Moyo Enos, Moyo Perseverance, Dzinamarira Tafadzwa, Ross Andrew
School of Nursing & Public Health, University of Kwa-Zulu Natal, College of Health Sciences, Durban, South Africa.
Medical Centre Oshakati, Oshakati, Namibia.
Birth. 2025 Mar;52(1):5-15. doi: 10.1111/birt.12872. Epub 2024 Oct 17.
Postnatal care (PNC) is a critical service for the health and well-being of new mothers and newborns. However, in sub-Saharan Africa (SSA), most efforts to improve maternal and child health have been directed toward enhancing skilled birth attendance and urgent obstetric and neonatal care. This is despite the fact that more than half of maternal deaths globally occur in the postnatal period, with 65% of these occurring in the first week following birth. One of the health system factors influencing PNC utilization is the women's previous PNC experience at healthcare facilities. The aim of this review was to gain a better understanding of women's experiences of PNC in SSA.
This study followed a qualitative evidence synthesis design. The phenomenon of interest was postpartum women's experiences of PNC in SSA. PubMed, CINAHL, EMBASE, Science Direct, Africa Journals Online (AJOL), SCOPUS, and Google Scholar were searched for peer-reviewed articles published in English between 2013 and 2023. To assess the quality of the included studies, we used an appraisal tool developed by the Evidence for Policy and Practice Information and Co-ordinating Centre. Two authors independently extracted relevant data from the included studies. Thomas and Harden's thematic synthesis framework was used to synthesize the data.
Eight articles were used in this review. Seven articles reported on qualitative studies, and one reported on a mixed-method study. All the included studies fully or partially met the 12 quality assessment criteria. Synthesis of the data resulted in the development of five analytical themes. The five themes were the adequacy of physical examination and communication of the findings, adequacy of PNC information, the quality of interactions with healthcare workers (HCWs), the availability of resources and adequacy of HCWs, and denial of care. The overall confidence in the review's findings was either moderate or high.
Based on our findings, we recommend that countries in the region address staff shortages, implement task shifting, electronic medicine stock management systems, optimal supply chain policies, and train HCWs on PNC and interpersonal communication skills.
产后护理（PNC）对于新妈妈和新生儿的健康与福祉而言是一项关键服务。然而，在撒哈拉以南非洲地区（SSA），大多数改善母婴健康的努力都集中在提高熟练接生率以及提供紧急产科和新生儿护理上。尽管全球超过一半的孕产妇死亡发生在产后阶段，其中65%发生在分娩后的第一周。影响产后护理利用率的卫生系统因素之一是女性之前在医疗机构接受产后护理的经历。本综述的目的是更好地了解撒哈拉以南非洲地区女性的产后护理经历。
本研究采用定性证据综合设计。感兴趣的现象是撒哈拉以南非洲地区产后妇女的产后护理经历。在PubMed、CINAHL、EMBASE、Science Direct、非洲在线期刊（AJOL）、SCOPUS和谷歌学术上搜索了2013年至2023年期间以英文发表的同行评审文章。为评估纳入研究的质量，我们使用了政策与实践信息及协调中心开发的评估工具。两位作者独立从纳入研究中提取相关数据。采用托马斯和哈登的主题综合框架对数据进行综合。
本综述使用了八篇文章。七篇文章报告了定性研究，一篇报告了混合方法研究。所有纳入研究均完全或部分符合12项质量评估标准。数据综合产生了五个分析主题。这五个主题是体格检查的充分性及检查结果的沟通、产后护理信息的充分性、与医护人员（HCWs）互动的质量、资源的可用性及医护人员的充足性以及拒绝提供护理。对综述结果的总体信心为中等或高。
基于我们的研究结果，我们建议该地区各国解决人员短缺问题，实施任务转移、电子药品库存管理系统、优化供应链政策，并对医护人员进行产后护理和人际沟通技能培训。
