Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool UK.
Kenya Medical Research Institute, Centre for Global Health Research, Kisumu, Kenya.
Paediatr Int Child Health. 2021 May;41(2):145-153. doi: 10.1080/20469047.2021.1881269. Epub 2021 Feb 28.
Low-birthweight (LBW) infants (<2500 g) are at greatest risk of mortality in the neonatal period, particularly in low- and middle-income countries. Timely access to quality healthcare averts adverse outcomes.
To explore caregiver experiences and healthcare provider perspectives of accessing healthcare for LBW infants in rural Kenya.
This qualitative study was undertaken in Homa Bay County of in rural western Kenya in June 2019. In-depth interviews with eleven caregivers and four healthcare providers were conducted by a trained research assistant. All interviews were transcribed verbatim, and transcripts in the local languages were translated into English. A thematic framework was used to analyse the data.
At the community and individual level,community misconceptions about LBW infants, inadequate infant care practices after discharge, lack of maternal support networks, long distances from healthcare facilities and lack of financial support were key challenges. In addition, long hospital waiting times, healthcare worker strikes and the apparent inadequate knowledge and skills of healthcare providers were disincentives among caregivers. Among healthcare providers, health system deficiencies (staff shortages and inadequate resources for optimal assessment and treatment of LBW infants) and maternal illiteracy were key challenges. Education by staff during antenatal visits and community support groups were enablers.
Accessing healthcare for LBW infants in this community is fraught with challenges which have implications for their post-discharge outcome. There is an urgent need to develop and test strategies to address the barriers at the community and health system level to optimise outcome..
低出生体重（LBW）婴儿（<2500 克）在新生儿期死亡率最高，尤其是在低收入和中等收入国家。及时获得高质量的医疗保健可以避免不良后果。
探讨肯尼亚农村地区照顾者获得 LBW 婴儿医疗保健的经验和医疗服务提供者的看法。
本 qualitative 研究于 2019 年 6 月在肯尼亚西部农村的 Homa Bay 县进行。通过一名经过培训的研究助理对 11 名照顾者和 4 名医疗服务提供者进行深入访谈。所有访谈均逐字转录，并将当地语言的转录翻译成英文。使用主题框架分析数据。
在社区和个人层面上，社区对 LBW 婴儿的误解、出院后婴儿护理不足、缺乏产妇支持网络、远离医疗机构以及缺乏经济支持是主要挑战。此外，长时间的医院等待时间、医护人员罢工以及医护人员明显缺乏知识和技能也是照顾者的障碍。在医疗服务提供者中，卫生系统缺陷（人员短缺和缺乏资源以最佳评估和治疗 LBW 婴儿）和产妇文盲是主要挑战。工作人员在产前检查期间和社区支持小组提供的教育是促进因素。
在这个社区中，为 LBW 婴儿获得医疗保健存在诸多挑战，这对他们出院后的结果有影响。迫切需要制定和测试策略，以解决社区和卫生系统层面的障碍，优化结果。
