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印度新冠疫情期间的母婴健康服务：凸显基层医疗医生在维持连续护理中的作用

Maternal and child health services during COVID-19 in India: Highlighting the role of primary care physicians in maintaining continuum of care.

作者信息

Sharma Saurabh, Aggarwal Sumit, Singh Kh Jiten Kumar, Singh Lucky, Gaym Asheber, Sahu Damodar, Adhikari Tulsi, Nair Saritha, Kumar Anil, Juneja Atul, Rao Mendu Vishnu Vardhana

机构信息

ICMR-National Institute of Medical Statistics, New Delhi, India.

ECD Division, ICMR Head Quarters, New Delhi, India.

出版信息

J Family Med Prim Care. 2024 Nov;13(11):5256-5264. doi: 10.4103/jfmpc.jfmpc_203_23. Epub 2024 Nov 18.

DOI:10.4103/jfmpc.jfmpc_203_23
PMID:39722985
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11668487/
Abstract

BACKGROUND

This study aims to address the lack of substantial evidence regarding the effect of COVID-19 on maternal and child health (MCH) services in India and also highlight the role of primary care physicians in maintaining essential services during a pandemic. While studies conducted worldwide and in India have examined the effects of COVID-19 on these services, a significant gap in robust evidence remains.

METHODS

Forty-two districts were selected randomly from seven regional states of India. Data on five selected MCH indicators were extracted from HMIS for the months from March to June 2019 and 2020. Relative changes in service utilization for each month from March to June over the two years were compared. Comparisons were also made between the selected districts based on the COVID-19 categorization into red and green zones.

RESULTS

COVID-19 and its associated restrictive measures created significant disruption to essential MCH service utilization in India across all states reviewed. Both institutional, and outreach services were impacted; however, hospital-based services were more impacted. Institutional deliveries and emergency obstetric services saw a decline in March and April 2020 which gradually improved between May and June in some states. Immunization sessions held in 2020 observed a decrease in April.

CONCLUSIONS

The analysis indicates a disruption in service delivery during the initial phase of the lockdown. However, the services resumed gradually as national and state-specific operational guidelines were implemented to maintain a continuum of care.

摘要

背景

本研究旨在解决关于新冠疫情对印度母婴健康（MCH）服务影响的实质性证据不足的问题，并强调基层医疗医生在疫情期间维持基本服务中的作用。虽然全球和印度开展的研究已考察了新冠疫情对这些服务的影响，但在有力证据方面仍存在重大差距。

方法

从印度七个地区邦中随机选取42个区。从卫生管理信息系统（HMIS）中提取2019年和2020年3月至6月这几个月中五个选定的母婴健康指标的数据。比较了这两年3月至6月每个月服务利用情况的相对变化。还根据新冠疫情分类为红色和绿色区域，对选定地区进行了比较。

结果

在所有接受审查的邦中，新冠疫情及其相关限制措施对印度基本母婴健康服务的利用造成了重大干扰。机构服务和外展服务均受到影响；然而，基于医院的服务受到的影响更大。2020年3月和4月，机构分娩和急诊产科服务有所下降，一些邦在5月至6月间逐渐有所改善。2020年4月的免疫接种场次有所减少。

结论

分析表明在封锁初期服务提供出现了中断。然而，随着国家和邦级具体操作指南的实施以维持连续护理，服务逐渐恢复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2e85/11668487/67685843b1f4/JFMPC-13-5256-g010.jpg
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