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哥伦比亚两个城市中感染寨卡病毒(ZIKV)的女性经历与卫生服务提供情况:一项定性研究。

Experiences of women with Zika virus (ZIKV) versus the provision of health services in two cities in Colombia: A qualitative study.

作者信息

Ocampo Cañas Jovana Alexandra, Pinilla Alfonso Maria Janeth, Navarro Plazas Clemencia Del Pilar, Mejia Arbelaez Carlos Mauricio, Patiño Rueda Jhon Sebastián

机构信息

Research Line on Health Systems, Childhood, Gender, Interculturality and Tropical Diseases, Research Group on Public Health, Medical Education and Medical Professionalism, School of Medicine, Universidad de los Andes, Bogotá DC, Colombia.

出版信息

PLoS One. 2021 Dec 2;16(12):e0260583. doi: 10.1371/journal.pone.0260583. eCollection 2021.

Abstract

BACKGROUND

In February 2016, the World Health Organization (WHO) declared the epidemic of the ZIKA virus (ZIKV) in Latin America to be a public health emergency. In Colombia, 11,944 pregnant women registered a ZIKV infection during the epidemic. So far, little is known about the experiences of women infected with ZIKV during their pregnancy, especially those relating to the provision of health services during the period of the epidemic.

OBJECTIVE

To explore the experiences of pregnant women diagnosed with ZIKV infection about the provision of health services in two Colombian cities, considering the perspective of sexual and reproductive rights.

METHODS

Qualitative study under the grounded theory approach, which uses semi-structured interviews as tools to explore the biographical experience of mothers during their gestation process and ZIKV infection, dividing the interview into two broad categories: before and during pregnancy.

RESULTS

Twenty-two women were interviewed, 10 in Cali and 12 in Villavicencio. The average age at the time of pregnancy was 27.6 years. Most women were not planning at the time of pregnancy and the pregnancy was unwanted. Most campaigns focused on mosquito eradication rather than on sexual and reproductive health campaigns. The quality of health care was not sufficient, adequate, or appropriate. Also, the breakdown of the health system to deal with the pandemic was also noted. Some women were treated with disrespect by health professionals. Voluntary termination of pregnancy was inadequately advised, and women lost autonomy regarding decisions about their health.

CONCLUSIONS

In the health care of ZIKV epidemics, it is necessary to include the gender perspective, more specifically, sexual and reproductive rights. In addition, these epidemics must be addressed through a comprehensive, appropriate, and not fragmented health system, in which sexual and reproductive rights must be mainstreamed in all health promotion and prevention programs.

摘要

背景

2016年2月,世界卫生组织(WHO)宣布拉丁美洲的寨卡病毒(ZIKV)疫情为突发公共卫生事件。在哥伦比亚,疫情期间有11944名孕妇登记感染了寨卡病毒。到目前为止,对于孕期感染寨卡病毒的女性的经历,尤其是与疫情期间卫生服务提供相关的经历,人们了解甚少。

目的

从性与生殖权利的角度出发,探讨在哥伦比亚两个城市被诊断为感染寨卡病毒的孕妇在获得卫生服务方面的经历。

方法

采用扎根理论方法进行定性研究,使用半结构化访谈作为工具,探索母亲在妊娠过程和感染寨卡病毒期间的生平经历,将访谈分为两大类:怀孕前和怀孕期间。

结果

共采访了22名女性,其中10名在卡利,12名在比亚维森西奥。怀孕时的平均年龄为27.6岁。大多数女性在怀孕时并未计划要孩子,此次怀孕属于意外怀孕。大多数宣传活动侧重于灭蚊,而非性与生殖健康宣传。卫生保健的质量不足、不够充分或不合适。此外,还注意到卫生系统应对疫情的能力出现了故障。一些女性受到了卫生专业人员的不尊重对待。自愿终止妊娠的建议不足,女性在健康决策方面失去了自主权。

结论

在寨卡病毒疫情的卫生保健中,有必要纳入性别视角,更具体地说是性与生殖权利。此外,必须通过一个全面、适当且非碎片化的卫生系统来应对这些疫情,其中性与生殖权利必须纳入所有健康促进和预防计划的主流。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/153a/8638867/bae39fa9323d/pone.0260583.g001.jpg

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