题。“三个延误模型”表明,孕产妇死亡是由于在寻求护理、获得医疗护理和接受护理方面的延误所致。生育准备和并发症应对(BPCR)是指在孕期制定的一项计划,用于为正常分娩及应对并发症做准备。在撒哈拉以南非洲的许多社区,男性伴侣在女性的生育准备及应对产科并发症的能力方面可发挥关键作用。本综述旨在确定:关于撒哈拉以南非洲男性伴侣参与生育准备和并发症应对这一主题的研究范围和质量;研究涵盖的人群和地理区域范围;男性伴侣参与是如何被概念化的;男性伴侣对产科并发症的应对是如何被概念化的;男性伴侣参与程度的差异是如何衡量的,以及是否实施了任何干预措施。

方法

在这项范围综述中,通过系统检索MEDLINE、EMBASE和母婴护理数据库以及人工查阅相关论文、期刊和网站来识别文章。所有作者都参与了筛选过程,并使用Kmet清单进行质量评估。使用范围综述的PRISMA检查表来指导检索、数据制表和综述报告。该方案已在PROSPERO(编号:CRD42019126263)注册。

结果

35篇文章符合纳入标准,包括:13篇定性研究、13篇横断面研究、5篇混合方法研究和4篇干预研究。数据由约14550名参与者提供(焦点小组的人数并非总是有报告),包括:在过去3年内怀孕或经历过怀孕或分娩的女性、她们的男性伴侣以及诸如卫生工作者和社区领袖等关键信息提供者。

结论

这一系列文献中研究设计、目标和来源国的多样性反映了研究的一个新兴阶段;因此,本综述在某些领域得出了有力证据,而在其他领域存在空白。男性伴侣参与生育准备和并发症应对可被概念化为在应对并发症方面发挥核心作用,并通过其在决策链中的地位和提供后勤支持在生育准备中发挥一定作用。然而,他们对妊娠并发症的了解以及生育准备水平较低,这表明他们在做决策时并未充分了解情况。关于改善他们知识水平的干预措施的证据有限。未来的研究工作应集中于产生标准化的、适合文化背景的、更高水平的证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8950/7881528/7d55c66250ff/12884_2021_3606_Fig1_HTML.jpg

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