71个低收入和中等收入国家的妇女分娩和产后护理:使用家庭调查分析覆盖率差距
Emily B Wilson1, Lori Niehaus2, Safia S Jiwani2
1Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. ewilso28@jhu.edu.
BMC pregnancy and childbirth
|July 26, 2024
概括
在低收入国家,孕产妇死亡率仍然很高. 一项全面的分娩护理措施揭示了显著的差距,即使增加了设施分娩,突出了改善护理质量的需要.
科学领域:
- 全球健康 全球健康
- 孕产妇健康 孕产妇健康
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在低收入和中等收入国家 (LMICs) 中,持续高的孕产妇发病率和死亡率.
- 设施分娩和熟练分娩人员覆盖率的增加并没有完全缓解这些结果.
- 需要评估超越设施服务的综合性医疗服务.
研究的目的:
- 用简要的分娩护理措施来比较设施出生率.
- 量化基本分娩护理干预措施的覆盖差距.
- 评估分娩护理覆盖率与产妇死亡率 (MMR) 之间的关联.
主要方法:
- 通过使用分娩地点,熟练护理人员,产后停留时间和产后健康检查的数据,估计了分娩护理得分.
- 分析了来自71个国家的3333316名妇女 (年龄在15-49岁) 的数据 (2013-2020年).
- 按国家MMR和财富五分位数进行分层分析,以确定覆盖差异和错过的机会.
主要成果:
- 产妇护理覆盖范围差异很大 (24%-100%),中位数为70%.
- 虽然76%的妇女在设施中分娩,但只有41%的妇女获得了所有四个基本护理组成部分.
- 在所有MMR水平上存在覆盖差距,特别是在高MMR国家的财富五分位数之间;分娩护理覆盖与MMR负面相关.
结论:
- 解决综合性分娩护理方面的差距至关重要,超出了设施访问范围.
- 必须优先考虑各国的护理质量和公平性,财富五分位数和MMR水平.
- 干预措施应侧重于确保分娩护理的所有基本组成部分得到满足,以减少孕产妇死亡率.
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