"Our voices matter": a before-after assessment of the effect of a community-participatory intervention to promote uptake of maternal and child health services in Kwale, Kenya
"Our voices matter": a before-after assessment of the effect of a community-participatory intervention to promote uptake of maternal and child health services in Kwale, Kenya
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DOI：
10.1186/s12913-018-3739-9
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发表时间：
2018-12-04
影响因子：
2.8
通讯作者：
Gichangi, Peter
中科院分区：
文献类型：
--
作者：
Mochache, Vernon;Irungu, Eunice;Gichangi, Peter
背景社区参与方法对于有效的孕产妇和儿童健康干预措施非常重要。肯尼亚夸勒县实施了社区参与干预措施（对话模式），以提高育龄妇女对特定孕产妇和儿童保健服务的接受程度。方法对社区志愿者进行培训，以促进与夸勒马图加干预卫生设施相关的社区单位开展对话模式课程。干预设施的选择是基于那些拥有活跃社区单位的设施。对于每个机构，使用配对样本 t 检验对干预实施前（2012 年 10 月至 2013 年 9 月）和实施后（2016 年 1 月至 12 月）对地区卫生信息系统 (DHIS)-2 中报告的计划生育、产前护理和机构分娩的接受情况进行比较。 结果 2013 年 10 月至 2015 年 12 月期间，各机构共举办了 570 场对话模型会议。 12 个社区单位与 10 个干预设施相关。每个设施每月的中位数[四分位距 (IQR)] 会话次数为 2 (1-3)。总体而言，这些机构报告计划生育、产前护理和机构分娩的接受率分别增加了 15%、2% 和 74%。这对于计划生育前（平均值（M）= 1014；标准差（SD）= 381）与计划生育后（M = 1163；SD = 400）相比具有统计学意义； t (18)=-0.603，P=0.04）以及基于设施的分娩前（M=185；SD=216）与术后（M=323；SD=384）； t (18)=-0.698，P=0.03)。 结论 结构化的社区参与性干预措施提高了肯尼亚农村地区对计划生育服务和设施分娩的接受程度。这种方法通过为社区提供影响其健康结果的利害关系，有助于解决需求方因素。
BackgroundCommunity-participatory approaches are important for effective maternal and child health interventions. A community-participatory intervention (the Dialogue Model) was implemented in Kwale County, Kenya to enhance uptake of select maternal and child health services among women of reproductive age.MethodsCommunity volunteers were trained to facilitate Dialogue Model sessions in community units associated with intervention health facilities in Matuga, Kwale. Selection of intervention facilities was purposive based on those that had an active community unit in existence. For each facility, uptake of family planning, antenatal care and facility-based delivery as reported in the District Health Information System (DHIS)-2 was compared pre- (October 2012 - September 2013) versus post- (January - December 2016) intervention implementation using a paired sample t-test.ResultsBetween October 2013 and December 2015, a total of 570 Dialogue Model sessions were held in 12 community units associated with 10 intervention facilities. The median [interquartile range (IQR)] number of sessions per month per facility was 2 (1-3). Overall, these facilities reported 15, 2 and 74% increase in uptake of family planning, antenatal care and facility-based deliveries, respectively. This was statistically significant for family planning pre- (Mean (M)=1014; Standard deviation (SD)=381) versus post- (M=1163; SD=400); t (18)=-0.603, P=0.04) as well as facility-based deliveries pre- (M=185; SD=216) versus post- (M=323; SD=384); t (18)=-0.698, P=0.03).ConclusionsA structured, community-participatory intervention enhanced uptake of family planning services and facility-based deliveries in a rural Kenyan setting. This approach is useful in addressing demand-side factors by providing communities with a stake in influencing their health outcomes.