Is the Maternal and Child Health (MCH) handbook effective in improving health-related behavior? Evidence from Palestine
Is the Maternal and Child Health (MCH) handbook effective in improving health-related behavior? Evidence from Palestine
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DOI：
10.1057/jphp.2012.56
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发表时间：
2013-01-01
影响因子：
3.8
通讯作者：
Sawada, Yasuyuki
中科院分区：
文献类型：
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作者：
Hagiwara, Akiko;Ueyama, Mika;Sawada, Yasuyuki
目的：本研究考察了《妇幼保健手册》（一种以家庭为基础的健康记录）对巴勒斯坦杰里科省和拉马拉省妇女的知识和行为的影响。方法：本研究使用重复的横断面数据集，其中将干预前和干预后的情况纳入两组：接触MCH手册的组和未接触MCH手册的组。我们对24个妇幼保健“治疗”中心（N = 260,270，前/后）的妇女进行了预先测试的知识、态度和实践调查，并与未发布妇幼保健手册的6个妇幼保健中心（N = 70,70，前/后）的妇女进行了比较，采用了差异中差异回归分析。一名训练有素的调解人与42人进行了一系列焦点小组讨论。作为妇幼保健服务客户的妇女和25名保健提供者，均来自干预地区，以确认定量研究获得的结果。研究结果：妇幼保健手册使用者，尤其是受教育程度较低的妇女，对纯母乳喂养的重要性以及如何应对妊娠期胎膜破裂风险等妇幼保健相关知识的了解有所增加。对于受过高等教育和受教育程度较低的首次怀孕妇女来说，妇幼保健手册可能是与保健提供者和丈夫沟通的有效工具。我们的研究结果表明，虽然受教育程度较低的妇女很少自己在家阅读手册，但她们通过卫生机构卫生服务提供者利用妇幼保健手册提供的个性化指导，熟悉了与妇幼保健相关的健康信息和选择。结论：妇幼保健手册可能是一种有效的工具，可以改善(i)客户与保健提供者之间的沟通，（ii）妇女在孕产妇、新生儿和儿童健康方面的知识和求医行为。公共卫生政策杂志（2013）34,31-45。doi: 10.1057 / jphp.2012.56;2012年11月15日在线发布
Objective: This study examines the effect of the Maternal and Child Health (MCH) handbook - a home-based health record - on women's knowledge and behavior in the Jericho and Ramallah Governorates of Palestine. Methods: This study uses a repeated, cross-sectional data set in which pre- and post-intervention situations are incorporated on two groups: those exposed and those not exposed to the MCH handbook. We employed a difference-in-difference regression analysis utilizing a pre-tested knowledge, attitude, and practice survey of women at 24 MCH 'treatment' centers (N = 260, 270, pre-/post-) in comparison with the women at 6 MCH centers (N = 70, 70, pre-/post-) where the MCH handbook was not released. A trained facilitator conducted a series of focus group discussions with 42. women who were the clients of MCH services and 25 health providers, both from the intervention area, to confirm the results obtained from the quantitative study. Findings: Knowledge related to MCH such as the importance of exclusive breastfeeding and how to cope with the risks of rupture of membranes during pregnancy increased among MCH handbook users, especially among less-educated women. The MCH handbook may be an effective tool for communication with health providers and husbands, for both highly educated and less-educated women during their first pregnancy. Our results suggest that although less-educated women rarely read the handbook themselves at home, they became familiar with health information and options related to MCH through personalized guidance that was provided by health providers at health facilities utilizing MCH handbook. Conclusion: The MCH handbook may be an effective tool to improve (i) communication between the client and the health provider and (ii) women's knowledge- and health-seeking behaviors related to maternal, newborn, and child health. Journal of Public Health Policy (2013) 34, 31-45. doi:10.1057/jphp.2012.56; published online 15 November 2012