Lieberman Lawry Lynn, Gabor Rachel, Katele Jacques, Baak Madut Lazarus, Sommers Katina, Manuel David, Nadolski Claire, Lado Mounir, Koehlmoos Tracey, Clemmer William
Uniformed Services University, Bethesda, Maryland, USA
Uniformed Services University, Bethesda, Maryland, USA.
BMJ Open. 2025 Jan 6;15(1):e083905. doi: 10.1136/bmjopen-2024-083905.
To understand the current state of maternal, newborn and child health (MNCH) among internally displaced persons (IDPs), returnees and host communities in remote counties of Jonglei state.
Cross-sectional, randomly sampled, mixed-methods, population-based household study.
Ayod, Nyirol, Fangak and Pigi counties of Jonglei, South Sudan.
859 households, including 586 adult females and 273 adult males.
Knowledge, attitudes and practices of MNCH. Secondary: contraception, pregnancies, pregnancy outcomes, use or non-use of antenatal care (ANC)/postnatal care (PNC), use of skilled birth attendants, breastfeeding, knowledge of warning or danger signs of pregnancy, gender-based violence (GBV) and MNCH attitudes/cultural norms.
A total of 859 households consented to the study (586 females and 273 males) with a response rate of 96% among females and 94% among males. The ability to list at least three warning/danger signs or essentials of care for different MNCH categories among respondents was low (range, 37·0%-47·1%). 1% of females and 3% of males use contraception. ANC and PNC are suboptimal and largely provided by unskilled providers. 26% of women exclusively breastfed for up to 6 months. For respondents with children<2 years of age, 68·9% (95% CI 64·7 to 72·7) had received three doses of Penta valent vaccine. Females and males reported similar lifetime GBV rates.
Conflict and flooding in the remote survey areas are significant barriers to MNCH. Evidence-based interventions that decrease mortality and morbidity are lacking and the dearth of skilled health providers and healthcare facilities limits improvements in MNCH. Establishing cost-effective and evidence-based interventions proven to reduce MNCH mortality either at fixed facilities and/or in combination with mobile clinics and community outreach are necessary to ensure that IDPs and returnees are reached.
了解琼莱州偏远县境内流离失所者、回返者和收容社区中孕产妇、新生儿和儿童健康（MNCH）的现状。
横断面、随机抽样、混合方法、基于人群的家庭研究。
南苏丹琼莱州的阿约德、尼罗尔、方阿克和皮吉县。
859户家庭，包括586名成年女性和273名成年男性。
孕产妇、新生儿和儿童健康的知识、态度和行为。次要指标：避孕、怀孕、妊娠结局、是否使用产前护理（ANC）/产后护理（PNC）、是否使用熟练的助产士、母乳喂养、对妊娠警示或危险信号的了解、基于性别的暴力（GBV）以及孕产妇、新生儿和儿童健康的态度/文化规范。
共有859户家庭同意参与研究（586名女性和273名男性），女性应答率为96%，男性应答率为94%。受访者中能够列出至少三种不同孕产妇、新生儿和儿童健康类别的警示/危险信号或护理要点的能力较低（范围为37.0% - 47.1%）。1%的女性和3%的男性使用避孕措施。产前护理和产后护理情况不理想，主要由非专业人员提供。26%的女性纯母乳喂养长达6个月。对于有2岁以下儿童的受访者，68.9%（95%置信区间64.7至72.7）接种过三剂五价疫苗。女性和男性报告的终身基于性别的暴力发生率相似。
偏远调查地区的冲突和洪水是孕产妇、新生儿和儿童健康的重大障碍。缺乏降低死亡率和发病率的循证干预措施，熟练卫生保健人员和医疗设施的匮乏限制了孕产妇、新生儿和儿童健康状况的改善。有必要建立经证明在固定设施和/或结合移动诊所及社区外展活动可降低孕产妇、新生儿和儿童健康死亡率的具有成本效益的循证干预措施，以确保惠及境内流离失所者和回返者。
