使用移动产科急救系统改善利比里亚邦邦县的产科转诊:一项前后研究
HaEun Lee1, Bernice Dahn2, Joseph Sieka2
1University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
概括
在利比里亚实施移动产科急救系统 (MORES) 增加了剖腹产率,改善了新生儿的结果. 这一系统有望提高在资源乏的环境中获得紧急产科护理的机会.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 孕产妇和儿童的健康
背景情况:
- 利比里亚在剖腹产 (CS) 覆盖率方面面临着严重的差距 (5%),远低于与更好的孕产妇和新生儿结果相关的9%-19%.
- 农村卫生设施 (RHF) 与地区医院之间的沟通效率低下阻碍了急诊产科和新生儿护理 (CEmONC) 的转诊,导致CS率较低.
研究的目的:
- 评估实施移动产科紧急系统 (MORES) 对产科紧急情况的转诊时间的影响.
- 评估利比里亚的MORES实施与母亲和新生儿结果之间的关联.
主要方法:
- 进行了前后描述性分析,使用了来自Bong县20家RHF和两家医院的数据.
- 分析了来自RHF和医院的匹配推数据,以提取转移时间,推原因以及母亲/新生儿结果.
- 后勤回归模型检查了干预对分娩方式,母亲/新生儿结果和转移时间的影响.
主要成果:
- 女性在干预后进行剖腹产的几率增加 (OR:1.86).
- 新生儿表现出较低的非强烈症状的几率 (OR:0.31).
- 在MORES实施和转移时间之间没有发现显著的关联.
结论:
- 莫雷斯的干预显示了改善推途径内的及时寻求护理的潜力.
- 这种系统可以提高对剖腹产的准入,并改善新生儿在低收入和中等收入国家.
- 移动卫生干预可以有效地加强产科紧急护理系统.
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