Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo.
Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo.
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DOI：
10.1186/1752-1505-3-12
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发表时间：
2009-12-21
影响因子：
3.6
通讯作者：
Austin, Judy
中科院分区：
文献类型：
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作者：
Casey, Sara E;Mitchell, Kathleen T;Austin, Judy
背景：长期暴露于战争严重影响了刚果民主共和国（DRC）卫生服务的提供。卫生基础设施被摧毁，卫生工作者逃离，政府对保健服务的支持因持续不断的冲突而变得困难。生殖健康指标不佳表明刚果民主共和国的长期危机对刚果妇女的生殖健康产生了影响。2007年，在RAISE倡议的支持下，国际救援委员会（IRC）和CARE对公立医院进行了基线评估，以评估其满足当地人口RH需求的能力，并确定RH服务的可用性、利用率和质量，包括紧急产科护理（EmOC）和计划生育（FP）。数据收集自2007年3月、4月和11月刚果民主共和国5个省9家综合转诊医院的设施评估。访谈，观察和临床记录审查被用来评估的一般基础设施，EmOC和FP提供的服务，并在每个facility.RESULTS的感染预防环境：没有9家医院符合标准的分类为EmOC设施（无论是基本的或全面的）。大多数设施缺乏任何计划生育服务。训练有素的工作人员、基本用品和药品短缺以及感染预防措施不力的情况一直存在。所有的设施都有不良的系统，定期监测RH服务，特别是关于EmOC.CONCLUSIONS：妇女的生命可以保存和改善他们的福祉与功能RH服务。随着刚果民主共和国局势的稳定，因诺琴蒂救济委员会和援外社与当地卫生部和其他提供服务的伙伴合作，通过以下方式改善生殖健康服务：1）为卫生设施提供必要的设备和翻修; 2）改善供应管理系统; 3）为卫生服务提供者提供生殖健康和预防感染方面的全面能力培训; 4）改善医院转诊系统;（5）倡导国家生殖健康政策和议定书的变革;（6）为监测和评估关键的生殖健康指标提供技术援助。这些举措将共同提高刚果民主共和国生殖健康服务的质量和可获得性-这些服务是迫切需要的，也是刚果妇女根据国际人权法有权获得的服务。
BACKGROUND: Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP).METHODS: Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities.RESULTS: None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC.CONCLUSIONS: Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for health providers in RH and infection prevention; 4) improving referral systems to the hospitals; 5) advocating for changes in national RH policies and protocols; and 6) providing technical assistance for monitoring and evaluation of key RH indicators. Together, these initiatives will improve the quality and accessibility of RH services in the DRC - services which are urgently needed and to which Congolese women are entitled by international human rights law.