Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak.
Patient Satisfaction With Maternity Waiting Homes in Liberia: A Case Study During the Ebola Outbreak.
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DOI：
10.1111/jmwh.12600
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发表时间：
2017-03
影响因子：
2.7
通讯作者：
Williams, Garfee
中科院分区：
文献类型：
--
作者：
Lori, Jody R.;Munro-Kramer, Michelle L.;Shifman, Jordan;Amarah, Patricia N. M.;Williams, Garfee
关键词：
西非的利比里亚是世界上产妇死亡率最高的国家之一（990/100 000活产）。利比里亚的许多妇女生活在偏远的农村，很少有机会获得安全的孕产服务。世界卫生组织已将待产之家确定为一项战略，以尽量减少在获得熟练助产士方面的距离障碍。然而，利比里亚对产妇保健或孕产妇保健满意度的数据有限。这种混合方法的案例研究探讨了妇女的满意度，他们留在MWH和比较利用率之前和埃博拉疫情期间。从2012年到2014年，对利比里亚农村6个产妇保健中心之一的650名妇女在围产期或产后期间进行了调查。此外，还对传统提供者、熟练助产士和使用产妇保健服务的妇女进行了60次半结构化访谈。定量分析评估了埃博拉疫情爆发前和爆发期间的满意度。半结构化访谈的内容分析补充了定量数据，并提供了一个透镜的满意度与产妇保健的元素。大多数使用MWH的妇女表示，她们会向怀孕的朋友或亲戚建议MWH（99.5%），几乎所有人都会再次使用家庭（98.8%）。尽管在埃博拉疫情期间，对MWH的满意度显著下降（P < .001），但参与者对MWH总体满意。内容分析确定了满意度的领域，包括宁静和支持性的环境，以及需要改进的领域，如缺乏必要的资源和孤独的主题。该案例研究表明，利比里亚邦州使用MWH的妇女普遍对其经验感到满意，并计划在未来怀孕期间再次使用MWH，以便在分娩时获得熟练的助产士。妇女也愿意鼓励家人和朋友使用产妇保健工具。
Liberia in West Africa has one of the highest maternal mortality ratios in the world (990/100,000 live births). Many women in Liberia live in rural, remote villages with little access to safe maternity services. The World Health Organization has identified maternity waiting homes (MWHs) as one strategy to minimize the barrier of distance in accessing a skilled birth attendant. However, limited data exist on satisfaction with MWHs or maternal health care in Liberia. This mixed-methods case study examines women’s satisfaction with their stay at a MWH and compares utilization rates before and during the Ebola outbreak. From 2012 to 2014, 650 women who stayed at one of 6 MWHs in rural Liberia during the perinatal or postnatal period were surveyed. Additionally, 60 semi-structured interviews were conducted with traditional providers, skilled birth attendants, and women utilizing the MWHs. Quantitative analyses assessed satisfaction rates before and during the Ebola outbreak. Content analysis of semi-structured interviews supplemented the quantitative data and provided a lens into the elements of satisfaction with the MWHs. The majority of women who utilized the MWHs stated they would suggest the MWH to a friend or relative who was pregnant (99.5%), and nearly all would utilize the home again (98.8%). Although satisfaction with the MWHs significantly decreased during the Ebola outbreak (P < .001), participants were satisfied overall with the MWHs. Content analysis identified areas of satisfaction that encompassed the themes of restful and supportive environment as well as areas for improvement such as lacking necessary resources and loneliness. This case study demonstrated that women using MWHs in Bong County, Liberia are generally satisfied with their experience and plan to use an MWH again during future pregnancies to access a skilled birth attendant for birth. Women are also willing to encourage family and friends to use MWHs.
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