Maternal morbidity in the first year after childbirth in Mombasa Kenya; a needs assessment
Maternal morbidity in the first year after childbirth in Mombasa Kenya; a needs assessment
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DOI：
10.1186/1471-2393-9-51
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发表时间：
2009-01-01
影响因子：
3.1
通讯作者：
Temmerman, Marleen
中科院分区：
文献类型：
--
作者：
Chersich, Matthew F.;Kley, Nicole;Temmerman, Marleen
背景：在撒哈拉以南非洲，很少有服务专门针对妇女产后第一年的需求。通过评估这一时期妇女的健康状况，可以确定改善产妇保健的关键干预措施。将这些干预措施纳入为到儿童保健诊所就诊的妇幼夫妇提供的一揽子服务的机会尚未得到充分利用。方法：这项需求评估包括对在肯尼亚蒙巴萨省医院儿童保健诊所就诊的500名妇女进行横断面调查。进行了结构化问卷调查、临床检查、收集血液、尿液、宫颈拭子和巴氏涂片。妇女的保健需求在分娩后的早期（分娩后四周至两个月）、中期（2至6个月）和后期（6至12个月）进行了比较。结果：超过三分之一的妇女未满足避孕需求（39%,187/475）。与其他时间段相比，月经后期的女性有更多的一般性健康症状，如腹痛、发烧和抑郁，但泌尿或乳房问题较少。在每个时期，超过50%的妇女患有贫血（Hb < 11 g/l; 265/489），在剖腹产或怀孕期间未补充铁的妇女中，贫血水平更高。细菌性阴道病占32%(141/447)，梅毒占1%(5/495)，阴道毛滴虫占8% (35/454)，HIV感染占11%（54/496）。结论：在分娩后的第一年，妇女的发病率很高。应利用与儿童保健诊所卫生工作者的联系，治疗贫血、筛查和治疗生殖道感染，并提供计划生育咨询和避孕。在儿童保健诊所就诊期间提供这些服务，可以为改善妇女的健康作出重要贡献，因为这些诊所在分娩后的一年中都有很高的覆盖率。
Background: In sub-Saharan Africa, few services specifically address the needs of women in the first year after childbirth. By assessing the health status of women in this period, key interventions to improve maternal health could be identified. There is an underutilised opportunity to include these interventions within the package of services provided for woman-child pairs attending child-health clinics.Methods: This needs assessment entailed a cross-sectional survey with 500 women attending a child-health clinic at the provincial hospital in Mombasa, Kenya. A structured questionnaire, clinical examination, and collection of blood, urine, cervical swabs and Pap smear were done. Women's health care needs were compared between the early (four weeks to two months after childbirth), middle (two to six months) and late periods (six to twelve months) since childbirth.Results: More than one third of women had an unmet need for contraception (39%, 187/475). Compared with other time intervals, women in the late period had more general health symptoms such as abdominal pain, fever and depression, but fewer urinary or breast problems. Over 50% of women in each period had anaemia (Hb < 11 g/l; 265/489), with even higher levels of anaemia in those who had a caesarean section or had not received iron supplementation during pregnancy. Bacterial vaginosis was present in 32% (141/447) of women, while 1% (5/495) had syphilis, 8% (35/454) Trichomonas vaginalis and 11% (54/496) HIV infection.Conclusion: Throughout the first year after childbirth, women had high levels of morbidity. Interface with health workers at child health clinics should be used for treatment of anaemia, screening and treatment of reproductive tract infections, and provision of family planning counselling and contraception. Providing these services during visits to child health clinics, which have high coverage both early and late in the year after childbirth, could make an important contribution towards improving women's health.