Health service utilization for perceived postpartum morbidity among poor women living in Karachi
Health service utilization for perceived postpartum morbidity among poor women living in Karachi
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DOI：
10.1016/j.socscimed.2003.11.034
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发表时间：
2004-08-01
影响因子：
5.4
通讯作者：
Rahbar, MH
中科院分区：
文献类型：
--
作者：
Fikree, FF;Ali, T;Rahbar, MH
探讨传统的信仰和做法，评估产褥期发病率，并了解求医行为，定性和定量研究进行了低社会经济住区的卡拉奇，巴基斯坦。2000年7月和8月，进行了五次焦点小组讨论和15次深入访谈。525名产后6-8周的穆斯林妇女在家中接受了采访。产妇保健相对较好，超过四分之三的最近的母亲寻求产前保健和一半以上（267/525）在医院或产院分娩。在设施分娩中，16%（43/267）的人咨询去产后诊所，其中只有26%（11/43）的人去了。分娩和产褥期的做法，如在分娩过程中用芥子油按摩阴道壁以促进分娩，插入阴道或直肠草药子宫托以促进“子宫收缩”和/或“加强脊柱”，是普遍的。产褥期临床上重要的核心症状是大量阴道出血和高热，因为如果不寻求适当和及时的护理，它们可能是致命的症状。大约一半的研究女性（53.3%）报告至少一种疾病症状，高烧（21.1%），大量阴道出血（13.9%）和恶臭的阴道分泌物（9.6%）。妇女不知道其产后发病率的潜在生物学原因;经常提到虚弱。妇女最初向近亲或传统治疗师寻求治疗，如果她们继续患病，她们最终会求助于受过训练的保健（对抗疗法）提供者。产后抑郁症的高患病率说明了对产后社区卫生保健计划的需求。我们建议促进孕产妇健康教育，鼓励妇女通过获得公共或私人保健服务寻求适当和及时的护理。(C)2003 Elsevier Ltd.保留所有权利。
To explore traditional beliefs and practices, to assess puerperal morbidity, and to understand care-seeking behaviors, a qualitative and quantitative study was conducted in low socio-economic settlements of Karachi, Pakistan. Five focus group discussions and 15 in-depth interviews were conducted in July and August 2000. 525 Muslim women, who were 6-8 weeks post-partum, were then interviewed at home. Maternal care was relatively good-more than three-quarters of recent mothers Sought antenatal care and more than half (267/525) delivered in a hospital or maternity home. Counseling to attend post-partum clinics among facility deliveries was 16% (43/267), of which only 26% (11/43) attended. Practices during the delivery and puerperium, such as massaging the vaginal walls with mustard oil during labor to facilitate delivery and inserting vaginal or rectal herbal pessaries to facilitate 'shrinkage of the Uterus' and/or strengthening of the backbone', were pervasive.The core symptoms that are clinically significant during the puerperium are heavy vaginal bleeding and high fever, since they are potentially fatal symptoms if appropriate and timely care is not sought. About half of the Study women (53.3%) reported at least one illness symptom, high fever (21.1%), heavy vaginal bleeding (13.9%), and foul smelling vaginal discharge (9.6%). Women did not know the underlying biologic cause of their perceived post-partum morbidity; weakness was frequently mentioned. Women Sought care initially from close relatives or traditional healers and if they continued to suffer from their morbidity they finally approached a trained health care (allopathic) provider. The high prevalence of perceived post-partum Morbidity illustrates the demand for post-partum community-based health care programs. We Suggest promoting maternal health education that encourages women to seek appropriate and timely care by accessing public or private health services. (C) 2003 Elsevier Ltd. All rights reserved.