Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Ifakara Health Institute, Dar es Salaam, Tanzania.
Glob Health Sci Pract. 2021 Dec 21;9(4):1000-1010. doi: 10.9745/GHSP-D-20-00684. Print 2021 Dec 31.
Maternal and newborn health (MNH) service delivery redesign aims to improve maternal and newborn survival by shifting deliveries from poorly equipped primary care facilities to adequately prepared designated delivery hospitals. We assess the feasibility of such a model in Kakamega County, Kenya, by determining the capacity of hospitals to provide services under the redesigned model and the acceptability of the concept to providers and users. We find many existing system assets to implement redesign, including political will to improve MNH outcomes, a strong base of support among providers and users, and a good geographic spread of facilities to support implementation. There are nonetheless health workforce gaps, infrastructure deficits, and transportation challenges that would need to be addressed ahead of policy rollout. Implementing MNH redesign would require careful planning to limit unintended consequences and rigorous evaluation to assess impact and inform scale-up.
孕产妇和新生儿健康（MNH）服务提供方式的重新设计旨在通过将分娩从设备简陋的初级保健机构转移到有充分准备的指定分娩医院，来提高孕产妇和新生儿的生存率。我们通过确定医院在重新设计的模式下提供服务的能力以及提供者和使用者对该概念的接受程度，来评估肯尼亚卡卡梅加县实施这种模式的可行性。我们发现许多现有的系统资产可用于实施重新设计，包括改善母婴健康结果的政治意愿、提供者和使用者的强大支持基础，以及支持实施的设施的良好地理分布。然而，在政策推出之前，还需要解决卫生人力短缺、基础设施不足和交通挑战等问题。实施 MNH 重新设计需要精心规划以限制意外后果，并进行严格评估以评估影响并为扩大规模提供信息。
