Maternal Survival 3 - Going to scale with professional skilled care
Maternal Survival 3 - Going to scale with professional skilled care
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DOI：
10.1016/s0140-6736(06)69382-3
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发表时间：
2006-10-14
期刊：
影响因子：
168.9
通讯作者：
van Lerberghe, Wim
中科院分区：
文献类型：
--
作者：
Koblinsky, Marge;Matthews, Zoe;van Lerberghe, Wim
由于大多数妇女更喜欢专业提供的孕产妇保健时，他们可以获得它，因为所需的临床干预措施是众所周知的，我们在他们的文件中讨论了什么是需要向前迈进，从明显的全球停滞在孕产妇死亡率高的孕产妇保健的提供和使用。扩大保健的主要障碍是：熟练的提供者和保健系统基础设施极为缺乏，保健质量不合格，妇女不愿意在费用高和服务不协调的地方使用产妇保健。为了增加专业熟练分娩护理的供应，必须在三个方面做出战略决策：培训，部署和保留卫生工作者。根据模拟结果，到2015年，在设施中工作的助产士和助产士助理团队可以将产妇护理覆盖率提高40%。提供者团队是有效的选择，与部署单独的卫生工作者与专门或多功能工作者一起在家分娩的情况相比，扩大规模的速度可能快10倍。
Because most women prefer professionally provided maternity care when they have access to it, and since the needed clinical interventions are well known, we discuss in their paper what is needed to move forward from apparent global stagnation in provision and use of maternal health care where maternal mortality is high. The main obstacles to the expansion of care are the dire scarcity of skilled providers and health-system infrastructure, substandard quality of care, and women's reluctance to use maternity care where there are high costs and poorly attuned services. To increase the supply of professional skilled birthing care, strategic decisions must be made in three areas: training, deployment, and retention of health workers. Based on results from simulations, teams of midwives and midwife assistants working in facilities could increase coverage of maternity care by up to 40% by 2015. Teams of providers are the efficient option, creating the possibility of scaling up as much as 10 times more quickly than would be the case with deployment of solo health workers in home deliveries with dedicated or multipurpose workers.