产后出血的早期检测和治疗捆绑策略:一种混合方法的评估过程
Meghan A Bohren1, Suellen Miller2, Kristie-Marie Mammoliti3
1Gender and Women's Health Unit, Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
The Lancet. Global health
|January 31, 2025
概括
使用校准窗和治疗包的E-MOTIVE干预显示出高准确性和可行性,可以减少产后出血 (PPH) 的不良结果. 建议将这种干预纳入国家政策,解决劳动力和供应需求.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 实施科学 实施科学
背景情况:
- 产后出血 (PPH) 是全球主要的孕产妇死亡原因.
- 在E-MOTIVE试验中,通过一种新的干预措施,显著减少了PPH不良结果.
- 在四个非洲国家进行了混合方法的过程评估.
研究的目的:
- 评估E-MOTIVE干预措施在不同医疗机构的实施情况.
- 评估干预组件的忠实性,采用性,适应性,可接受性和可行性.
- 确定阻碍和促进者,以成功扩大PPH管理策略.
主要方法:
- 混合方法方法结合了直接观察,卫生工作者调查和定性访谈.
- 干预站点使用校准的窗和MOTIVE治疗包;控制站点使用标准的窗.
- 收集的数据是关于对校准窗使用的忠实性,PPH治疗捆绑交付和护理的及时性.
主要成果:
- 在校准的窗使用和PPH治疗捆绑交付 (96.9%) 中观察到高保真度 (98.3%-100%).
- 卫生工作者报告说,干预组件的接受度和可行性很高.
- 在81.5%的病例中,在诊断后15-20分钟内启动PPH治疗的中度至高准确性得到了实现.
结论:
- 在现实环境中,E-MOTIVE干预证明了高准确性,可行性和可接受性.
- 建议将其纳入国家政策,重视加强卫生系统 (劳动力,物资,药物).
- 成功实施需要解决已识别的卫生系统限制,以实现最佳的PPH管理.
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