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坦桑尼亚乞力马扎罗地区提供孕产妇和新生儿医疗保健服务的可及性与准备情况:一项横断面研究

Service availability and readiness to provide maternal and newborn healthcare services in Kilimanjaro region, Tanzania: a cross sectional study.

作者信息

Kimario Agathon Avelin, Mahmoud Ashraf, Thomas Jonaviva A, Mallilah Benardine P, Mlay Pendo S, Olomi Gaudensia, Mmbaga Blandina

机构信息

Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania

Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania.

出版信息

BMJ Open. 2024 Dec 9;14(12):e086275. doi: 10.1136/bmjopen-2024-086275.

Abstract

OBJECTIVE

To assess service availability and readiness of health facilities to provide maternal and newborn care in the Kilimanjaro region, northern Tanzania: a study conducted between August to October 2022.

DESIGN

The study used a cross-sectional design by adopting WHO Service Availability and Readiness Assessment tool to assess basic maternal, newborn and child health services delivery in the health facilities of the Kilimanjaro region.

SETTING

The study was conducted in seven districts of Kilimanjaro region at health facilities with a labour ward and where delivery and maternal services for women and neonatal care were offered.

PARTICIPANTS

The study included all district hospitals, two selected health centres and two dispensaries within every district with high utilisation of delivery services as well as the regional hospital of Kilimanjaro region making a total of 37 health facilities that were assessed.

PRIMARY OUTCOME

Basic emergency obstetric and newborn care (BEmONC) service availability, BEmONC service readiness, comprehensive emergency obstetric and newborn care (CEmONC) service availability and CEmONC service readiness.

RESULTS

A total of 37 facilities were enrolled that included 14 dispensaries, 14 health centres, 8 district hospitals and 1 regional hospital. The study highlights that majority of the signal functions are available in all levels of health facilities with overall readiness scores in BEmONC and CEmONC being 83% and 98.87%, respectively. However, the study reports that 40.5% of health facilities do not conduct death reviews. Similarly, on-job trainings regarding maternal and newborn healthcare was low, with only 29.8% of all healthcare workers in the region received training for the past 2 years.

CONCLUSION

Despite progress, challenges persist in delivering tailored maternal and newborn healthcare services in Kilimanjaro region. The study revealed strong readiness in essential care functions, but shortcomings in maternal and neonatal death reviews and training, emphasise the need for improved practices to further enhance maternal and newborn health outcomes.

摘要

目的

评估坦桑尼亚北部乞力马扎罗地区医疗机构提供孕产妇和新生儿护理的服务可及性和准备情况:一项于2022年8月至10月开展的研究。

设计

本研究采用横断面设计,采用世界卫生组织服务可及性和准备情况评估工具,评估乞力马扎罗地区医疗机构基本孕产妇、新生儿和儿童保健服务的提供情况。

背景

本研究在乞力马扎罗地区的七个区的医疗机构开展,这些机构设有产房,并提供妇女分娩和孕产妇服务以及新生儿护理。

参与者

本研究纳入了所有区级医院、每个区两所选定的卫生中心和两所门诊所,这些机构分娩服务利用率高,以及乞力马扎罗地区医院,共有37个医疗机构接受了评估。

主要结果

基本急诊产科和新生儿护理(BEmONC)服务可及性、BEmONC服务准备情况、综合急诊产科和新生儿护理(CEmONC)服务可及性和CEmONC服务准备情况。

结果

共纳入37个机构,包括14个门诊所、14个卫生中心、8个区级医院和1个地区医院。研究强调,大多数信号功能在各级医疗机构中都有,BEmONC和CEmONC的总体准备得分分别为83%和98.87%。然而,研究报告称,40.5%的医疗机构不进行死亡审查。同样,孕产妇和新生儿保健方面的在职培训较少,该地区所有医护人员中在过去两年接受培训的仅占29.8%。

结论

尽管取得了进展,但乞力马扎罗地区在提供量身定制的孕产妇和新生儿保健服务方面仍存在挑战。研究显示在基本护理功能方面准备充分,但在孕产妇和新生儿死亡审查及培训方面存在不足,强调需要改进做法以进一步改善孕产妇和新生儿健康结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7798/11628971/d16bca918d4f/bmjopen-14-12-g001.jpg

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