在低资源环境中获得持续的孕产妇和产周保健服务的空间访问:跨部门研究
Qin Li1,2, Elsa Kanduma3, Isaías Ramiro3
1HEOA Group, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, China.
JMIR public health and surveillance
|July 18, 2024
概括
在莫桑比克,获得孕产妇和产周保健服务仍然是一个挑战,超过51%的妇女无法在两小时内获得护理. 需要有针对性的战略来改善因罕巴内和尼亚萨等地区的准入和公平.
科学领域:
- 孕产妇和产周健康
- 公共卫生 公共卫生
- 医疗服务的可访问性
背景情况:
- 孕产妇和产周健康对人类发展至关重要.
- 低资源环境,特别是撒哈拉以南非洲地区,在减少孕产妇,新生儿和儿童死亡率方面面临重大挑战.
- 为实现可持续发展目标3 (SDG3) 和全民健康覆盖 (UHC),改善获得持续孕产妇和产周保健服务 (CMPHS) 的机会至关重要.
研究的目的:
- 开发一种广泛适用的程序,以评估生育年龄妇女在CMPHS获得的挑战.
- 在低资源环境中为政策制定和资源分配提供信息.
- 确定CMPHS的空间障碍和资源短缺区域.
主要方法:
- 定义CMPHS为产前护理 (ANC),机构分娩 (ID) 和产后护理 (PNC) 的连续.
- 使用最近邻近方法 (NNM) 来评估每个服务包的空间访问.
- 进行了重叠分析,以确定八种类型的资源短缺区域.
主要成果:
- 到达ANC,ID和PNC的中位时间分别为2.38小时,3.69小时和4.16小时.
- 在不同地区和区域内观察到访问和公平的显著空间差异.
- 在莫桑比克83.25%的土地面积中,超过51%的妇女无法及时 (在2小时内) 获得任何CMPHS套餐.
结论:
- 莫桑比克CMPHS的空间可访问性和公平性对实现SDG3和UHC提出了重大挑战.
- 建议包括Inhambane的去中心化和设施升级,以及Niassa的社区助产服务.
- 拟议的两步程序可以在其他资源较少的环境中实施,以提高CMPHS的可访问性.
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