Exploring perceptions of group antenatal Care in Urban India: results of a feasibility study
Exploring perceptions of group antenatal Care in Urban India: results of a feasibility study
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DOI：
10.1186/s12978-018-0498-3
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发表时间：
2018-04-03
影响因子：
3.4
通讯作者：
Wegner, Mary Nell
中科院分区：
文献类型：
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作者：
Jolivet, R. Rima;Uttekar, Bella Vasant;Wegner, Mary Nell
背景：在孕期向所有妇女提供高质量的保健服务是改善世界各地母亲和婴儿围产期结局的关键战略。来自高收入国家的研究表明，集体提供产前护理可能是改善对孕妇和新生儿护理的提供、经验和结果的有效方式。一些研究人员和程序员正在调整团体产前护理(ANC)模式，以用于低收入和中等收入国家(LMIC)，但来自这些环境的证据基础有限，到目前为止还没有研究评估团体ANC在印度的可行性和可接受性。方法：我们通过对现有的关于LMIC中团体ANC的证据进行系统的范围审查，将其应用于印度的城市环境，并对模型内容进行了调整，以适应当地、国家和全球指南的发展。我们向印度瓦多达拉三个不同类型的医疗机构的医生、助产士、管理人员、孕妇和支持人员演示了该模式的一次会议，并使用定性方法收集和分析参与者对该模式的可行性和可接受性的反馈。结果：护理提供者和接受者对该模式表示支持和热情，并就其组成部分：身体评估、主动学习和社会支持提供了具体的反馈。总体而言，在见证了该模式的演示后，两组参与者-提供者和受益者-都将团体ANC视为一种提供更全面的ANC服务、改善护理体验、使妇女成为更积极的合作伙伴和参与者的工具，并有可能解决当前的一些卫生系统挑战。结论：本研究表明，引入团体ANC将是可行的，并可被来自不同护理提供环境的利益相关者接受，包括印度市区的一家城市初级卫生诊所、一家社区母婴保健中心和一家私立医院。
Background: Making high-quality health care available to all women during pregnancy is a critical strategy for improving perinatal outcomes for mothers and babies everywhere. Research from high-income countries suggests that antenatal care delivered in a group may be an effective way to improve the provision, experiences, and outcomes of care for pregnant women and newborns. A number of researchers and programmers are adapting group antenatal care (ANC) models for use in low-and middle-income countries (LMIC), but the evidence base from these settings is limited and no studies to date have assessed the feasibility and acceptability of group ANC in India.Methods: We adapted a "generic" model of group antenatal care developed through a systematic scoping review of the existing evidence on group ANC in LMICs for use in an urban setting in India, after looking at local, national and global guidelines to tailor the model content. We demonstrated one session of the model to physicians, auxiliary nurse midwives, administrators, pregnant women, and support persons from three different types of health facilities in Vadodara, India and used qualitative methods to gather and analyze feedback from participants on the perceived feasibility and acceptability of the model.Results: Providers and recipients of care expressed support and enthusiasm for the model and offered specific feedback on its components: physical assessment, active learning, and social support. In general, after witnessing a demonstration of the model, both groups of participants-providers and beneficiaries-saw group ANC as a vehicle for delivering more comprehensive ANC services, improving experiences of care, empowering women to become more active partners and participants in their care, and potentially addressing some current health system challenges.Conclusion: This study suggests that introducing group ANC would be feasible and acceptable to stakeholders from various care delivery settings, including an urban primary health clinic, a community-based mother and child health center, and a private hospital, in urban India.