USAID Transform: Primary Health Care Activity, JSI Research & Training Institute Inc., Addis Ababa, Ethiopia.
USAID Surveillance for Malaria Elimination Activity, PATH, Addis Ababa, Ethiopia.
PLoS One. 2023 Feb 15;18(2):e0281626. doi: 10.1371/journal.pone.0281626. eCollection 2023.
A minimum of one ultrasound scan is recommended for all pregnant women before the 24th week of gestation. In Ethiopia, there is a shortage of skilled manpower to provide these services. Currently, trained mid-level providers are providing the services at the primary healthcare level. The aims of this study were to compare antenatal care 1 (ANC1), antenatal care 4 (ANC4), skilled birth attendance (SBA), and postnatal care (PNC) service utilization before and after institutionalizing Vscan limited obstetric ultrasounds at semi-urban health centers in Ethiopia.
A pre and post intervention observational study was conducted to investigate maternal and neonatal health service utilization rates before and after institutionalizing Vscan limited obstetric ultrasound services, between July 2016 and June 2020. The data were extracted from 1st August- 31st December 2020.
The observed monthly increase on the mean rank of first ANC visits after the introduction of Vscan limited obstetric ultrasound services showed a statistically significant difference at KW-ANOVA H (3) = 17.09, P = 0.001. The mean rank of fourth ANC utilization showed a statistically significant difference at KW- ANOVA H (3) = 16.24, P = 0.001. The observed mean rank in skilled birth attendance (SBA) showed a statistically significant positive difference using KW-ANOVA H (3) = 23.6, P<0.001. The mean rank of increased utilization in postnatal care showed a statistically significant difference using KW-ANOVA H (3) = 17.79, P<0.001.
The introduction of limited obstetric ultrasound services by trained mid-level providers at the primary healthcare level was found to have improved the utilization of ANC, SBA, and postnatal care (PNC) services. It is recommended that the institutionalization of limited obstetric ultrasound services be scaled up and a further comparative study between facilities with and without ultrasound services be conducted to confirm causality and assess effects on maternal and perinatal outcomes.
建议所有孕妇在妊娠 24 周前至少进行一次超声检查。在埃塞俄比亚，缺乏提供这些服务的熟练人力。目前，经过培训的中级医务人员正在初级保健一级提供这些服务。本研究的目的是比较在埃塞俄比亚半城市卫生中心将 Vscan 有限产科超声纳入常规服务前后的产前护理 1（ANC1）、产前护理 4（ANC4）、熟练接生（SBA）和产后护理（PNC）服务的利用情况。
在 2016 年 7 月至 2020 年 6 月期间，进行了一项在半城市卫生中心将 Vscan 有限产科超声纳入常规服务前后的孕产妇和新生儿健康服务利用情况的预-后干预观察研究。数据是从 2020 年 8 月 1 日至 12 月 31 日提取的。
在引入 Vscan 有限产科超声服务后，首次 ANC 就诊的平均等级每月呈观察性增长，KW-ANOVA H（3）=17.09，P=0.001，差异有统计学意义。第四次 ANC 利用的平均等级差异有统计学意义，KW-ANOVA H（3）=16.24，P=0.001。熟练接生（SBA）的观察平均等级差异有统计学意义，KW-ANOVA H（3）=23.6，P<0.001。利用 KW-ANOVA H（3）=17.79，P<0.001，产后护理利用增加的平均等级差异有统计学意义。
在初级保健一级由经过培训的中级医务人员提供有限的产科超声服务，发现提高了 ANC、SBA 和产后护理（PNC）服务的利用率。建议扩大有限产科超声服务的制度化，并在有和没有超声服务的设施之间进行进一步的比较研究，以确认因果关系并评估对孕产妇和围产期结局的影响。
