高所得国における産婦人医療の原動力:保健システムは女性中心のケアをサポートできるのか?
Dorothy Shaw1, Jeanne-Marie Guise2, Neel Shah3
1Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada; Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada; BC Women's Hospital and Health Centre, Vancouver, BC, Canada.
Lancet (London, England)
|September 20, 2016
まとめ
高所得国では 妊産婦と新生児の死亡率が低いのですが 出産時のケアモデルには 大きな違いがあります 公平で証拠に基づいた 女性中心の妊産婦のケアを 改善することは より良い結果を得るために不可欠です
科学分野:
- 妊婦と妊婦の健康について
- 医療提供モデル
- 公衆衛生政策
背景:
- 高所得国では 医療介入により 低妊産婦と新生児の死亡率を達成しています
- 成功しているにもかかわらず,産婦人ケア提供モデル,慣行,施設の種類は変わりません.
- 新興の課題には 変化する母親の疫学 (例えば肥満,高齢の母親) とデータアクセシビリティの問題があります.
研究 の 目的:
- 米国とスウェーデンを事例として用いて,高所得国における主要な産婦人保育の提供モデルを提示する.
- これらの多様なケアモデルに影響を与える 重要な要因を調べる
- 産婦人ケアの質,安全,公平性を改善すべき分野を特定する.
主な方法:
- アメリカとスウェーデンの産婦人保育制度の比較事例分析
- 介護の提供モデル,ドライバー,結果に関する既存の文献のレビュー
- 女性中心のケアに重点を置く
主要な成果:
- 出産の慣行,提供者幹部,施設の種類,出産の場所には大きな違いがあります. 熟練した出産者の割合が高いにもかかわらず.
- すべてのケアが証拠に基づいているわけではないし,一部の慣行は有害である可能性があります.恐れと高いコストは一般的な問題です.
- 不公平な結果が持続し,恵まれない人口はアクセス障壁と高リスクに直面しています.
結論:
- 妊産婦のケアにおける進歩は,ほとんどの女性の出産を正常化し,合併症に対する統合されたサービスを確保する必要があります.
- 品質と安全性の向上には 女性の経験と 医学的証拠を 組み込むことが必要です
- 女性中心の費用対効果の高いケアモデルに関するさらなる研究と評価は,変化を促し,公平な結果を改善するために必要です.
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