Department of Family and Community Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako Sekip Utara Sleman, Yogyakarta, Indonesia.
Iwoimendaa Primary Health Center, Kolaka Regency, South-east Sulawesi, Indonesia.
BMC Pregnancy Childbirth. 2023 Mar 1;23(1):132. doi: 10.1186/s12884-023-05433-8.
Limited evidence is available as the reference for the model of care on providing maternity care in low-and-middle-income countries (LMICs) to cope with pandemic disruption. This study aimed to adopt international recommendations to develop the model of care with the context of Indonesian settings.
Four codesign workshops and substitute interviews with stakeholders, covering the (i) exploration of service provision during the pandemic, (ii) adoption of international recommendations, (iii) designing and (iv) finalising model of care for maternal health services in primary care under the COVID-19 pandemic. The study took place in Yogyakarta Province Indonesia from July-November 2021. The participants were general practitioners, midwives, nurses, patients, and obstetricians. The data were analysed thematically.
Twenty-three participants were recruited. As many as 23, 16, 14 and 16 participants participated in the first to fourth codesign workshops or substitute interviews. Key recommendations agreed upon in the workshop were health screening, maintaining antenatal-postnatal breastfeeding care, limiting visitors, using telemedicine, and creating a multidisciplinary team to provide the care. A model of care for improving maternal service was also agreed and received suggestions from the participants. Identified barriers to the recommendation implementation, such as the available clinical resources and negotiating providers' authority in practice.
Recommendations and the model of care for improving maternity care in Indonesia are beneficial to be implemented in Indonesian primary care during the COVID-19 pandemic. Further research includes pilot studies to explore the acceptability of the model and recommendation implementation in practice.
为应对大流行带来的干扰，低中等收入国家（LMICs）提供产妇保健服务的护理模式可参考的相关证据有限。本研究旨在结合印度尼西亚的实际情况，采用国际建议来制定护理模式。
在 2021 年 7 月至 11 月期间，在印度尼西亚日惹特区开展了四次共同设计研讨会和利益相关者替代访谈，涵盖了（i）探索大流行期间的服务提供情况，（ii）采用国际建议，（iii）设计和（iv）为在 COVID-19 大流行下的初级保健中的产妇保健服务制定护理模式。参与者包括全科医生、助产士、护士、患者和产科医生。对数据进行了主题分析。
共招募了 23 名参与者。分别有 23、16、14 和 16 名参与者参加了前四期共同设计研讨会或替代访谈。在研讨会上达成的主要建议是健康筛查、保持产前-产后母乳喂养护理、限制访客、使用远程医疗和创建多学科团队来提供护理。还达成了改善产妇服务的护理模式，并收到了参与者的建议。确定了实施建议的障碍，例如现有的临床资源和在实践中协商提供者的权力。
印度尼西亚改善产妇保健的建议和护理模式有利于在 COVID-19 大流行期间在印度尼西亚的初级保健中实施。进一步的研究包括试点研究，以探索模型和建议在实践中的可接受性。
