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在孟加拉国新冠疫情期间,实施一项基于社区的转诊项目,以改善罗兴亚人群获得紧急产科和新生儿护理的机会。

Implementation of a community-based referral project to improve access to emergency obstetric and newborn care in Rohingya population during COVID-19 pandemic in Bangladesh.

作者信息

Barua Mrittika, Saha Avijit, Chowdhury Srizan, Chowdhury Sayantan, Sajow Stenly Hely, Sarker Malabika

机构信息

BRAC University James P Grant School of Public Health, Dhaka, Bangladesh.

International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.

出版信息

BMJ Innov. 2022 Sep 29;8(4):247-254. doi: 10.1136/bmjinnov-2021-000831. Epub 2022 May 23.

Abstract

INTRODUCTION

The delay in seeking emergency obstetric care leads to significant maternal morbidity and mortality and can worsen during pandemics, especially in humanitarian conflict settings with low uptake of obstetric services. To mitigate the challenges related to the second delay caused by lack of transport in the COVID-19 pandemic, the organisation United Nations Population Fund implements a community-based referral project called Referral Hub in the Rohingya refugee population in Bangladesh. The objective of the paper is to describe the implementation process of the Referral hub and present clients' utilisation and perception of the service.

METHODS

Findings from part of a larger mixed-method study, the analysis of the standard operating protocol of the intervention, secondary data of routine utilisation of the 12 referral hubs between January and August 2020, 21 key informant interviews and a community survey among 100 pregnant women are presented in this paper.

RESULTS

The findings show an increasing trend in the referral hub utilisation and a strong recommendation of the service.

CONCLUSION

Due to a robust referral mechanism by collaborating with the community and engaging accessible and free of cost transport service, the intervention has high potential to improve access to facility care in low-resource and humanitarian contexts, especially during pandemics.

摘要

引言

寻求紧急产科护理的延迟会导致孕产妇出现严重发病和死亡情况,在大流行期间情况可能会恶化,尤其是在产科服务利用率低的人道主义冲突环境中。为了缓解新冠疫情期间因缺乏交通工具导致的二次延迟相关挑战,联合国人口基金组织在孟加拉国的罗兴亚难民群体中实施了一个名为“转诊中心”的社区转诊项目。本文的目的是描述转诊中心的实施过程,并介绍服务对象对该服务的使用情况和看法。

方法

本文呈现了一项更大规模混合方法研究的部分结果,对干预措施的标准操作流程进行了分析,分析了2020年1月至8月期间12个转诊中心的常规使用情况的二手数据,进行了21次关键信息访谈,并对100名孕妇进行了社区调查。

结果

结果显示转诊中心的利用率呈上升趋势,且该服务获得了强烈推荐。

结论

通过与社区合作建立强大的转诊机制,并提供便捷且免费的交通服务,该干预措施在低资源和人道主义环境中,尤其是在大流行期间,具有很大潜力改善获得设施护理的机会。

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