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在资源匮乏地区评估产后免疫服务:一项横断面调查。

Assessing Postnatal Immunisation Services in a Low-Resource Setting: A Cross-Sectional Survey.

作者信息

Abukari Alhassan Sibdow, Gaddah Rejoice, Ayivor Emmanuella Vincentia, Haruna Ibrahim Sadik, Korsah Emmanuel Kwame

机构信息

Department of Maternal and Child Health, School of Nursing & Midwifery, University of Ghana, Legon, Accra P.O. Box LG 25, Ghana.

Department of Nursing, Wisconsin International University College, North Legon, Accra P.O. Box LG 751, Ghana.

出版信息

Healthcare (Basel). 2025 Jun 11;13(12):1389. doi: 10.3390/healthcare13121389.

Abstract

Postnatal immunisation is critical for maternal and child health, particularly in low-income countries. Despite international efforts, maternal awareness and access to care remain limited. Understanding the drivers behind postnatal immunisation services is critical for improving neonatal and maternal healthcare interventions. A tertiary healthcare facility's postpartum mothers who were seeking immunisation services participated in a prospective cross-sectional electronic survey. Convenience sampling was used to select respondents, who then answered a structured electronic questionnaire intended to obtain information on immunisation practices. To evaluate important trends and correlations, data was analysed using both descriptive and inferential statistics. A factor analysis was performed using the principal component analysis method, eigenvalue criteria, communalities, and confirmatory factor analysis. The study adhered to the STROBE guidelines. We found that postnatal mothers' good immunisation practices were influenced by their adherence to immunisation schedules (% variance: 56.407; Eigenvalue: 7.33), and significant satisfaction with communication (% variance: 8.338; Eigenvalue: 1.084); giving a cumulative variance explained of 64.745% of the total variance of variables under study. However, suboptimal practices include limited resource availability, poor record maintenance, insufficient support for side effects, a lack of support from healthcare providers, and a decline in immunisation recommendations, all of which had Eigenvalue <1 and insignificant percentage of variance contribution to the total variance explained. We developed a two-factor model of postnatal immunisation practices, focusing on adherence and effective communication. The model showed high loadings and adequate fit indices (χ(34) = 91.333, < 0.001; CFI = 0.945; TLI = 0.927; RMSEA = 0.071; SRMR = 0.042), good evidence of internal consistency ( = 0.823-0.877), and composite reliability ( = 0.832-0.877). The study recommends a comprehensive approach to increasing newborn vaccine coverage, which includes health education, improved service delivery, and culturally sensitive communication strategies. Future research should focus on digital health interventions, community-based initiatives, and policy-driven postnatal care.

摘要

产后免疫接种对母婴健康至关重要,在低收入国家尤其如此。尽管国际社会做出了努力,但母亲们的认知度和获得护理的机会仍然有限。了解产后免疫接种服务背后的驱动因素对于改善新生儿和孕产妇医疗保健干预措施至关重要。一家三级医疗保健机构中寻求免疫接种服务的产后母亲参与了一项前瞻性横断面电子调查。采用便利抽样法选择受访者,然后他们回答一份结构化电子问卷,旨在获取有关免疫接种做法的信息。为了评估重要趋势和相关性,使用描述性统计和推断性统计对数据进行了分析。使用主成分分析法、特征值标准、共同度和验证性因子分析进行了因子分析。该研究遵循了STROBE指南。我们发现,产后母亲的良好免疫接种做法受到她们对免疫接种时间表的遵守情况(方差百分比:56.407;特征值:7.33)以及对沟通的显著满意度(方差百分比:8.338;特征值:1.084)的影响;累计方差解释率为研究中变量总方差的64.745%。然而,不理想的做法包括资源可用性有限、记录保存不佳、对副作用的支持不足、缺乏医疗保健提供者的支持以及免疫接种建议的减少,所有这些的特征值均<1,对方差总解释量的方差贡献百分比不显著。我们建立了一个产后免疫接种做法的双因素模型,重点关注遵守情况和有效沟通。该模型显示出高载荷和适当的拟合指数(χ(34)=91.333,<0.001;CFI=0.945;TLI=0.927;RMSEA=0.071;SRMR=0.042),有良好的内部一致性证据(=0.823 - 0.877)和组合信度(=0.832 - 0.877)。该研究建议采取综合方法来提高新生儿疫苗接种覆盖率,包括健康教育、改善服务提供以及具有文化敏感性的沟通策略。未来的研究应侧重于数字健康干预、基于社区的举措以及政策驱动的产后护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4ce/12192839/56f148009ff3/healthcare-13-01389-g001.jpg

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