The challenges of meeting rural Bangladeshi women's needs in delivery care
The challenges of meeting rural Bangladeshi women's needs in delivery care
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DOI：
10.1016/s0968-8080(01)90094-1
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发表时间：
2001-11-01
影响因子：
--
通讯作者：
Rashid, SF
中科院分区：
文献类型：
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作者：
Afsana, K;Rashid, SF
尽管在国家和国际两级采取了举措和干预措施，但孟加拉国仍然忽视产妇保健，产妇死亡率仍然是世界上最高的国家之一。为了改善农村妇女获得产妇护理的机会，1996年，孟加拉国农村发展委员会在每个托纳区的27个保健机构设立了产妇服务机构。本文报告了三年后进行的研究，该研究基于对在BRAC一家保健中心（BHQ）分娩的妇女和在家分娩的妇女的访谈，对BHQ工作人员的访谈以及对医患关系的观察。农村妇女接受在保健机构分娩的情况仍然很少。由于并发症，大多数妇女只到保健中心就诊，但保健中心无法处理大多数并发症，并将妇女转到地区医院，在那里她们得到的护理质量很差。费用、对医院的恐惧以及对“异常”分娩的污名化也是重要的制约因素。参与正常分娩的女性护理人员因关怀而受到称赞，但模式女性躺着分娩，并不总是使用无菌程序，而且太忙而无法提供信息，使分娩成为一种被动的体验。关于在基本保健中心提供全面产科急诊、提高工作人员技能、引进农村医疗保险和其他建议已经开始执行。
Despite initiatives and interventions undertaken at national and international levels, maternal health is still neglected in Bangladesh, and the maternal mortality ratio remains one of the highest in the world. In order to improve rural women's access to maternity care, in 1996 the Bangladesh Rural Advancement Committee (BRAQ instituted services for birthing women in 27 health facilities in each Thona. This paper reports on research conducted three years later, based on interviews with women who gave birth in one BRAC Health Centre (BHQ and women who gave birth at home, interviews with staff of the BHC and observation of provider-patient relations. Acceptance of delivery in a health facility by rural women is still minimal. Most women only attended the BHC due to complications, yet the BHC was unable to handle most complications and referred women to the district hospital, where they received poor quality care. Cost, fear of hospitals and the stigma of on 'abnormal' birth were also important constraints. Female paramedics who attended normal deliveries were praised for being caring, but mode women deliver lying down, did not always use aseptic procedures and were too busy to give information, making birth a passive experience. Recommendations to provide comprehensive emergency obstetric care at the BHC and upgrade staff skills, introduce rural health insurance and others hove already begun to be implemented.