Maternity waiting homes and traditional midwives in rural Liberia
Maternity waiting homes and traditional midwives in rural Liberia
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DOI：
10.1016/j.ijgo.2013.05.024
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发表时间：
2013-11-01
影响因子：
3.8
通讯作者：
Gwenegale, Walter
中科院分区：
文献类型：
--
作者：
Lori, Jody R.;Munro, Michelle L.;Gwenegale, Walter
目标：待产之家可通过增加获得熟练助产士的机会，降低产妇发病率和死亡率。目前的分析进行，以确定是否MWH增加使用SBAs在农村初级卫生诊所在利比里亚，以确定是否传统助产士（TM）能够与SBAs作为一个团队，并描述TM的看法，因为他们从事SBAs;并确定是否MWH降低孕产妇和儿童的发病率和死亡率。研究方法：本分析是在一项大型队列研究的中途进行的，其中5个利比里亚社区接受了干预措施（建立了MWH），5个利比里亚社区没有接受干预措施（对照组）。焦点小组进行了审查TM的意见，他们融入卫生队。结果如下：从基线到干预后，具有MWH的社区的团队分娩显著增加（10.8%对95.2%，P < 0.001），TM参与度更高。据报告，在有产妇出生体重的社区，产妇死亡率和围产期死亡率较低。结论：发病率和死亡率的下降表明，建立产妇保健中心是增加使用母乳喂养、改善母乳喂养与母乳喂养管理之间的合作以及改善产妇和新生儿健康的有效战略。(C)2013年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
Objective: Maternity waiting homes (MWHs) can reduce maternal morbidity and mortality by increasing access to skilled birth attendants (SBAs). The present analysis was conducted to determine whether MWHs increase the use of SBAs at rural primary health clinics in Liberia; to determine whether traditional midwives (TMs) are able to work with SBAs as a team and to describe the perceptions of TMs as they engage with SBAs; and to determine whether MWHs decrease maternal and child morbidity and mortality. Methods: The present analysis was conducted halfway through a large cohort study in which 5 Liberian communities received the intervention (establishment of an MWH) and 5 Liberian communities did not (control group). Focus groups were conducted to examine the views of TMs on their integration into health teams. Results: Communities with MWHs experienced a significant increase in team births from baseline to post-intervention (10.8% versus 95.2%, P < 0.001), with greater TM engagement. Lower rates of maternal and perinatal death were reported from communities with MWHs. Conclusion: The reduction in morbidity and mortality indicates that the establishment of MWHs is an effective strategy to increase the use of SBAs, improve the collaboration between SBAs and TMs, and improve maternal and neonatal health. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.