肯尼亚妇女的自主权和孕产妇健康决策:对服务提供改革的影响 - - 定性研究
Easter Olwanda1, Kennedy Opondo2, Dorothy Oluoch1
1KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya.
BMC women's health
|March 20, 2024
概括
妇女在孕产妇医疗保健中的决策权受个人,关系和系统因素的影响. 促进妇女的声音对于改善获得和使用产前,分娩和产后服务至关重要.
科学领域:
- 公共卫生 公共卫生
- 孕产妇健康 孕产妇健康
- 生殖能力的增强 繁殖能力的增强
背景情况:
- 卡卡梅加县面临着高的孕产妇 (316/100k) 和新生儿 (19/1k) 死亡率.
- 很大一部分 (35%) 的分娩是在家中发生的,这表明潜在的进入障碍.
- 目前正在进行母婴健康服务 (SDR) 的重新设计,以改善结果.
研究的目的:
- 了解妇女在寻求孕产妇医疗保健时的决策过程.
- 评估决策如何影响获得和使用产前,分娩和产后服务.
- 为卡卡梅加SDR流程评估提供信息.
主要方法:
- 调整了ICRW框架,重点关注女性自主权和女性代理权 (发言权,选择权,权力).
- 采用了定性方法:采访关键信息者,深入采访,与男女聚焦小组.
- 使用NVivo 12中的专题分析进行数据分析.
主要成果:
- 在女性中观察到更大的行动,她们有积极的分娩经历,高自尊和社会支持.
- 财务控制和尊重的合作伙伴沟通与更高的家庭机构相关联.
- 卫生系统的障碍 (等待时间,工作人员的可用性) 和社会文化规范影响了妇女的代理和自主权.
结论:
- 个人,关系和系统因素在很大程度上影响了妇女在产妇医疗保健方面的决策权.
- 促进妇女发言的特定背景策略对于持续使用服务至关重要.
- 这些发现可以指导实施卡卡梅加SDR模型,以改善母亲和新生儿的健康.
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