在西非三个国家探索修改的世卫组织安全分娩清单实施的障碍和驱动因素:使用更新的实施研究综合框架进行定性研究
Kadidiatou Raïssa Kourouma1,2, Wambi Maurice Evariste Yaméogo3,4, Daouda Doukouré1,2
1National Institute of Public Health (INSP), Abidjan, Côte d'Ivoire.
Frontiers in health services
|July 4, 2025
概括
在撒哈拉以南非洲实施修改后的安全分娩检查清单 (mSCC) 取得了成功,尽管存在资源挑战. 关键的驱动因素包括明确的指导方针和培训,同时必须解决人员短缺和工作负载等障碍,以实现更广泛的采用.
科学领域:
- 全球卫生健康 全球卫生健康
- 产科和妇科的产科和妇科.
- 医疗服务研究 医疗服务研究
背景情况:
- 撒哈拉以南非洲地区的孕产妇和新生儿死亡率是全球最高的.
- 世界卫生组织的安全分娩检查清单 (WHO SCC) 旨在通过基于证据的实践来降低这些率.
- 在布基纳法索,科特迪瓦和几内亚实施了经过修改的WHO SCC (mSCC),以评估其可行性.
研究的目的:
- 探索影响修改世卫组织SCC (mSCC) 实施的障碍和驱动因素.
- 确定促进或阻碍将mSCC纳入选定的西非医院常规产科护理的因素.
主要方法:
- 采用了定性多个案例研究设计.
- 在三个国家的四个区域医院中,与110名利益相关者进行了个别采访.
- 以更新的CFIR框架为指导并使用NVivo 14进行主题分析,用于分析数据.
主要成果:
- 确定了17个驱动因素和7个阻碍mSCC实施的障碍.
- 主要驱动因素包括mSCC的清晰度,简单性,与国家指导方针一致,有效的培训,指导和利益相关方参与.
- 主要障碍包括资源限制 (药品,物资,人员,空间),工作量增加和缺乏激励措施,布基纳法索和科特迪瓦特别指出了这些问题.
结论:
- 成功实施mSCC需要解决资源限制,优化工作量,并提供激励措施.
- 在资源有限的环境中引入类似干预措施时,特定于环境的策略和强有力的领导支持至关重要.
- 一般来说,mSCC的接受度很好,这表明在适当的支持下,它有可能被纳入常规护理.
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