Engaging Users for Quality Enhancement and Rights (EU QUERO):Strengthening the maternal and child healthcare system over the first 1000 days in Brazil
让用户参与质量提升和权利 (EU QUERO):在巴西前 1000 天加强妇幼保健系统
基本信息
- 批准号:MR/R022933/1
- 负责人:
- 金额:$ 25.78万
- 依托单位:
- 依托单位国家:英国
- 项目类别:Research Grant
- 财政年份:2018
- 资助国家:英国
- 起止时间:2018 至 无数据
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
The quality of healthcare available to women and children within the first 1000 days of life (from conception until about 2 years of age) in Brazil is highly variable, despite policies for improvement. This has led to higher maternal mortality and morbidity than may be expected in a country such as Brazil. This project, EU QUERO (meaning 'I want' in Portuguese), is testing whether an intervention to improve the quality of care is feasible to conduct as well as indicating whether it is likely to be successful. This will be conducted in two states of Brazil, Goiás and Maranhão, both of which have poorer maternal health than expected. Prior to the intervention, a period of assessment of current quality will be conducted using two datasets that have already been collected. Results from this analysis will be mapped using the latest techniques so that hotspots of good or bad quality healthcare can be identified. This will inform the areas selected for the intervention. The EU QUERO intervention is implemented within Basic Health Units (the smallest level of the health system organisation) and encompasses two different elements. The first is to make mothers and the wider community more aware of the current quality of care available to them at different points within the first 1000 days of life - during pregnancy, during delivery, in the immediate post-delivery period and with regard to the child's health. This will be conducted by the development of facility level quality scorecards which will highlight the good and poor aspects of healthcare to users. The scorecards will list the four different phases within the 1000 days and rate the services available to the mother within each phases, with the best quality services receiving a 'Diamond' rating, while the poorest will receive a 'Bronze' rating. Previous research indicates that knowledge of these aspects improves quality through greater transparency of the health system, while health workers also understand the aspects where they are not performing and make a concerted effort to improve. The second element of the intervention is through the delivery of rights-based education to mothers. This will include knowledge about individual rights to health care, including highlighting what an individual should be entitled to and the quality that should be expected. This has been seen to empower mothers who will then be encouraged to demand more of the health providers, again improving quality of care. EU QUERO will develop these scorecards and rights based education materials to disseminate within selected Basic Health Units and, following this happening, assess if this is a feasible intervention to conduct at a wider scale. Improvements in quality will be assessed through the development of new quality scorecards, which will indicate what has been improved and whether any improvements have occurred evenly over the 1000 days period under study. Quality will also be assessed through looking at health outcomes, such as whether mothers received adequate antenatal care or whether the child received vaccinations in a timely fashion. A further aspect is an explicit focus on ensuring that adolescent voices are heard throughout the intervention and evaluation. The project is conducted in collaboration with the state Ministries of Health and hence the successful implementation of the intervention will inform future strategies to improve healthcare for mothers and children. It will also engage mothers, communities, health workers and policymakers throughout the period of implementation, with the actual intervention co-created between the project team and these stakeholders, so the material presented to mothers is relevant and understandable. The intervention will be assessed for scalability within Brazil and in other countries, with mothers facilitated to demand the best quality care available, strengthening the health system as it responds to these demands.
在巴西,妇女和儿童在出生后1 000天内(从受孕到大约2岁)可获得的保健质量差异很大,尽管有改善的政策。在巴西这样的国家,这导致产妇死亡率和发病率高于预期。该项目名为EU QUERO(葡萄牙语意为“我想要”),旨在测试提高护理质量的干预措施是否可行,并表明其是否可能成功。这项工作将在巴西的戈亚斯州和马拉尼昂州进行,这两个州的产妇保健情况都比预期的差。在干预之前,将使用已经收集的两个数据集对当前质量进行评估。这项分析的结果将使用最新的技术进行映射,以便可以识别优质或劣质医疗保健的热点。这将为选定的干预领域提供信息。欧盟QUERO干预措施在基本卫生单位(卫生系统组织的最小一级)内实施,包括两个不同的要素。第一个目标是使母亲和更广泛的社区更好地认识到在生命最初1000天内的不同阶段-怀孕期间、分娩期间、分娩后的第一个阶段以及在儿童健康方面-她们目前可获得的护理质量。这将通过制定设施级质量记分卡来进行,该记分卡将向用户突出医疗保健的好的和差的方面。记分卡将列出1000天内的四个不同阶段,并对每个阶段内母亲可获得的服务进行评级,最优质的服务将获得“钻石”评级,而最差的服务将获得“青铜”评级。以前的研究表明,了解这些方面可以通过提高卫生系统的透明度来提高质量,而卫生工作者也了解他们没有表现出来的方面,并作出协调一致的努力来改善。干预措施的第二个要素是向母亲提供基于权利的教育。这将包括了解个人享有保健的权利,包括强调个人应有权享有什么以及应期望的质量。这被视为增强了母亲的权能,从而鼓励她们向保健提供者提出更多要求,再次提高了护理质量。欧盟QUERO将制定这些记分卡和基于权利的教育材料,在选定的基本卫生单位内传播,并在此之后评估这是否是一种可行的干预措施,可以在更大范围内进行。将通过制定新的质量记分卡来评估质量方面的改进,记分卡将表明在所研究的1 000天期间改进了哪些方面,以及是否有任何改进。还将通过观察健康结果来评估质量,例如母亲是否得到充分的产前护理或儿童是否及时接种疫苗。另一个方面是明确注重确保在整个干预和评价过程中听取青少年的意见。该项目是与各州卫生部合作开展的,因此,干预措施的成功实施将为今后改善母亲和儿童保健的战略提供信息。它还将在整个实施期间让母亲、社区、卫生工作者和决策者参与,项目小组和这些利益攸关方共同制定实际干预措施,以便向母亲提供相关和可理解的材料。将评估该干预措施在巴西和其他国家的可扩展性,帮助母亲要求提供最优质的护理,加强卫生系统对这些需求的响应。
项目成果
期刊论文数量(2)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
Prenatal care and human rights: Addressing the gap between medical and legal frameworks and the experience of women in Brazil.
- DOI:10.1371/journal.pone.0281581
- 发表时间:2023
- 期刊:
- 影响因子:3.7
- 作者:
- 通讯作者:
Everyday Political Economy of Human Rights to Health: Dignity and Respect as an Approach to Gendered Inequalities and Accountability
健康人权的日常政治经济学:尊严和尊重作为性别不平等和责任的一种方法
- DOI:10.1080/13563467.2020.1841144
- 发表时间:2020
- 期刊:
- 影响因子:4.2
- 作者:Riggirozzi P
- 通讯作者:Riggirozzi P
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Andrew Channon其他文献
Andrew Channon的其他文献
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{{ truncateString('Andrew Channon', 18)}}的其他基金
Enhancing Undergraduate Quantitative Methods in the Social Sciences through Curriculum Change
通过课程改革加强社会科学本科生的定量方法
- 批准号:
ES/J011908/1 - 财政年份:2012
- 资助金额:
$ 25.78万 - 项目类别:
Research Grant
Increasing Researcher Use of Large Scale Social Surveys in the Social Sciences through Teaching and Support
通过教学和支持增加研究人员在社会科学中使用大规模社会调查
- 批准号:
ES/J011797/1 - 财政年份:2012
- 资助金额:
$ 25.78万 - 项目类别:
Research Grant
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