Integration of postpartum care into child health and immunization services in Burkina Faso: findings from a cross-sectional study.
Integration of postpartum care into child health and immunization services in Burkina Faso: findings from a cross-sectional study.
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DOI：
10.1186/s12978-018-0602-8
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发表时间：
2018-10-11
影响因子：
3.4
通讯作者：
Degomme O
中科院分区：
文献类型：
--
作者：
Yugbaré Belemsaga D;Goujon A;Bado A;Kouanda S;Duysburgh E;Temmerman M;Degomme O
旨在提升孕产妇和婴儿产后护理水平的“错失母婴保健机会”项目实施了一揽子干预措施，包括2013年至2015年在布基纳法索卡亚卫生区的12个卫生设施将孕产妇产后护理纳入婴儿免疫服务。本文评估了母婴联合PPC在生殖、孕产妇、新生儿和儿童健康服务（RMNCH）中的覆盖率和质量。我们在卡亚健康和人口监测系统干预前后进行了一项混合方法研究和横断面调查。在定量方面，2012年（N = 757）和2014年（N = 754）在产后一年内的母亲中进行了两次家庭调查。该分析检查了PPC计划中三个关键时间点的分娩日期的干预结果：前48小时，第6-10天和第6-8周及以后。在定性方面，2012年和2015年在四个卫生设施进行了深入访谈、焦点小组讨论和观察。参与者包括产后母亲、设施和社区卫生工作者以及其他利益攸关方。我们进行了描述性分析和两个样本的定量数据的比例检验。定性数据被记录，转录和分析沿着相关的干预主题。调查结果表明，在体检和咨询方面，遵循了世卫组织关于孕产妇PPC内容和改进的指导方针。它们还表明，孕产妇PPC服务的覆盖率从干预前的50%（372/752）大幅提高到干预开始一年后的81%（544/672）。然而，在第6-10天接受评估的妇女多于以后的访问。孕产妇PPC的整合率很低，在免疫服务中对母亲的病史和体检几乎没有改善。虽然卫生工作者是多职能的，但重组和组织服务方面的困难阻碍了整合。除非在生殖、孕产妇、新生儿和儿童保健服务范围内实施一项综合战略，以解决卫生系统内的初级保健挑战，否则综合将不会产生预期的结果。
The Missed Opportunities for Maternal and Infant Health (MOMI) project, which aimed at upgrading maternal and infant postpartum care (PPC), implemented a package of interventions including the integration of maternal PPC in infant immunization services in 12 health facilities in Kaya Health district in Burkina Faso from 2013 to 2015. This paper assesses the coverage and the quality of combined mother-infant PPC in reproductive, maternal, newborn and child health services (RMNCH). We conducted a mixed methods study with cross-sectional surveys before and after the intervention in the Kaya health and demographic surveillance system. On the quantitative side, two household surveys were performed in 2012 (N = 757) and in 2014 (N = 754) among mothers within one year postpartum. The analysis examines the result of the intervention by the date of delivery at three key time points in the PPC schedule: the first 48 h, days 6–10 and during weeks 6–8 and beyond. On the qualitative side, in depth interviews, focus group discussions and observations were conducted in four health facilities in 2012 and 2015. They involved mothers in the postpartum period, facility and community health workers, and other stakeholders. We performed a descriptive analysis and a two-sample test of proportions of the quantitative data. The qualitative data were recorded, transcribed and analysed along the themes relevant for the intervention. The findings show that the WHO guidelines, in terms of content and improvement of maternal PPC, were followed for physical examinations and consultations. They also show a significant increase in the coverage of maternal PPC services from 50% (372/752) before the intervention to 81% (544/672) one year after the start of the intervention. However, more women were assessed at days 6–10 than at later visits. Integration of maternal PPC was low, with little improvements in history taking and physical examination of mothers in immunization services. While health workers are polyvalent, difficulties in restructuring and organizing services hindered the integration. Unless a comprehensive strategy of integration within RMNCH services is implemented to address the primary health care challenges within the health system, integration will not yield the desired results.
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影响因子：
2.8
作者：
Geelhoed D;Lafort Y;Chissale É;Candrinho B;Degomme O
通讯作者：
Degomme O
影响因子：
2.8
作者：
Bertone, Maria Paola;Lagarde, Mylene;Witter, Sophie
通讯作者：
Witter, Sophie
影响因子：
3.2
作者：
Bertone, Maria Paola;Meessen, Bruno
通讯作者：
Meessen, Bruno
影响因子：
3.1
作者：
Duysburgh E;Kerstens B;Kouanda S;Kaboré CP;Belemsaga Yugbare D;Gichangi P;Masache G;Crahay B;Gondola Sitefane G;Bique Osman N;Foia S;Barros H;Castro Lopes S;Mann S;Nambiar B;Colbourn T;Temmerman M
通讯作者：
Temmerman M
影响因子：
8.1
作者：
Djellouli N;Mann S;Nambiar B;Meireles P;Miranda D;Barros H;Bocoum FY;Yaméogo WME;Yaméogo C;Belemkoabga S;Tougri H;Coulibaly A;Kouanda S;Mochache V;Mwakusema OK;Irungu E;Gichangi P;Dembo Z;Kadzakumanja A;Makwenda CV;Timóteo J;Cossa MG;de Melo M;Griffin S;Osman NB;Foia S;Ogbe E;Duysburgh E;Colbourn T
通讯作者：
Colbourn T