Harrison Margo S, Yarinbab Teklemariam, Dorsey-Holliman Brooke, Aarons Gregory A, Betran Ana Pilar, Goldenberg Robert L, Muldrow Margaret
Department of Obstetrics & Gynecology, University of Colorado, Mail Stop B198-2, Academic Office 1, 12631 E. 17th Avenue, Rm 4211, Aurora, CO, 80045, USA.
Mizan Tepi University Teaching Hospital, Mizan Aman, Ethiopia.
Pilot Feasibility Stud. 2021 Dec 15;7(1):218. doi: 10.1186/s40814-021-00955-4.
As an evidence-based intervention to prevent maternal and neonatal morbidity and mortality, cesarean birth at rates of under 2%, which is the case in rural Southwest Ethiopia, is an unacceptable public health problem and represents an important disparity in the use of this life-saving treatment compared to more developed regions. The objective of this study is to explore an innovative clinical solution (a mobile cesarean birth center) to low cesarean birth rates resulting from the Three Delays to emergency obstetric care in isolated and underserved regions of Ethiopia, and the world.
We will use mixed but primarily qualitative methods to explore and prepare the mobile cesarean birth center for subsequent implementation in communities in Bench Sheko and West Omo Zones. This will involve interviews and focus groups with key stakeholders and retreat settings for user-centered design activities. We will present stakeholders with a prototype surgical truck that will help them conceive of the cesarean birth center concept and discuss implementation issues related to staffing, supplies, referral patterns, pre- and post-operative care, and relationship to locations for vaginal birth.
Completion of our study aims will allow us to describe participants' perceptions about barriers and facilitators to cesarean birth and their attitudes regarding the appropriateness, acceptability, and feasibility of a mobile cesarean birth center as a solution. It will also result in a specific, measurable, attainable, relevant, and timely (SMART) implementation blueprint(s), with implementation strategies defined, as well as recruitment plans identified. This will include the development of a logic model and process map, a timeline for implementation with strategies selected that will guide implementation, and additional adaptation/adjustment of the mobile center to ensure fit for the communities of interest.
There is no healthcare intervention on human participants occurring as part of this research, so the study has not been registered.
剖宫产作为一种基于证据的预防孕产妇和新生儿发病及死亡的干预措施，在埃塞俄比亚西南部农村地区剖宫产率低于2%，这是一个不可接受的公共卫生问题，与更发达地区相比，这代表了在使用这种挽救生命的治疗方法上存在的重大差距。本研究的目的是探索一种创新的临床解决方案（移动剖宫产中心），以解决埃塞俄比亚及全球偏远和服务不足地区因“三个延误”导致的急诊产科护理剖宫产率低的问题。
我们将使用混合但主要是定性的方法来探索并筹备移动剖宫产中心，以便随后在本奇谢科和西奥莫地区的社区实施。这将包括与关键利益相关者进行访谈和焦点小组讨论，以及开展以用户为中心的设计活动的研讨会议。我们将向利益相关者展示一辆原型手术车，这将帮助他们构想剖宫产中心的概念，并讨论与人员配备、物资供应、转诊模式、术前和术后护理以及与阴道分娩地点的关系等相关的实施问题。
完成我们的研究目标将使我们能够描述参与者对剖宫产的障碍和促进因素的看法，以及他们对移动剖宫产中心作为一种解决方案的适宜性、可接受性和可行性的态度。这还将产生一个具体、可衡量、可实现、相关且及时的（SMART）实施蓝图，确定实施策略以及制定招募计划。这将包括制定逻辑模型和流程图、选定指导实施的策略的实施时间表，以及对移动中心进行额外的调整/调适，以确保适合目标社区。
本研究中没有对人类参与者进行医疗干预，因此该研究未进行注册。
