Bharadwaj Gauri, Sankhe Lalit, Bharadwaj Shubhendra
Department of Community Medicine, Teer Thanker Mahavir Medical University, Uttar Pradesh, India.
Department of Community Medicine, Grant Government Medical College and JJ Group of Hospitals, Mumbai, Maharashtra, India.
J Family Med Prim Care. 2024 Nov;13(11):5019-5026. doi: 10.4103/jfmpc.jfmpc_710_24. Epub 2024 Nov 18.
Maternal and neonatal mortality rates remain alarmingly high in low-resource settings, with infections acquired during childbirth contributing significantly to this burden. Effective infection control measures at delivery points are crucial for mitigating these risks. This observational study aimed to assess the quality of infection control practices in delivery points in a tribal district of Maharashtra, India.
A community-based study was conducted at delivery points across eight talukas in Palghar district. A total of 15 delivery points were selected using convenient sampling, representing three levels of facilities (L1, L2 and L3) which are healthcare facilities divided on the basis of the provision of services by Maternal and Newborn Health Toolkit. Data was collected using the validated LaQshya programme's checklist through direct observation from June 1 to June 18, 2021. Compliance with infection control protocols was scored based on predefined criteria.
The majority of L1 delivery points showed non-compliance in criteria such as surface microbiological surveillance and monitoring of infection control practices, 20-40% of Delivery points also showed non-compliance in the availability of personal protective equipment and waste management practices.
This study highlights the need for targeted interventions to improve infection control practices in delivery points, particularly in lower-level facilities. Strengthening adherence to established protocols, enhancing staff training, ensuring availability of essential supplies and implementing robust monitoring systems are imperative for reducing the burden of maternal and neonatal infections and improving healthcare outcomes in resource-constrained settings.
在资源匮乏地区，孕产妇和新生儿死亡率仍然高得惊人，分娩期间获得的感染是造成这一负担的重要因素。分娩点有效的感染控制措施对于降低这些风险至关重要。这项观察性研究旨在评估印度马哈拉施特拉邦一个部落地区分娩点的感染控制措施质量。
在帕尔加尔 district 的八个 talukas 的分娩点开展了一项基于社区的研究。采用方便抽样法共选取了 15 个分娩点，代表了三个级别的设施（L1、L2 和 L3），这些设施是根据孕产妇和新生儿健康工具包提供的服务划分的医疗保健设施。2021 年 6 月 1 日至 6 月 18 日，通过直接观察，使用经过验证的 LaQshya 计划清单收集数据。根据预先确定的标准对感染控制协议的遵守情况进行评分。
大多数 L1 分娩点在表面微生物监测和感染控制措施监测等标准方面不符合要求，20 - 40%的分娩点在个人防护设备的可用性和废物管理措施方面也不符合要求。
本研究强调需要采取有针对性的干预措施，以改善分娩点的感染控制措施，特别是在较低级别的设施中。加强对既定协议的遵守、加强工作人员培训、确保基本用品的供应以及实施强大的监测系统对于减轻孕产妇和新生儿感染负担以及改善资源有限环境中的医疗保健结果至关重要。
