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实现袋鼠式护理实践的高覆盖率是可行的:来自埃塞俄比亚提格雷地区加速扩大规模实施研究的经验教训。

Achieving high coverage of Kangaroo mother care practice is possible: Lessons from implementation research for accelerating scale-up in Tigray Region, Ethiopia.

机构信息

School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

Department of Pediatrics and Child Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.

出版信息

Acta Paediatr. 2023 Aug;112 Suppl 473:77-85. doi: 10.1111/apa.16374. Epub 2022 Jun 1.

Abstract

AIM

To evaluate coverage of effective Kangaroo mother care (KMC) by developing a model that would result in high coverage (≥80%) of KMC for newborn weighing less than 2000 g at birth in Tigray region, Ethiopia.

METHODS

The study used formative research and continuous programme learning in iterative cycles of model development and modification conducted in close collaboration with the Tigray Regional Health Bureau. Quantitative methods were used to evaluate the various models. All study facilities were enrolled simultaneously, and hospitals and health centres were considered to become KMC-providers.

RESULTS

The final scalable model implemented in two rural districts and one special urban zone of Tigray region attained the desired objective, with coverage of effective KMC of 82.3% at discharge.

CONCLUSION

Achieving high coverage of KMC is possible through the design of context-specific implementation strategies. The key factors for success were the commitment and strong leadership from the regional health bureau, strong linkages within the health system and between different departments within health facilities, improved health worker knowledge, skills and attitudes, hospitals and health centres that supported KMC performance, and systematic generation and use of data for continuous quality improvement.

摘要

目的

通过建立一种模式来评估有效的袋鼠式护理(KMC)的覆盖范围,以使提格雷地区出生体重低于 2000 克的新生儿的 KMC 覆盖率(≥80%)。

方法

本研究采用形成性研究和连续的方案学习,在与提格雷地区卫生局密切合作的情况下,对模型进行迭代开发和修改。采用定量方法评估各种模型。所有研究设施同时参与,医院和卫生中心被视为 KMC 提供者。

结果

在提格雷地区的两个农村地区和一个特殊城市地区实施的最终可扩展模型实现了预期目标,出院时有效 KMC 的覆盖率为 82.3%。

结论

通过设计特定于背景的实施策略,可以实现 KMC 的高覆盖率。成功的关键因素是地区卫生局的承诺和强有力的领导、卫生系统内以及卫生设施内不同部门之间的紧密联系、提高卫生工作者的知识、技能和态度、支持 KMC 表现的医院和卫生中心,以及系统地生成和使用数据以持续质量改进。

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