提高加纳产后护理质量：一项平行随机对照试验方案

Improving the Quality of Postpartum Care in Ghana: Protocol for a Parallel Randomized Controlled Trial.

作者信息

Adams Yenupini Joyce, Agbenyo John Stephen

机构信息

Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States.

Savana Signatures, Tamale, Ghana.

出版信息

JMIR Res Protoc. 2023 Aug 22;12:e47519. doi: 10.2196/47519.

DOI:10.2196/47519

PMID:37606965

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10481215/

Abstract

BACKGROUND

Although the postpartum period poses substantial risks and can result in significant maternal morbidity and mortality, postpartum care of the mother receives much less attention in transitional countries.

OBJECTIVE

We describe the protocol for a randomized controlled trial to implement and evaluate a postpartum care delivery model titled Focused-PPC (Focused Postpartum Care).

METHODS

Focused-PPC is an integrated group postpartum care model that meets the clinical care, education, and support needs of mothers up to 1 year after birth. The Focused-PPC intervention is a parallel randomized controlled trial with a total of 192 postpartum women at 4 health centers in Tamale, Ghana. Participants will be randomized into 1 of 2 trial arms at a 1:1 allocation ratio: (1) the control arm, which receives the standard postnatal care currently delivered in health facilities, or (2) the intervention arm, which receives the Focused-PPC model of care. Women enrolled in the intervention arm will receive postpartum clinical assessments and education for the first 6 weeks and will continue to receive education, measures of vital signs, and peer support for 12 months post partum during child welfare visits. Led by trained midwives, each postpartum group in the intervention arm will meet at 1-2 weeks, 6 weeks, and monthly thereafter for up to 1 year post partum, following the Ghana Health Service postnatal care schedule.

RESULTS

The Focused-PPC guide, data collection tools, and audiovisual education materials were successfully developed and translated into the local language. We have enrolled and conducted baseline surveys for 192 women (sample size met) in the Focused-PPC trial who have been randomized into intervention and control arms. We have established a total of 12 Focused-PPC groups in the intervention arm, 3 groups from each site, all of which have sessions underway.

CONCLUSIONS

Focused-PPC has the potential to change the postpartum care delivery model in Ghana and other countries in sub-Saharan Africa and beyond.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05280951; https://clinicaltrials.gov/study/NCT05280951.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47519.

摘要

背景

尽管产后时期存在重大风险，可能导致产妇出现严重发病和死亡情况，但在转型国家，对母亲的产后护理关注较少。

目的

我们描述了一项随机对照试验的方案，以实施和评估一种名为聚焦产后护理（Focused-PPC）的产后护理模式。

方法

聚焦产后护理是一种综合的群体产后护理模式，可满足母亲产后长达1年的临床护理、教育和支持需求。聚焦产后护理干预是一项平行随机对照试验，在加纳塔马利的4个健康中心共有192名产后妇女参与。参与者将按1:1的分配比例随机分为2个试验组之一：（1）对照组，接受目前在医疗机构提供的标准产后护理；（2）干预组，接受聚焦产后护理模式。干预组的妇女在前6周将接受产后临床评估和教育，并在产后12个月的儿童福利访视期间继续接受教育、生命体征测量和同伴支持。在训练有素的助产士的带领下，干预组的每个产后小组将在产后1至2周、6周以及此后每月会面，直至产后1年，遵循加纳卫生服务局的产后护理时间表。