Data Science and Evaluation Unit, African Population and Health Research Center (APHRC), Nairobi, Kenya.
Department of Community Health, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
PLoS One. 2023 Nov 16;18(11):e0294536. doi: 10.1371/journal.pone.0294536. eCollection 2023.
Between 2019 and 2022, the digital dividend project (DDP), a technology-based intervention that combined care (MomCare) and quality improvement (SafeCare) bundles to empower mothers to access quality care during pregnancy, labor, and delivery, and postnatally, was implemented in Kenya and Tanzania aiming to improve maternal and newborn health outcomes. We describe the experiences of the mothers in accessing and utilizing health services under the bundles, and the experiences of the health workers in providing the services. Between November and December 2022, we conducted a qualitative evaluation across health facilities in Kenya and Tanzania. We held Interviews with mothers (pregnant and postpartum women who had benefited from the care bundles) and health workers (physicians, nurses, and midwives who provided the care bundles, including health facility In-Charges) at the antenatal care (ANC), skilled birth attendance (SBA), and postnatal care (PNC) service delivery points. We performed content analysis. Findings are reported using themes and quotes from the participants. We included 127 mothers (Kenya = 76, Tanzania = 51) and 119 health workers. Findings revealed that among mothers, the care bundles eased access to health services, ensured easy access and optimal ANC use, provision of respectful care, removed financial constraints, and led to the receipt of sufficient health education. Health workers reported that the care bundles offered them a new opportunity to provide quality maternal and newborn care and to adhere to the standard of care besides experiencing a positive and fulfilling practice. Health systems improvements included prompt emergency response and continual care, infrastructural developments, medical supplies and logistics, staffing, and increased documentation. Overall, the care bundles led to the strengthening of the healthcare system (staffing, service delivery, financing, supplies/logistics, and information management) in order to deliver quality maternal and child health services. The bundles should be replicated in settings with similar maternal and child health challenges.
2019 年至 2022 年期间，数字红利项目（DDP）在肯尼亚和坦桑尼亚实施，该项目是一项基于技术的干预措施，将护理（MomCare）和质量改进（SafeCare）一揽子措施结合起来，使母亲能够在怀孕、分娩和产后获得优质护理。该项目旨在改善母婴健康结果。我们描述了母亲在使用一揽子服务时获取和利用卫生服务的经验，以及卫生工作者提供服务的经验。2022 年 11 月至 12 月，我们在肯尼亚和坦桑尼亚的卫生机构进行了定性评估。我们对接受护理包的母亲（受益于护理包的孕妇和产后妇女）和卫生工作者（提供护理包的医生、护士和助产士，包括卫生设施负责人）进行了访谈，访谈地点为产前护理 (ANC)、熟练接生 (SBA) 和产后护理 (PNC) 服务点。我们进行了内容分析。研究结果使用参与者的主题和引语进行报告。我们纳入了 127 名母亲（肯尼亚=76，坦桑尼亚=51）和 119 名卫生工作者。研究结果表明，在母亲方面，护理包方便了获得卫生服务，确保了便捷的 ANC 利用和最佳 ANC 利用，提供了尊重的护理，消除了经济限制，并使她们获得了足够的健康教育。卫生工作者报告说，护理包为他们提供了提供优质母婴保健的新机会，并遵守了护理标准，同时他们还体验到了积极和充实的实践。卫生系统的改进包括快速的应急反应和持续的护理、基础设施的发展、医疗用品和物流、人员配备以及文档的增加。总的来说，护理包加强了医疗保健系统（人员配备、服务提供、融资、用品/物流和信息管理），以提供优质的母婴保健服务。在面临类似母婴健康挑战的环境中，应该复制这些护理包。
