United Nations Population Fund, New Delhi, India.
Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Glob Health Sci Pract. 2022 Apr 29;10(2). doi: 10.9745/GHSP-D-21-00590. Print 2022 Apr 28.
Implementation research with pre- and post-comparison was planned to improve the quality of evidence-based intrapartum care services in Indian medical schools. We present the baseline study results to assess the status of adherence to intrapartum evidence-based practices (IP-EBP) in study schools in 3 states in India and the perception of the faculty.
A concurrent mixed-methods approach was used to conduct the baseline assessment in 9 medical schools in Rajasthan, Gujarat, and Union Territory from October 2018 to June 2019. IP-EBP among pregnant women in uncomplicated first (n=135), second (n=120), and third stage (n=120) of labor were observed using a predesigned, pretested checklist quantitatively. We conducted in-depth interviews with 33 obstetrics and gynecology faculty to understand their perceptions of intrapartum practices. Quantitative data were analyzed using SPSS (version 22). COM-B (Capability, Opportunity, and Motivation Behavior) model was used to understand the behaviors, and thematic analysis was done for the qualitative data.
Unindicated augmentation of labor was done in 64.4%, fundal pressure applied in 50.8%, episiotomy done in 58.3%, and delivery in lithotomy position was performed in 86.7% of women in labor.
Intrapartum practices that are not recommended were routinely practiced in the study medical schools due to a lack of staff awareness of evidence-based practices and incorrect beliefs about their impact.
为了提高印度医学院校基于证据的分娩护理服务质量，计划进行预对照实施研究。我们呈现基线研究结果，以评估印度 3 个邦和联邦属地的研究学校中遵循产时基于证据的实践（IP-EBP）的情况和教师的看法。
采用同期混合方法，于 2018 年 10 月至 2019 年 6 月在拉贾斯坦邦、古吉拉特邦和联邦属地的 9 所医学院进行基线评估。使用预先设计的预测试清单对无并发症的第一产程（n=135）、第二产程（n=120）和第三产程（n=120）的孕妇进行 IP-EBP 观察。我们对 33 名妇产科教师进行深入访谈，以了解他们对分娩实践的看法。使用 SPSS（版本 22）对定量数据进行分析。使用 COM-B（能力、机会和动机行为）模型来理解行为，并对定性数据进行主题分析。
64.4%的产妇未经指征行催产素点滴，50.8%的产妇行宫底按压，58.3%的产妇行会阴切开术，86.7%的产妇行截石位分娩。
由于医护人员对基于证据的实践缺乏认识以及对其影响的错误看法，研究中的医学院校常规进行不推荐的产时实践。
