Department of Community Health Sciences, University of California Los Angeles, Los Angeles, California, USA
California Center for Population Research, University of California Los Angeles, Los Angeles, California, USA.
BMJ Open. 2021 Sep 28;11(9):e045907. doi: 10.1136/bmjopen-2020-045907.
Disrespectful and poor treatment of newborns such as unnecessary separation from parents or failure to obtain parental consent for medical procedures occurs at health facilities across contexts, but little research has investigated the prevalence, risk factors or associated outcomes. This study examined these experiences and associations with healthcare satisfaction, use and breast feeding.
Prospective cohort study.
3 public hospitals, 2 private hospitals, and 1 health centre/dispensary in Nairobi and Kiambu counties in Kenya.
Data were collected from women who delivered in health facilities between September 2019 and January 2020. The sample included 1014 women surveyed at baseline and at least one follow-up at 2-4 or 10 weeks post partum. PRIMARY AND SECONDARY OUTCOME MEASURES: (1) Outcomes related to satisfaction with care and care utilisation; (2) continuation of post-discharge newborn care practices such as breast feeding.
17.6% of women reported newborn separation at the facility, of whom 71.9% were separated over 10 min. 44.9% felt separation was unnecessary and 8.4% reported not knowing the reason for separation. 59.9% reported consent was not obtained for procedures on their newborn. Women separated from their newborn (>10 min) were 44% less likely to be exclusively breast feeding at 2-4 weeks (adjusted OR (aOR)=0.56, 95% CI: 0.40 to 0.76). Obtaining consent for newborn procedures corresponded with 2.7 times greater likelihood of satisfaction with care (aOR=2.71, 95% CI: 1.67 to 4.41), 27% greater likelihood of postpartum visit attendance for self or newborn (aOR=1.27, 95% CI: 1.05 to 1.55), and 33% greater likelihood of exclusive breast feeding at 10 weeks (aOR=1.33, 95% CI: 1.10 to 1.62).
Newborns, mothers and families have a right to high-quality, respectful care, including the ability to stay together, be informed and properly consent for care. The implications of these experiences on health outcomes a month or more after discharge illustrate the importance of a positive experience of postnatal care.
在不同背景下的医疗机构中，都会出现对新生儿的不尊重和不良待遇，例如不必要的与父母分离或未能获得父母对医疗程序的同意，但很少有研究调查这种现象的普遍程度、风险因素或相关结果。本研究调查了这些经历以及与医疗保健满意度、使用和母乳喂养的关联。
前瞻性队列研究。
肯尼亚内罗毕和基安布县的 3 家公立医院、2 家私立医院和 1 家卫生中心/诊所。
数据收集于 2019 年 9 月至 2020 年 1 月期间在医疗机构分娩的妇女。样本包括在基线和至少一次产后 2-4 周或 10 周时进行的 1014 名妇女。
（1）与护理满意度和护理利用相关的结果；（2）新生儿出院后护理措施的持续情况，如母乳喂养。
17.6%的妇女报告在医疗机构新生儿被分离，其中 71.9%的新生儿分离超过 10 分钟。44.9%的妇女认为分离是不必要的，8.4%的妇女报告不知道分离的原因。59.9%的妇女报告在新生儿身上进行的程序没有获得同意。与新生儿分离超过 10 分钟的妇女在 2-4 周时进行纯母乳喂养的可能性降低 44%（调整后的比值比（aOR）=0.56，95%置信区间：0.40 至 0.76）。获得新生儿程序的同意与护理满意度增加 2.7 倍（aOR=2.71，95%置信区间：1.67 至 4.41）、产妇或新生儿产后就诊的可能性增加 27%（aOR=1.27，95%置信区间：1.05 至 1.55）和 10 周时纯母乳喂养的可能性增加 33%（aOR=1.33，95%置信区间：1.10 至 1.62）相关。
新生儿、母亲和家庭有权获得高质量、有尊严的护理，包括能够在一起、知情并适当同意护理。这些经历对出院后一个月或更长时间的健康结果的影响表明，积极的产后护理体验非常重要。
