University of California San Francisco, San Francisco, USA.
University of Rwanda School of Public Health, Kigali, Rwanda.
BMC Pregnancy Childbirth. 2021 Apr 10;21(1):290. doi: 10.1186/s12884-021-03747-z.
Research suggests that women's experience of antenatal care is an important component of high-quality antenatal care. Person-centered antenatal care (PCANC) reflects care that is both respectful of, and responsive to, the preferences, needs, and values of pregnant women. Little is known in Rwanda about either the extent to which PCANC is practiced or the factors that might determine its use. This is the first study to quantitatively examine the extent of and the factors associated with PCANC in Rwanda.
We used quantitative data from a randomized control trial in Rwanda. A total of 2150 surveys were collected and analyzed from 36 health centers across five districts. We excluded women who were less than 16 years old, were referred to higher levels of antenatal care or had incomplete survey responses. Both bivariate and multivariate logistic regression analyses were used to test the hypothesis that certain participant characteristics would predict high PCANC.
PCANC level was found to be sub-optimal with one third of women leaving antenatal care (ANC) with questions or confused and one fourth feeling disrespected. In bivariate analysis, social support, greater parity, being in the traditional care (control group), and being from Burera district significantly predict high PCANC. Additionally, in the multivariate analysis, being in the traditional care group and the district in which women received care were significantly associated with PCANC.
This quantitative analysis indicates sub-optimal levels of PCANC amongst our study population in Rwanda. We find lower levels of PCANC to be regional and defined by the patient characteristics parity and social support. Given the benefits of PCANC, improvements in PCANC through provider training in Rwanda might promote an institutional culture shift towards a more person-centered model of care.
研究表明，女性对产前护理的体验是高质量产前护理的重要组成部分。以患者为中心的产前护理（PCANC）反映了对孕妇的偏好、需求和价值观既尊重又做出回应的护理。在卢旺达，人们对 PCANC 的实施程度或可能决定其使用的因素知之甚少。这是第一项定量研究卢旺达 PCANC 的实施程度和相关因素的研究。
我们使用了卢旺达一项随机对照试验的定量数据。共从五个区的 36 个卫生中心收集和分析了 2150 份调查。我们排除了年龄不足 16 岁的妇女、被转介到更高层次的产前护理或调查回复不完整的妇女。使用双变量和多变量逻辑回归分析来检验以下假设，即某些参与者特征将预测高 PCANC。
PCANC 水平不理想，三分之一的妇女离开产前护理（ANC）时仍有疑问或感到困惑，四分之一的妇女感到不受尊重。在双变量分析中，社会支持、更高的生育次数、处于传统护理（对照组）以及来自布瑞拉区显著预测了 PCANC 较高。此外，在多变量分析中，处于传统护理组和妇女接受护理的地区与 PCANC 显著相关。
这项定量分析表明，卢旺达研究人群的 PCANC 水平不理想。我们发现 PCANC 水平较低与地区相关，并由患者特征的生育次数和社会支持来定义。鉴于 PCANC 的益处，在卢旺达通过提供者培训来提高 PCANC，可能会促进机构文化朝着更以患者为中心的护理模式转变。
