Yussf Nafisa, Allard Nicole, Romero Nicole, Wilson Ann, Wallace Jack, Perrier Meg, Rowe Stacey, Morey Rosemary, Aykut Neylan, Cowie Benjamin
WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia; and Department of Infectious Diseases, University of Melbourne, Melbourne, Vic. 3000, Australia.
WHO Collaborating Centre for Viral Hepatitis, Peter Doherty Institute for Infection and Immunity, Melbourne, Vic. 3000, Australia.
Aust J Prim Health. 2023 Jul;29(3):276-283. doi: 10.1071/PY22158.
Standard care for pregnant women includes universal screening for hepatitis B, and administration of influenza and pertussis vaccination to women and hepatitis B infant vaccination. This study explored how perinatal services relating to the prevention of these vaccine-preventable diseases are delivered to women and their infants in Victoria, Australia.
Two online surveys investigated service delivery for the prevention of influenza, pertussis and hepatitis B to identify barriers to optimal care during January-June 2021; (1) The Birthing Hospitals Survey captured facility-level information about service delivery for influenza and pertussis vaccination, and interventions to prevent mother-to-child-transmission of chronic hepatitis B (CHB); and (2) The Healthcare Providers Survey captured individual staff perceptions and knowledge in community and hospital settings.
Thirty-four hospital unit managers (61%) completed The Birthing Hospitals Survey . One-hundred and forty participants completed The Healthcare Providers Survey . Half of the birthing hospitals provided influenza (50%) and pertussis (53%) vaccinations to pregnant women, and 53% provided an infectious diseases service for women with CHB. Barriers to optimal care delivery included reliance on pregnant woman's self-report to confirm influenza, pertussis vaccination and CHB status, lack of standardised reporting, inadequate workforce training, poor communication between services, and lack of guideline-based clinical care for mothers with CHB and their infants. Three hospitals reported 'stock out' of hepatitis B immunoglobulin (HBIG).
Coordinated and standardised system and clinical care improvements are required to provide equitable care for pregnant women and their infants, including training and education for healthcare providers, improving data capture and communication among health services.
孕妇的标准护理包括普遍进行乙肝筛查，为孕妇接种流感疫苗和百日咳疫苗以及为婴儿接种乙肝疫苗。本研究探讨了澳大利亚维多利亚州如何为妇女及其婴儿提供与预防这些疫苗可预防疾病相关的围产期服务。
两项在线调查研究了预防流感、百日咳和乙肝的服务提供情况，以确定2021年1月至6月期间最佳护理的障碍；（1）《分娩医院调查》收集了有关流感和百日咳疫苗接种服务提供以及预防慢性乙肝母婴传播干预措施的机构层面信息；（2）《医疗服务提供者调查》收集了社区和医院环境中个体工作人员的看法和知识。
34名医院科室经理（61%）完成了《分娩医院调查》。140名参与者完成了《医疗服务提供者调查》。一半的分娩医院为孕妇提供流感（50%）和百日咳（53%）疫苗接种，53%为慢性乙肝女性提供传染病服务。最佳护理提供的障碍包括依赖孕妇自我报告来确认流感、百日咳疫苗接种和慢性乙肝状况，缺乏标准化报告，工作人员培训不足，服务之间沟通不畅，以及缺乏针对慢性乙肝母亲及其婴儿的基于指南的临床护理。三家医院报告乙肝免疫球蛋白（HBIG）缺货。
需要协调和标准化系统以及改善临床护理，为孕妇及其婴儿提供公平的护理，包括对医疗服务提供者的培训和教育，改善卫生服务之间的数据收集和沟通。
