Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, UK.
The Global Fund for Aids Tuberculosis and Malaria, Switzerland, Geneva.
BMC Pregnancy Childbirth. 2022 May 28;22(1):448. doi: 10.1186/s12884-022-04752-6.
Postnatal Care (PNC) is one of the healthcare-packages in the continuum of care for mothers and children that needs to be in place to reduce global maternal and perinatal mortality and morbidity. We sought to identify the essential components of PNC and develop signal functions to reflect these which can be used for the monitoring and evaluation of availability and quality of PNC.
Systematic review of the literature using MESH headings for databases (Cinahl, Cochrane, Global Health, Medline, PubMed, and Web of Science). Papers and reports on content of PNC published from 2000-2020 were included. Narrative synthesis of data and development of signal function through 7 consensus-building workshops with 184 stakeholders.
Forty-Eight papers and reports are included in the systematic review from which 22 essential components of PNC were extracted and used to develop 14 signal functions. Signal functions are used in obstetrics to denote a list of interventions that address major causes of maternal and perinatal morbidity or mortality. For each signal function we identified the equipment, medication and consumables required for implementation. The prevention and management of infectious diseases (malaria, HIV, tuberculosis) are considered essential components of routine PNC depending on population disease burden or whether the population is considered at risk. Screening and management of pre-eclampsia, maternal anaemia and mental health are recommended universally. Promotion of and support of exclusive breastfeeding and uptake of a modern contraceptive method are also considered essential components of PNC. For the new-born baby, cord care, monitoring of growth and development, screening for congenital disease and commencing vaccinations are considered essential signal functions. Screening for gender-based violence (GBV) including intimate partner- violence (IPV) is recommended when counselling can be provided and/or a referral pathway is in place. Debriefing following birth (complicated or un-complicated) was agreed through consensus-building as an important component of PNC.
Signal functions were developed which can be used for monitoring and evaluation of content and quality of PNC. Country adaptation and validation is recommended and further work is needed to examine if the proposed signal functions can serve as a useful monitoring and evaluation tool.
The systematic review protocol was registered: PROSPERO 2018 CRD42018107054 .
产后护理（PNC）是母婴护理连续体中的医疗保健套餐之一，需要到位以降低全球孕产妇和围产期死亡率和发病率。我们旨在确定 PNC 的基本组成部分，并制定信号功能来反映这些功能，以便用于监测和评估 PNC 的可用性和质量。
使用数据库的 MESH 标题对文献进行系统评价（Cinahl、Cochrane、全球健康、Medline、PubMed 和 Web of Science）。纳入 2000-2020 年发表的关于 PNC 内容的论文和报告。通过与 184 名利益攸关方进行 7 次共识建设研讨会，对数据进行叙述性综合，并制定信号功能。
系统评价共纳入 48 篇论文和报告，从中提取了 22 个 PNC 的基本组成部分，并用于制定 14 个信号功能。信号功能用于产科，以表示一组干预措施，用于解决孕产妇和围产期发病率或死亡率的主要原因。对于每个信号功能，我们确定了实施所需的设备、药物和消耗品。根据人口疾病负担或人口是否被认为有风险，预防和管理传染病（疟疾、艾滋病毒、结核病）被认为是常规 PNC 的基本组成部分。普遍建议筛查和管理子痫前期、产妇贫血和心理健康。促进和支持纯母乳喂养以及采用现代避孕方法也被认为是 PNC 的基本组成部分。对于新生儿，脐带护理、生长发育监测、先天性疾病筛查和开始接种疫苗被认为是基本的信号功能。建议在能够提供咨询和/或建立转介途径的情况下，筛查性别暴力（GBV），包括亲密伴侣暴力（IPV）。通过共识建设，一致认为分娩后（复杂或不复杂）的汇报是 PNC 的一个重要组成部分。
制定了信号功能，可用于监测和评估 PNC 的内容和质量。建议进行国家调整和验证，并进一步研究拟议的信号功能是否可以作为有用的监测和评估工具。
系统评价方案已在 PROSPERO 注册：2018 CRD42018107054。
