与妇女团体的参与性干预对尼泊尔出生结果的影响:集群随机对照试验
Dharma S Manandhar1, David Osrin, Bhim Prasad Shrestha
1Mother and Infant Research Activities (MIRA), PO Box 921, Kathmandu, Nepal.
Lancet (London, England)
|September 15, 2004
概括
在尼泊尔,以社区为基础的参与性干预通过赋予妇女团体以应对当地围产期挑战来显著降低新生儿死亡率. 这种低成本的方法改善了脆弱人群的分娩结果和孕产妇健康.
科学领域:
- 全球健康 全球健康
- 孕产妇和儿童的健康
- 基于社区的干预措施
背景情况:
- 新生儿死亡对发展中国家的5岁以下死亡率有很大影响.
- 在最贫穷的人群中,家庭分娩很普遍,增加了新生儿的风险.
- 正在探索以社区为基础的参与性方法,以减少新生儿死亡率.
研究的目的:
- 评估以社区为基础的参与性干预在降低新生儿死亡率方面的有效性.
- 评估妇女团体对围产期问题和健康结果的影响.
- 确定干预的可扩展性和可持续性.
主要方法:
- 一个对配集群随机对照试验在尼泊尔的Makwanpur地区进行.
- 在当地妇女的帮助下,妇女团体参与了行动学习周期,以确定和解决围产期问题.
- 在一个由28931名妇女组成的队列中,监测了分娩结果,并根据治疗意图进行分析.
主要成果:
- 新生儿死亡率在干预集群 (26.2/1000) 与对照集群 (36.9/1000) 相比显著较低.
- 在干预组 (69/100,000) 和对照组 (341/100,000) 中,孕产妇死亡率大幅降低.
- 干预参与者显示,他们越来越多地利用产前护理,机构分娩和卫生生产实践.
结论:
- 使用女性团体的低成本参与性干预可以显著改善资源有限的环境中的分娩结果.
- 该干预表明了改善母亲和新生儿健康的可持续性和可扩展性的潜力.
- 通过参与式方法赋予当地社区权力,有效地应对关键的健康挑战.
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