Skilled birth attendance: What does it mean and how can it be measured? A clinical skills assessment of maternal and child health workers in Nepal
Skilled birth attendance: What does it mean and how can it be measured? A clinical skills assessment of maternal and child health workers in Nepal
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DOI：
10.1016/j.ijgo.2004.12.044
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发表时间：
2005-05-01
影响因子：
3.8
通讯作者：
McCall, M
中科院分区：
文献类型：
--
作者：
Carlough, M;McCall, M
在分娩时有熟练的助产士在场，对于避免孕产妇和新生儿的死亡率和发病率很重要。它现在表明，在大多数情况下，即使是训练有素的传统助产士(TBA)也无法有效地挽救妇女的生命，因为他们无法治疗并发症，而且往往无法转诊。在发展中国家大多数妇女接生的农村地区和社区环境中，往往找不到合格的助产士和医生。确定满足熟练助产士定义所需的最低能力水平是重要的，特别是在尼泊尔等以设施为基础的产科急救服务有限的国家。妇幼保健工作者是18至35岁的当地妇女，她们完成了为期15周的妇幼保健课程。随着妇幼保健员的作用扩大，以满足该国对熟练接生的需求，提供了为期6周的助产技能进修课程。这项对尼泊尔15个地区随机抽取的104名妇幼保健院进行的临床技能评估结果支持这样一个前提，即经过适当培训的妇幼保健院具有可接受的知识和技能水平，并在实践中得到证明，以满足社区一级熟练助产士的定义。然而，仅有能力并不一定会改善这种情况。为了影响尼泊尔的孕产妇死亡率，必须广泛提供妇幼保健服务，必须允许他们做他们受过培训的事情，他们必须得到后勤和政策支持。(C)2005年国际妇产科联合会。爱思唯尔爱尔兰有限公司出版。版权所有。
The presence of a skilled birth attendant at delivery is important in averting maternal and neonatal mortality and morbidity. It has now shown that even trained traditional birth attendants (TBAs) cannot, in most cases, save women's lives effectively because they are unable to treat complications, and are often unable to refer. Qualified midwives and doctors are often not available in the rural areas and community settings where most women in developing countries deliver. Defining the minimum competency level necessary to meet the definition of skilled birth attendant is important, particularly in countries such as Nepal with limited availability of facility-based emergency obstetric care. Maternal and child health workers are local women aged 18-35 who completed a 15-week course in maternal and child health. As the role of MCHWs has expanded to meet the country's needs for skilled attendance, a 6-week "refresher" course in midwifery skills is offered. The results of this clinical skills assessment of 104 randomly selected MCHWs from 15 districts across Nepal supports the premise that MCHWs with appropriate training have an acceptable level of knowledge and skill, demonstrated in a practice situation, to meet the definition of community level skilled birth attendants. Yet, competency alone will not necessarily improve the situation. To affect maternal mortality in Nepal, MCHWs must be widely available, they must be allowed to do what they are trained to do, and they must have logistical and policy support. (c) 2005 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.