Ndela Britou, N'siala Adrien, Ngwala Philippe, Kalonji Albert, Minuku Felix, Bokole Harmonie, Kemaina Pascal, Masumbuku Jean-Jacques, Kintaudi Ngoma Miezi, Mandja Bien-Aimé M
SANRU Asbl, Kinshasa, Democratic Republic of the Congo.
Faculty of Medicine, University of Bandundu, Bandundu, Democratic Republic of the Congo.
Reprod Health. 2024 May 2;21(1):62. doi: 10.1186/s12978-024-01801-5.
The burden of maternal and child mortality is high in the Democratic Republic of the Congo (DRC). While health workers (HWs) with adequate knowledge and practice of maternal and child health (MCH) are crucial to reduce this burden, the skill level of HWs in charge of MCH in the DRC is currently insufficient. This study aimed to assess the knowledge and practice of HWs towards MCH in Kasai and Maniema, two DRC provinces with very high maternal mortality ratios and under-5 mortality rates.
This cross-sectional study was conducted in 96 health facilities of Kasai and Maniema provinces in 2019. All HWs in charge of MCH were eligible for the study. Data were collected using a structured questionnaire containing 76 questions on knowledge and practice of MCH. Analyses were performed using the Wilcoxon-Mann-Whitney test, Kendall's correlation test, and a multivariate linear mixed regression model.
Among participating HWs, 42.6% were A2 nurses (lowest qualification), 81.9% had no up-to-date training in MCH, and 48.4% had only 1-5 years of experience in MCH. In the two provinces combined, about half of HWs had poor knowledge (50.6%) and poor practice (53.3%) of MCH. Knowledge and practice scores were higher in Maniema than in Kasai (P < 0.001). Good knowledge and practice scores were significantly associated with high qualification (P = 0.001), continuing up-to-date training in MCH (P = 0.009), and 6 years of experience or more in MCH (P = 0.01).
In Maniema and Kasai provinces, about half of HWs had poor knowledge and poor practice of MCH. The conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.
刚果民主共和国（DRC）的孕产妇和儿童死亡率负担沉重。虽然具备足够母婴健康（MCH）知识和实践能力的卫生工作者（HWs）对于减轻这一负担至关重要，但刚果民主共和国负责母婴健康的卫生工作者的技能水平目前不足。本研究旨在评估在孕产妇死亡率和5岁以下儿童死亡率极高的刚果民主共和国两个省份开赛省和马尼埃马省，卫生工作者对母婴健康的知识和实践情况。
2019年在开赛省和马尼埃马省的96个卫生机构开展了这项横断面研究。所有负责母婴健康的卫生工作者均符合研究条件。使用一份包含76个关于母婴健康知识和实践问题的结构化问卷收集数据。采用Wilcoxon-Mann-Whitney检验、Kendall相关检验和多元线性混合回归模型进行分析。
在参与研究的卫生工作者中，42.6%为A2级护士（最低资质），81.9%没有接受过最新的母婴健康培训，48.4%在母婴健康方面仅有1至5年的经验。在这两个省份中，约一半的卫生工作者母婴健康知识掌握得较差（50.6%），实践能力也较差（53.3%）。马尼埃马省的知识和实践得分高于开赛省（P < 0.001）。良好的知识和实践得分与高资质（P = 0.001）、持续接受最新的母婴健康培训（P = 0.009）以及在母婴健康方面有6年或更长时间的经验（P = 0.01）显著相关。
在马尼埃马省和开赛省，约一半的卫生工作者母婴健康知识掌握得较差，实践能力也较差。将A1级护士转变为助产士以及提供最新的母婴健康培训、监督和指导可以提高卫生工作者的技能水平，从而减轻刚果民主共和国的母婴健康负担。
