Capacities of women and men to improve maternal and newborn health: Effect of a community-based intervention package in rural Bangladesh
Capacities of women and men to improve maternal and newborn health: Effect of a community-based intervention package in rural Bangladesh
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妇女和男子改善孕产妇和新生儿健康的能力：孟加拉国农村地区基于社区的一揽子干预措施的效果
DOI：
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发表时间：
2019
影响因子：
7.2
通讯作者：
S. El Arifeen
中科院分区：
文献类型：
--
作者：
A. E. Rahman;J. Perkins;Tapas Mazumder;M. R. Haider;A. Siddique;Cecilia Capello;C. Santarelli;S. El Arifeen
背景尽管近几十年来有所改善，但孟加拉国的孕产妇和新生儿死亡率仍然很高。2009年在孟加拉国农村地区Netrokona启动了一项社区干预一揽子计划，使个人、家庭和社区参与改善孕产妇和新生儿健康。在本文中，我们介绍了一揽子干预措施对提高妇女在孕产妇和新生儿保健方面的能力、其丈夫有效支持她们的能力以及在怀孕、分娩和分娩后使用熟练服务的效果。方法采用准实验设计评价干预方案的效果。在干预点和比较点分别于2014年基线和2016年结束时进行了横断面家庭调查。共有725名妇女在基线时接受了访谈（干预n = 444，对照n = 281），在终点时接受了访谈（干预n = 442，对照n = 295）。在基线时（干预组n = 178，对照组n = 139）和结束时（干预组n = 440，对照组n = 291），共有317名她们的丈夫接受了访谈。进行倾向评分匹配（1:1），随后的分析仅限于基线时235名匹配女性和终点时217名匹配女性。对协变量进行描述性分析以进行匹配。对报告妇女及其丈夫关于怀孕和分娩、分娩准备和并发症准备做法以及卫生服务利用情况的基线和终点进行了双变量分析。结果妇女及其丈夫对怀孕、分娩和产后危险迹象的认识显著提高，对孕产妇和新生儿健康权利的认识也有所提高。在干预地点，孕妇及其丈夫的分娩准备和并发症准备实践也有显著增加。在使用熟练保健服务方面，早期接受产前保健、至少接受一次产前保健接触者和至少接受四次产前保健接触者的人数显著增加。在熟练助产士在场或使用产后护理的情况下分娩，没有观察到明显的改善。我们的结论是，一揽子干预措施在建立妇女能力和使其丈夫积极参与孕产妇和新生儿保健方面是有效的。这可能已转化为在怀孕期间更多地使用熟练护理。
Background Despite improvement in recent decades, maternal and newborn mortality in Bangladesh remain high. A community-based intervention package was initiated in 2009 in Netrokona, a rural district in Bangladesh, to engage individuals, families and communities to improve maternal and newborn health. In this article, we present the effect of the intervention package on improvement of women’s capacities with regard to maternal and newborn health, their husbands’ capacities to effectively support them and use of skilled services during pregnancy, childbirth and after childbirth. Methods We adopted a quasi-experimental design to evaluate the effect of the intervention package. A cross-sectional household survey was conducted in the intervention and comparison sites at baseline in 2014 and at endline in 2016. A total of 725 women were interviewed at baseline (intervention n = 444; comparison n = 281) and 737 at end-line (intervention n = 442; comparison n = 295). A total of 317 of their husbands were interviewed at baseline (intervention n = 178; comparison n = 139) and 731 at endline (intervention n = 440; comparison n = 291). Propensity score matching (1:1) was performed and the subsequent analysis was restricted among 235 matched women at baseline and 217 matched women at endline. Descriptive analyses were performed for the covariates for matching. Bivariate analyses between baseline and endline were done for reporting women and their husbands’ knowledge regarding pregnancy and childbirth, birth preparedness and complication readiness practices and utilization of health services. Results There was significant increase in awareness of danger signs during pregnancy, childbirth and following childbirth among women and their husbands, as well as increase in awareness of rights related to maternal and newborn health. There was also significant increase in birth preparedness and complication readiness practice among pregnant women and their husbands in the intervention site. Regarding use of skilled health services, there was significant increase in early initiation of antenatal care, attending at least one antenatal care contact and attending at least four antenatal care contacts. No notable improvement was observed in giving birth in the presence of skilled attendant or use of postnatal care. Conclusions We conclude that the intervention package was effective in building the capacities of women and in engaging their husbands positively in maternal and newborn health. This may have translated into increased use of skilled care during pregnancy.
对厄立特里亚促进安全孕产的社区干预进行评估。
DOI：
10.1111/j.1542-2011.2010.00001.x
发表时间：
2011
期刊：
Journal of midwifery & women's health
影响因子：
--
作者：
Turan,JanetMolzan;Tesfagiorghis,Mekonnen;Polan,MaryLake
通讯作者：
Polan,MaryLake