Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Pan Afr Med J. 2024 May 20;48:16. doi: 10.11604/pamj.2024.48.16.37504. eCollection 2024.
even though there are many initiatives to improve institutional delivery, there are low service utilization and community readiness for institutional delivery in Ethiopia. This study assessed the role of community readiness on delivery service use.
a pre-and post-test design with a control group was used for the evaluation of the stage-matched educational intervention following the protocol of the community readiness assessment model. Based on the baseline assessment of community readiness among 15 kebeles where the study was conducted, the overall score of nine kebeles was below stage-5 out of the nine stages, which were targeted for the intervention. The intervention group (n= three kebeles) participated in the stage-matched intervention for 15 months, while the control group (n= three kebeles) were not given the intervention. The data were analyzed using the difference in difference (DiD) method.
there were significant improvements in a stage of change for the promotion of institutional delivery (p-value <0.001) and institutional delivery use (p-value <0.001) in the intervention group as compared to the control group. The study revealed that the intervention influenced community resource allocation (at marginally significant levels), improved leader-ship quality of prevention, and community climate to supportive prevention efforts. There was evidence that the intervention (health promotion) also increased service use at a significant level.
the community readiness-based intervention (health promotion) can be useful to measure the combined attitude and behavior towards institutional delivery services. The village-based mobilizer approach had a positive effect on institutional delivery use and the level of community readiness on the promotion of institutional delivery.
尽管有许多举措旨在改善医疗机构分娩服务，但在埃塞俄比亚，服务利用率和社区对医疗机构分娩的准备情况仍然较低。本研究评估了社区准备情况对分娩服务利用的作用。
采用了一种预-后测试设计，并结合对照组，以评估基于社区准备评估模型方案的阶段匹配教育干预。根据在进行研究的 15 个 kebeles 进行的社区准备基线评估，9 个阶段中有 9 个 kebeles 的总得分低于 5 阶段，这是干预的目标。干预组（n=3 个 kebeles）参与了为期 15 个月的阶段匹配干预，而对照组（n=3 个 kebeles）则未接受干预。使用差异分析（DiD）方法对数据进行分析。
与对照组相比，干预组在促进医疗机构分娩的变化阶段（p 值<0.001）和医疗机构分娩使用（p 值<0.001）方面均有显著改善。研究表明，干预影响了社区资源分配（处于边缘显著水平），提高了预防领导力和社区气候，以支持预防工作。有证据表明，干预（健康促进）也在显著水平上增加了服务的使用。
基于社区准备的干预（健康促进）可用于衡量对医疗机构分娩服务的综合态度和行为。基于村庄的动员方法对医疗机构分娩的使用和促进医疗机构分娩的社区准备水平产生了积极影响。
