医疗服务提供者对新冠疫情及抗疫措施对肯尼亚内罗毕孕产妇保健服务影响的看法：一项定性研究
Health providers' perspectives on effects of the COVID-19 pandemic and anti-epidemic measures on maternal health services in Nairobi, Kenya: a qualitative study.
作者信息
Wangamati Cynthia Khamala, Geissler Paul Wenzel, Nyambedha Erick Otieno, Prince Ruth Jane
机构信息
Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Postboks 1130 Blindern, Oslo, 0318, Norway.
Department of Social Anthropology, University of Oslo, Oslo, Norway.
出版信息
BMC Pregnancy Childbirth. 2025 Apr 11;25(1):430. doi: 10.1186/s12884-025-07500-8.
BACKGROUND
The first case of COVID-19 in Kenya was confirmed in March 2020; the Kenyan government swiftly introduced measures to curb transmission, some of which negatively impacted maternal health services. Most research on the effects of COVID-19 on maternal health is from the perspectives of pregnant women and mothers. Our study explores health providers' perspectives on the effect of COVID-19 on maternal health services in Nairobi, Kenya.
METHODS
From February to May 2023, we conducted key informant interviews with 39 health providers in Nairobi County, Kenya. Study participants included medical doctors/officers, clinical officers, nurses, and community health assistants. Thematic inductive and deductive analysis were used to analyze the data; coding was done using NVIVO.
RESULTS
The interviewed health providers confirmed that COVID-19 prevention and infection control measures had negatively affected maternal health services. The measures led to the temporary closure of health facilities because there was a shortage of health providers due to their deployment in isolation centers and quarantine, and some contracted COVID-19, restricted access to maternal health services, and delayed service delivery due to social distancing. Health providers stated that they faced numerous challenges, including fear of and contracting COVID-19, being overworked as they were short-staffed, limited resources, stigma from the community as they were considered infectious, and psychological distress. In addition, health providers said that the Kenyan government addressed some challenges by providing personal protective equipment, prioritizing health providers for vaccination, facilitating their movement, and providing temporary tax relief.
CONCLUSION
Our findings highlight the negative effect of COVID-19 on maternal health services in Kenya. Future pandemic preparedness should entail proper planning, staffing, training, psychosocial support, and staff motivation through the provision of risk allowance and health insurance. In addition, funds should be set aside for purchasing medical supplies, equipment, and vaccines, building isolation centres, and other contingencies.
背景
肯尼亚的首例新冠病毒疾病（COVID-19）病例于2020年3月得到确认；肯尼亚政府迅速采取措施遏制传播，其中一些措施对孕产妇保健服务产生了负面影响。大多数关于COVID-19对孕产妇健康影响的研究是从孕妇和母亲的角度进行的。我们的研究探讨了医疗服务提供者对COVID-19对肯尼亚内罗毕孕产妇保健服务影响的看法。
方法
2023年2月至5月，我们对肯尼亚内罗毕县的39名医疗服务提供者进行了关键信息访谈。研究参与者包括医生/医务人员、临床干事、护士和社区卫生助理。采用主题归纳和演绎分析方法对数据进行分析；使用NVIVO进行编码。
结果
接受访谈的医疗服务提供者证实，COVID-19预防和感染控制措施对孕产妇保健服务产生了负面影响。这些措施导致医疗机构暂时关闭，原因是由于医务人员被部署到隔离中心和检疫点，导致医务人员短缺，一些人感染了COVID-19，限制了孕产妇保健服务的可及性，并且由于社交距离而导致服务提供延迟。医疗服务提供者表示，他们面临着许多挑战，包括对感染COVID-19的恐惧和感染、由于人员短缺而过度劳累、资源有限、因被社区视为具有传染性而受到污名化以及心理困扰。此外，医疗服务提供者表示，肯尼亚政府通过提供个人防护设备、优先为医疗服务提供者接种疫苗、便利他们的行动以及提供临时税收减免来应对一些挑战。
结论
我们的研究结果凸显了COVID-19对肯尼亚孕产妇保健服务的负面影响。未来的大流行防范应包括适当的规划、人员配备、培训、心理社会支持以及通过提供风险津贴和医疗保险来激励工作人员。此外，应预留资金用于购买医疗用品、设备和疫苗、建设隔离中心以及应对其他突发事件。
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