在马拉维的Blantyre区的复杂产科患者中描述转诊护理连续性:混合方法研究
Ashley Mitchell1,2, Luseshelo Simwinga2,3, Alden Blair1,2
1Institute for Global Health Sciences, University of California, San Francisco, San Francisco, California, United States of America.
改善马拉维的孕产妇结果需要解决转诊前护理方面的挑战. 产科转诊的延迟和沟通问题显著影响孕产妇死亡率,特别是在远方机构转诊的孕产妇中.
科学领域:
- 产科和妇科 产科和妇科
- 公共卫生 公共卫生
- 医疗保健服务研究 医疗服务研究
背景情况:
- 马拉维面临着高的孕产妇死亡率,尽管有高的设施分娩率.
- 大多数产妇死亡发生在二级和三级护理层面,这表明转诊护理质量存在问题.
- 了解转诊前的护理对于改善复杂产科病例的结果至关重要.
研究的目的:
- 描述马拉维的转诊前产科护理和结果.
- 识别助手和障碍产科推过程中的障碍.
- 为改善母亲在转诊环境中的结果制定策略提供信息.
主要方法:
- 融合,并行混合方法方法.
- 从一级医疗中心转移到三级医院的产科患者病历分析 (2019年3月 - 2020年3月).
- 对焦点小组讨论和与提供者和母亲进行深入采访的定性分析.
主要成果:
- 在398名妇女中,32%的妇女来自10公里外的设施.
- 死亡的母亲更有可能是从遥远的设施转移到的,他们到达时处于危急状态.
- 关键障碍包括系统性挑战,沟通不良以及社区/提供商对期望的影响.
结论:
- 加强推基础设施,沟通和减少推时间至关重要.
- 需要为提供者提供额外的培训和支持,以确保及时和持续的护理.
- 解决转诊前护理质量问题对于减少马拉维的孕产妇死亡率至关重要.
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