经认证的社会健康活动家(ASHA)工作人员提供产后护理的障碍与促进因素:一项来自古吉拉特邦部落地区的基于社区的定性研究
Barriers and Enablers of Postnatal Care by Accredited Social Health Activist (ASHA) Workers: A Community-Based Qualitative Study From Tribal Gujarat.
作者信息
Gadhavi Kinjal, Pandit Niraj, Pankaj Neelabh
机构信息
Department of Community Medicine, Smt. B. K. Shah Medical Institute & Research Centre, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, IND.
出版信息
Cureus. 2024 Mar 21;16(3):e56667. doi: 10.7759/cureus.56667. eCollection 2024 Mar.
Background The care provided to the mother and child from delivery to six weeks after is defined as postnatal care. The postnatal period is both a happy and critical phase for the mother and the newborn. However, the provision of high-quality care services is often ignored during this time. The objective of this study was to assess postnatal care services quality by Accredited Social Health Activist (ASHA) workers and associated factors such as newborn care in rural tribal areas of Gujarat, India. Methodology An ethnographic approach was adopted. Four primary health centers (PHCs) were selected purposively from Sankheda Block, Chhotaudepur, a tribal district in the eastern part of Gujarat. Information on obstacles and facilitators of postnatal care services was collected using in-depth interviews (IDIs) with a purposive sample of 22 ASHAs working in selected PHCs. Qualitative data were analyzed using thematic analysis. Results The median age of the ASHA workers was 39 years and ranged from 30 to 51 years (N = 22). Most ASHAs encountered logistical challenges when offering postnatal care services (e.g., they struggled to care for the mother and her babies because they were missing essential equipment, such as a thermometer and a salter-type baby weighing machine, or they had broken equipment). The two main issues facing ASHAs were incentives and timely payments. There were concerns about their safety and physical security during fieldwork. The majority of ASHA workers had good experiences during postnatal home visits, and they received support from other healthcare workers. There were many misconceptions and false assumptions in the community regarding breastfeeding, prelacteal feeding, family planning, and contraception methods. ASHAs wanted to become long-term government employees and believed they were entitled to sufficient training, assistance, recognition, and remuneration for the duties they performed. Conclusions Postnatal mothers receive considerably less attention than antenatal mothers because it mostly depends on ASHA workers and field staff. ASHA workers are doing their best regarding postnatal care. This study revealed some issues ASHAs face, including logistic issues, transportation issues, regular and timely payment issues, and local-level acceptance issues.
背景 从分娩到产后六周为母婴提供的护理被定义为产后护理。产后时期对母亲和新生儿来说既是一个幸福的阶段,也是一个关键阶段。然而,在此期间高质量护理服务的提供往往被忽视。本研究的目的是评估印度古吉拉特邦农村部落地区经认证的社会健康活动家(ASHA)工作人员提供的产后护理服务质量以及相关因素,如新生儿护理。
方法 采用人种志方法。从古吉拉特邦东部部落地区乔陶德布尔县桑克赫达街区有目的地选取了四个初级卫生保健中心(PHC)。通过对在选定的初级卫生保健中心工作的22名ASHA工作人员进行有目的抽样的深入访谈(IDI),收集了产后护理服务的障碍和促进因素方面的信息。使用主题分析法对定性数据进行了分析。
结果 ASHA工作人员的年龄中位数为39岁,年龄范围在30至51岁之间(N = 22)。大多数ASHA工作人员在提供产后护理服务时遇到后勤方面的挑战(例如,他们难以照顾母亲和婴儿,因为缺少基本设备,如温度计和盐秤式婴儿体重秤,或者设备损坏)。ASHA工作人员面临的两个主要问题是激励措施和及时支付报酬。在实地工作期间,他们对自身安全和人身安全感到担忧。大多数ASHA工作人员在产后家访期间有良好的体验,并且他们得到了其他医护人员的支持。社区中在母乳喂养、初乳喂养、计划生育和避孕方法方面存在许多误解和错误观念。ASHA工作人员希望成为长期政府雇员,并认为他们有权因其履行的职责获得充分的培训、协助、认可和报酬。
结论 产后母亲受到的关注远少于产前母亲,因为这主要取决于ASHA工作人员和现场工作人员。ASHA工作人员在产后护理方面尽了最大努力。本研究揭示了ASHA工作人员面临的一些问题,包括后勤问题、交通问题、定期及时支付报酬问题以及地方层面的接受问题。
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