The Effect of Community Maternal and Newborn Health Family Meetings on Type of Birth Attendant and Completeness of Maternal and Newborn Care Received During Birth and the Early Postnatal Period in Rural Ethiopia
The Effect of Community Maternal and Newborn Health Family Meetings on Type of Birth Attendant and Completeness of Maternal and Newborn Care Received During Birth and the Early Postnatal Period in Rural Ethiopia
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DOI：
10.1111/jmwh.12171
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发表时间：
2014-01-01
影响因子：
2.7
通讯作者：
Sibley, Lynn M.
中科院分区：
文献类型：
--
作者：
Barry, Danika;Frew, Aynalem Hailemichael;Sibley, Lynn M.
孕产妇和新生儿死亡主要发生在资源匮乏的环境中。以社区为基础的一揽子循证干预措施和熟练的助产护理可以减少这些死亡。孕产妇和新生儿健康在埃塞俄比亚的合作伙伴关系（MaNHEP）使用社区一级的卫生工作者进行产前社区孕产妇和新生儿健康家庭会议，以建立技能和寻求照顾的孕妇和家庭careful.MethodsBaseline和endline调查的行为提供了一个随机抽样的妇女在前一年出生的数据。意向治疗分析、合理净效应计算和剂量反应分析检查了随着时间的推移和会议参与的增加，护理完整性（执行的17项孕产妇和新生儿保健要素的平均百分比）增加。回归模型评估会议参与，完整的护理，并使用熟练的供应商或卫生推广工作者的生育carecontrolling为社会人口和卫生服务利用factors.ResultsA 151%的增长之间的关系发生在护理完整性从基线到终点。在终点，参加2次或2次以上会议的妇女比参加少于2次会议的妇女有更完整的护理（89% vs 76%的护理元素; P <0.001）。参加会议的次数和更高的护理完整性之间存在正的剂量反应关系（P <0.001）。接受过任何产前护理的妇女使用熟练提供者或保健推广人员进行分娩护理的可能性几乎高出3倍。与没有产前保健和参加不到2次会议的妇女相比，额外参加2次或2次以上与家庭成员会议的妇女使用这些提供者的可能性高出5倍以上（比值比，5.19; 95%可信区间，2.88-9.36; P < .001）。讨论MaNHEP的家庭会议通过让妇女和家庭照顾者参与自我照顾和寻求照顾来补充常规产前护理，从而使护理更加全面，分娩护理更加熟练。
IntroductionMaternal and newborn deaths occur predominantly in low-resource settings. Community-based packages of evidence-based interventions and skilled birth attendance can reduce these deaths. The Maternal and Newborn Health in Ethiopia Partnership (MaNHEP) used community-level health workers to conduct prenatal Community Maternal and Newborn Health family meetings to build skills and care-seeking behaviors among pregnant women and family caregivers.MethodsBaseline and endline surveys provided data on a random sample of women with a birth in the prior year. An intention-to-treat analysis, plausible net effect calculation, and dose-response analysis examined increases in completeness of care (mean percentage of 17 maternal and newborn health care elements performed) over time and by meeting participation. Regression models assessed the relationship between meeting participation, completeness of care, and use of skilled providers or health extension workers for birth carecontrolling for sociodemographic and health service utilization factors.ResultsA 151% increase in care completeness occurred from baseline to endline. At endline, women who participated in 2 or more meetings had more complete care than women who participated in fewer than 2 meetings (89% vs 76% of care elements; P < .001). A positive dose-response relationship existed between the number of meetings attended and greater care completeness (P < .001). Women with any antenatal care were nearly 3 times more likely to have used a skilled provider or health extension worker for birth care. Women who had additionally attended 2 or more meetings with family members were over 5 times as likely to have used these providers, compared to women without antenatal care and who attended fewer than 2 meetings (odds ratio, 5.19; 95% confidence interval, 2.88-9.36; P < .001).DiscussionMaNHEP's family meetings complemented routine antenatal care by engaging women and family caregivers in self-care and care-seeking, resulting in greater completeness of care and more highly skilled birth care.