Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic
Voices from the frontline: findings from a thematic analysis of a rapid online global survey of maternal and newborn health professionals facing the COVID-19 pandemic
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DOI：
10.1136/bmjgh-2020-002967
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发表时间：
2020-06-01
影响因子：
8.1
通讯作者：
Benova, Lenka
中科院分区：
文献类型：
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作者：
Semaan, Aline;Audet, Constance;Benova, Lenka
COVID-19疫情对全球孕产妇护理服务产生重大影响。根据模型进行的研究估计了这一流行病对服务和卫生成果的巨大间接影响。本研究的目的是前瞻性地记录一线孕产妇和新生儿保健提供者的经验。我们通过专业网络和社交媒体以12种语言传播的在线调查对孕产妇和新生儿卫生专业人员进行了一项全球横断面研究。于2020年3月24日至4月10日期间收集有关受访者的背景、对COVID-19的准备和应对以及他们在疫情期间的经验的资料。一个可选模块要求提供关于17个护理程序的适应情况。采用了描述性统计和定性专题分析来分析答复，并按低收入和中等收入国家以及高收入国家分列。结果我们分析了714名孕产妇和新生儿保健专业人员的答复。只有三分之一的人从他们的医疗机构接受了关于COVID-19的培训，几乎所有人都自己搜索信息。低收入国家中有一半的答复者收到了最新的护理提供指南，而高收入国家的这一比例为82%。总体而言，47%的中低收入国家参与者和69%的高收入国家参与者认为自己基本或完全了解如何护理COVID-19产妇。高收入国家对COVID-19的设施级应对（标识、筛查、检测和隔离室）比低收入国家更常见。在全球范围内，90%的受访者报告说，他们的压力水平略高或高得多。人们普遍认为，常规产妇护理服务的使用有所减少，护理程序有所改变，其中一些做法没有证据。结论在有或无COVID-19的孕产妇病例管理指导方面存在巨大的知识差距。必须为提供者建立正式的信息共享渠道，并提供心理健康支持。对产妇护理提供者的调查可以帮助跟踪情况，捕捉创新并支持快速制定有效的应对措施。
Introduction The COVID-19 pandemic has substantially impacted maternity care provision worldwide. Studies based on modelling estimated large indirect effects of the pandemic on services and health outcomes. The objective of this study was to prospectively document experiences of frontline maternal and newborn healthcare providers. Methods We conducted a global, cross-sectional study of maternal and newborn health professionals via an online survey disseminated through professional networks and social media in 12 languages. Information was collected between 24 March and 10 April 2020 on respondents' background, preparedness for and response to COVID-19 and their experience during the pandemic. An optional module sought information on adaptations to 17 care processes. Descriptive statistics and qualitative thematic analysis were used to analyse responses, disaggregating by low-income and middle-income countries (LMICs) and high-income countries (HICs). Results We analysed responses from 714 maternal and newborn health professionals. Only one-third received training on COVID-19 from their health facility and nearly all searched for information themselves. Half of respondents in LMICs received updated guidelines for care provision compared with 82% in HICs. Overall, 47% of participants in LMICs and 69% in HICs felt mostly or completely knowledgeable in how to care for COVID-19 maternity patients. Facility-level responses to COVID-19 (signage, screening, testing and isolation rooms) were more common in HICs than LMICs. Globally, 90% of respondents reported somewhat or substantially higher levels of stress. There was a widespread perception of reduced use of routine maternity care services, and of modification in care processes, some of which were not evidence-based practices. Conclusions Substantial knowledge gaps exist in guidance on management of maternity cases with or without COVID-19. Formal information-sharing channels for providers must be established and mental health support provided. Surveys of maternity care providers can help track the situation, capture innovations and support rapid development of effective responses.