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探索卢旺达卫生服务提供者对家庭母婴保健包的了解情况。

Exploring health provider's knowledge on the home-based maternal and neonatal health care package in Rwanda.

机构信息

School of Nursing and Public Health, University of KwaZulu-Natal, College of Health Sciences, King George Ave, Durban, 4001, South Africa.

Health Economics and HIV/AIDS Research Division (HEARD), University of KwaZulu-Natal, Durban, South Africa.

出版信息

BMC Pregnancy Childbirth. 2022 Feb 7;22(1):107. doi: 10.1186/s12884-022-04435-2.


DOI:10.1186/s12884-022-04435-2
PMID:35130858
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8819836/
Abstract

BACKGROUND: Rwanda implemented post-natal care home visits by maternal community health workers (M-CHWs) in charge of maternal and newborn health care in 2010 as a component of a home-based maternal and neonatal health care package (HB-MNHCP), this being a complementary strategy to facility-based postnatal care to improve survival. The country has not met its Sustainable Development Goal (SDG) 3 target of less than 70 maternal mortalities per 100,000 live births and less than 12 neonatal deaths per 1,000 live births. This study therefore aimed to establish the knowledge of the health providers, providing HB-MNHC services as part of their antenatal, delivery and postnatal care program, specifically the M-CHWs services. METHODS: The cross-sectional descriptive study included 79 purposively sampled health care providers who were directly involved in the various components of the HB-MNHCP, namely: professional nurses, midwives, M-CHW, social workers, supervisors and data managers. The Kibogora, Muhima and Nyamata District Hospitals and two rural, semi-urban and urban health facility were included. Data was collected using questionnaires from April to July 2018. This study followed the STROBE checklist form: Cross -sectional studies. RESULTS: Overall, 88.6% (n=70/79) of participants knew about the M-CHW three home visits scheduled during pregnancy, 73.4% (n=58/79) about the three postnatal home visits after birth when the weight was normal, and 64.6% (n=51/79) about the five PNC home visits for low birth weights. Most (97.5%, n=77/79) knew that the mother and newborn should be screened during the same M-CHW home visits, and 87.2% (n= 68/79) were aware of the seven postnatal core competencies of delivering key maternal and newborn interventions during PNC home visits. CONCLUSIONS: There were varying levels of knowledge among the HB-MNHCP staff, indicating the need for ongoing monitoring and training to ensure that the correct information is provided to the mothers throughout the antenatal and postnatal periods. While most of the M-CHWs appear to have had the correct knowledge, their executing of some activities needs to be monitored to ensure that they provide the required services, as this is an important step in lowering the maternal and infant mortality and enabling Rwanda to meet its SDG 3. Home visits by the M-CHWs could increase referrals and reduce maternal and newborn mortality.

摘要

背景:卢旺达于 2010 年实施了由负责产妇和新生儿保健的产妇社区卫生工作者(M-CHW)进行的产后家庭访视,作为基于家庭的产妇和新生儿保健套餐(HB-MNHCP)的一部分,这是改善生存的以机构为基础的产后护理的补充策略。该国尚未实现其可持续发展目标(SDG)3 的目标,即每 10 万活产儿中少于 70 例产妇死亡,每 1000 例活产儿中少于 12 例新生儿死亡。因此,这项研究旨在确定提供 HB-MNHC 服务的卫生提供者的知识,这些服务是他们产前、分娩和产后护理计划的一部分,特别是 M-CHW 服务。

方法:这项横断面描述性研究包括 79 名有目的地抽样的卫生保健提供者,他们直接参与了 HB-MNHCP 的各个组成部分,即:专业护士、助产士、M-CHW、社会工作者、主管和数据管理员。研究包括基博罗戈拉、穆希马和尼亚马塔区医院以及两个农村、半城市和城市卫生机构。数据于 2018 年 4 月至 7 月期间使用问卷收集。本研究遵循 STROBE 检查表形式:横断面研究。

结果:总体而言,88.6%(n=70/79)的参与者了解 M-CHW 在怀孕期间计划的三次家庭访视,73.4%(n=58/79)了解出生后体重正常时的三次产后家庭访视,64.6%(n=51/79)了解五次 PNC 家庭访视低出生体重。大多数(97.5%,n=77/79)知道母亲和新生儿应该在 M-CHW 家庭访视中同时接受筛查,87.2%(n=68/79)了解 M-CHW 在 PNC 家庭访视中提供关键产妇和新生儿干预措施的七项产后核心能力。

结论:HB-MNHCP 工作人员的知识水平参差不齐,这表明需要进行持续监测和培训,以确保在整个产前和产后期间向母亲提供正确的信息。虽然大多数 M-CHW 似乎都有正确的知识,但需要监测他们执行某些活动的情况,以确保他们提供所需的服务,因为这是降低产妇和婴儿死亡率并使卢旺达实现可持续发展目标 3 的重要步骤。M-CHW 的家访可以增加转诊人数,降低产妇和新生儿死亡率。

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引用本文的文献

[1]
Influence of Structured Training Programme on Healthcare Workers' Knowledge of Recommended Postnatal Care Services in Nigeria.

SAGE Open Nurs. 2022-8-8

本文引用的文献

[1]
Postnatal care in Rwanda: facilitators and barriers to postnatal care attendance and recommendations to improve participation.

J Glob Health Rep. 2019

[2]
Major causes of death in preterm infants in selected hospitals in Ethiopia (SIP): a prospective, cross-sectional, observational study.

Lancet Glob Health. 2019-8

[3]
National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: a systematic analysis.

Lancet Glob Health. 2019-6

[4]
The Human Resources for Health Program in Rwanda - Reflections on Achievements and Challenges Comment on "Health Professional Training and Capacity Strengthening Through International Academic Partnerships: The First Five Years of the Human Resources for Health Program in Rwanda".

Int J Health Policy Manag. 2018-11-21

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Causes of death and predictors of childhood mortality in Rwanda: a matched case-control study using verbal social autopsy.

BMC Public Health. 2018-12-17

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BMC Health Serv Res. 2018-11-19

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Reflecting strategic and conforming gendered experiences of community health workers using photovoice in rural Wakiso district, Uganda.

Hum Resour Health. 2018-8-22

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A Success Story: The Burden of Maternal, Neonatal and Childhood Mortality in Rwanda - Critical Appraisal of Interventions and Recommendations for the Future.

Afr J Reprod Health. 2018-6

[9]
Can community health worker home visiting improve care-seeking and maternal and newborn care practices in fragile states such as Afghanistan? A population-based intervention study.

BMC Med. 2018-7-9

[10]
Newborn Survival Case Study in Rwanda - Bottleneck Analysis and Projections in Key Maternal and Child Mortality Rates Using Lives Saved Tool (LiST).

Int J MCH AIDS. 2017

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