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对利用数字技术增强计划生育服务的看法:受益人和助产士的焦点小组讨论以及关键知情者的访谈。

Perceptions Toward the Use of Digital Technology for Enhancing Family Planning Services: Focus Group Discussion With Beneficiaries and Key Informative Interview With Midwives.

机构信息

Global Health Development | Eastern Mediterranean Public Health Network, Amman, Jordan.

Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

J Med Internet Res. 2021 Jul 28;23(7):e25947. doi: 10.2196/25947.

Abstract

BACKGROUND

Modern family planning (FP) methods allow married couples to discuss and determine the number of children and years of spacing between them. Despite many significant improvements in FP services in Jordan, there are still many issues related to the uptake of FP services for both host communities and Syrian refugees, due to limitations in the health care system based on public health facilities. Digital technologies can provide opportunities to address the challenges faced in the health system, thus offering the potential to improve both coverage and quality of FP services and practices.

OBJECTIVE

The aim of this study was to explore the perceptions of Jordanian women, Syrian refugees, and midwives in Jordan toward the use of digital health technology to support and enhance access to FP services.

METHODS

We employed a qualitative study based on semistructured, face-to face key informative interviews with 17 midwives (providers) and focus group discussions with 32 married women of reproductive age (clients). Both midwives and clients were recruited from 9 health centers in 2 major governorates in Jordan (Irbid and Mafraq), where 17 in-depth interviews were conducted with midwives and 4 focus groups were conducted with the women. Each focus group included 4 Syrian refugees and 4 Jordanian women. The transcribed narratives were analyzed using inductive thematic analysis.

RESULTS

Three major themes were derived from the narratives analysis, which covered the pros of using digital technology, concerns about digital technology use, and the ideal app or website characteristics. Ten subthemes emerged from these 3 main themes. Overall, midwives and women (Syrian refugees and host communities) agreed that digital technology can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman's awareness and knowledge regarding the FP methods and their side effect. Furthermore, digital technology can assist in enabling women's empowerment, which will allow them to make better decisions regarding FP use. No harmful risks or consequences were perceived to be associated with using digital technology. However, several concerns regarding digital technology use were related to eHealth literacy and the accuracy of the information provided. Midwives were mainly concerned about the patients who would rely mostly on the technology and choose to avoid consulting a health care professional.

CONCLUSIONS

As perceived by midwives and women, incorporating digital technology in FP services can be feasible, cost-effective, well accepted, and potentially beneficial in increasing woman's awareness regarding the FP methods and their side effect. It may also empower the women to play an active role in the shared (with their husband and family) decision-making process. Therefore, digital technologies are recommended to address the challenges faced in health system and to improve both the coverage and the quality of FP services and practices.

摘要

背景

现代计划生育(FP)方法允许已婚夫妇讨论并确定子女数量和生育间隔年限。尽管约旦的计划生育服务有了许多重大改进,但由于公共卫生设施为基础的医疗保健系统存在局限性,对于收容社区和叙利亚难民而言,计划生育服务的采用仍存在许多问题。数字技术可以为解决卫生系统面临的挑战提供机会,从而有可能提高计划生育服务和实践的覆盖范围和质量。

目的

本研究旨在探讨约旦妇女、叙利亚难民和约旦助产士对使用数字健康技术支持和增强计划生育服务获取途径的看法。

方法

我们采用了基于半结构化、面对面的关键信息访谈的定性研究,对 17 名助产士(提供者)进行了访谈,并对 32 名处于生育年龄的已婚妇女(客户)进行了焦点小组讨论。助产士和客户均来自约旦 2 个主要省份(伊尔比德和马弗拉克)的 9 个卫生中心,在那里对 17 名助产士进行了 17 次深入访谈,并对 4 个妇女焦点小组进行了访谈。每个焦点小组包括 4 名叙利亚难民和 4 名约旦妇女。转录的叙述内容采用归纳主题分析进行分析。

结果

从叙述内容的分析中得出了三个主要主题,涵盖了使用数字技术的优点、对使用数字技术的担忧以及理想的应用程序或网站特征。这 3 个主要主题衍生出 10 个子主题。总体而言,助产士和妇女(叙利亚难民和收容社区)一致认为,数字技术在提高妇女对计划生育方法及其副作用的认识和知识方面是可行的、具有成本效益的、易于接受的,并且具有潜在的益处。此外,数字技术可以帮助增强妇女的权能,使她们能够更好地做出计划生育使用的决策。使用数字技术没有被认为会带来任何有害的风险或后果。然而,与数字技术的使用相关的一些担忧与电子健康素养和提供信息的准确性有关。助产士主要担心的是那些将主要依赖技术并选择避免咨询医疗保健专业人员的患者。

结论

如助产士和妇女所认为的,将数字技术纳入计划生育服务是可行的、具有成本效益的、易于接受的,并且在提高妇女对计划生育方法及其副作用的认识方面具有潜在的益处。它还可以使妇女在与丈夫和家庭共同决策过程中发挥积极作用。因此,建议使用数字技术来应对卫生系统面临的挑战,以提高计划生育服务和实践的覆盖范围和质量。

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