将翻译经验转化为强化国家出生缺陷应对的措施;多利益攸关方视角,探讨在乌干达资源有限的情况下优先事项和提供高质量循证干预措施的机会。

Translating lessons to reinforce national stillbirth response; multi-stakeholder perspectives regarding priorities and opportunities to deliver quality evidence-based interventions within a limited-resource context in Uganda.

机构信息

Department of Health Policy Planning and Management, School of Public Health, College of Health Sciences, Makerere University, P.O. Box 7076, Kampala, Uganda.

School of Public Health, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, Republic of South Africa.

出版信息

BMC Health Serv Res. 2024 Jun 10;24(1):715. doi: 10.1186/s12913-024-11180-z.

Abstract

BACKGROUND

There is noted increase in attention towards implementation of evidence-based interventions in response to the stillbirth burden in low- and middle-income countries including Uganda. Recent results reporting some of the strategies adopted have tended to focus much attention towards their overall effect on the stillbirth burden. More is needed regarding stakeholder reflections on priorities and opportunities for delivering quality services within a limited resource setting like Uganda. This paper bridges this knowledge gap.

METHODS

Data collection occurred between March and June 2019 at the national level. Qualitative interviews were analysed using a thematic analysis technique.

RESULTS

Identified priorities included; a focus on supportive functions such as the referral system, attention to the demand side component of maternal health services, and improvements in the support supervision particularly focusing on empowering subnational level actors. The need to strengthen the learning for better implementation of strategies which are compatible with context was also reported. A comprehensive and favourable policy environment with the potential to direct implementation of strategies, harnessing the private sector contribution as well as the role of national level champions and patient advocates to amplify national stillbirth reduction efforts for continued visibility and impact were recommended.

CONCLUSION

Great potential exists within the current strategies to address the national stillbirth burden. However, priorities such as improving the supportive functions of MCH service delivery and attention to the demand side need to be pursued more for better service delivery with opportunities including a favourable policy environment primed to better serve the current strategies. This calls for dedicated efforts targeted at addressing gaps within the existing priorities and opportunities for better delivery of national strategies to address the stillbirth burden in Uganda.

摘要

背景

为了应对中低收入国家(包括乌干达)的死产负担,人们越来越关注实施基于证据的干预措施。最近的研究结果报告了一些已经采取的策略,这些策略往往更关注其对死产负担的总体影响。在乌干达等资源有限的环境中,需要更多地关注利益相关者对提供优质服务的优先事项和机会的反思。本文弥补了这一知识空白。

方法

数据收集于 2019 年 3 月至 6 月在国家一级进行。使用主题分析技术对定性访谈进行分析。

结果

确定的优先事项包括:关注支持性功能,如转诊系统;关注孕产妇保健服务的需求方部分;以及改善支持监督,特别是注重赋予国家以下各级行为者权力。还报告说,需要加强学习,以便更好地实施与国情相符的战略。建议建立一个全面和有利的政策环境,有可能指导战略的实施,利用私营部门的贡献以及国家一级的拥护者和患者倡导者的作用,为继续提高国家减少死产的努力提供可见度和影响力。

结论

目前的策略在解决国家死产负担方面具有巨大潜力。然而,需要优先考虑改善妇幼保健服务提供的支持性功能,并关注需求方,以实现更好的服务提供。机会包括一个有利的政策环境,这将有助于更好地实施当前的战略。这需要有针对性地努力,解决现有优先事项和机会中的差距,以更好地执行国家战略,解决乌干达的死产负担问题。

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