The use of health facility data to assess the effects of armed conflicts on maternal and child health: experience from the Kivu, DR Congo.
The use of health facility data to assess the effects of armed conflicts on maternal and child health: experience from the Kivu, DR Congo.
复制标题
使用医疗机构数据来评估武装冲突对孕产妇和儿童健康的影响：Kivu的经验，刚果博士。
DOI：
10.1186/s12913-021-06143-7
复制
发表时间：
2021-09-13
影响因子：
2.8
通讯作者：
Boerma T
中科院分区：
文献类型：
--
作者：
Malembaka EB;Altare C;Bigirinama RN;Bisimwa G;Banywesize R;Tabbal N;Boerma T
在受冲突影响的环境中，往往缺乏生殖、孕产妇、新生儿和儿童健康的数据，无法确定优先事项和及时作出决策。我们旨在通过将冲突数据与地区卫生信息系统2(DHIS2)的卫生设施数据联系起来，描述2015至2018年间基伍省RMNCH指标的水平和趋势。我们使用了2015-2018年DHIS2、2014年人口和健康调查、2018年多指标集群调查和乌普萨拉冲突数据方案的数据。根据年度冲突死亡率，将卫生区分为低、中、高三个冲突强度级别。我们还将每月冲突死亡率和冲突事件日数定义为冲突强度和不安全程度的衡量标准。结果是完成了四次产前护理访问、卫生设施分娩、剖腹产和五价疫苗覆盖率。我们评估了数据质量，并使用每年收集的高频数据，按冲突类别以图形方式分析了RMNCH指标的覆盖面和趋势。我们使用一系列固定效应回归模型来检验不同冲突强度和不安全感对RMNCH的潜在剂量-反应效应。总体上，HF报告良好，范围在83.3%到93.2%之间，在2016年和2017年冲突强度较高的卫生区趋于较低，在2018年趋于一致。尽管随着时间的推移，受冲突影响的卫生区越来越多，在北基伍比在南基伍更多，但我们无法确定RMNCH覆盖范围因冲突强度和不安全而有任何明显的变化。尽管北基伍省受冲突的影响更大，但北基伍省的RMNCH指标一直好于南基伍省。南北基伍作为一个整体的覆盖率高于国家一级。根据HF数据计算的RMNCH服务覆盖率与基于人口的调查是一致的，尽管各卫生区和冲突强度类别之间每年都存在波动。虽然总体情况良好，但南北基伍的高频报告率受到冲突强度的负面影响，特别是在DHIS2‘S汇总之初。常规高频数据似乎有助于评估和监测RMNCH服务覆盖的趋势，包括在高强度冲突地区。网上版载有补充材料，可在10.1186/s12913-021-06143-7查阅。
In conflict-affected settings, data on reproductive, maternal, newborn and child health (RMNCH) are often lacking for priority setting and timely decision-making. We aimed to describe the levels and trends in RMNCH indicators within Kivu provinces between 2015 and 2018, by linking conflict data with health facility (HF) data from the District Health Information System 2 (DHIS2). We used data from the DHIS2 for the period 2015–2018, the 2014 Demographic and Health Survey, the 2018 Multiple Indicators Cluster Survey and the Uppsala Conflict Data Program. Health zones were categorised in low, moderate and high conflict intensity level, based on an annual conflict death rate. We additionally defined a monthly conflict death rate and a conflict event-days rate as measures of conflict intensity and insecurity. Outcomes were completion of four antenatal care visits, health facility deliveries, caesarean sections and pentavalent vaccine coverage. We assessed data quality and analyzed coverage and trends in RMNCH indicators graphically, by conflict categories and using HF data aggregated annually. We used a series of fixed-effect regression models to examine the potential dose-response effect of varying conflict intensity and insecurity on RMNCH. The overall HF reporting was good, ranging between 83.3 and 93.2% and tending to be lower in health zones with high conflict intensity in 2016 and 2017 before converging in 2018. Despite the increasing number of conflict-affected health zones over time, more in North-Kivu than in South-Kivu, we could not identify any clear pattern of variation in RMNCH coverage both by conflict intensity and insecurity. North-Kivu province had consistently reported better RMNCH indicators than South-Kivu, despite being more affected by conflict. The Kivu as a whole recorded higher coverage than the national level. Coverage of RMNCH services calculated from HF data was consistent with population-based surveys, despite year-to-year fluctuation among health zones and across conflict-intensity categories. Although good in general, the HF reporting rate in the Kivu was negatively impacted by conflict intensity especially at the beginning of the DHIS2’s rolling-up. Routine HF data appeared useful for assessing and monitoring trends in RMNCH service coverage, including in areas with high-intensity conflict. The online version contains supplementary material available at 10.1186/s12913-021-06143-7.
登录
查看更多内容
影响因子：
3.7
作者：
Amouzou, Agbessi;Banda, Benjamin;Bryce, Jennifer
通讯作者：
Bryce, Jennifer
影响因子：
13.8
作者：
Akseer, Nadia;Rizvi, Arjumand;Bhutta, Zulfiqar A.
通讯作者：
Bhutta, Zulfiqar A.
影响因子：
3.6
作者：
Casey, Sara E;Mitchell, Kathleen T;Austin, Judy
通讯作者：
Austin, Judy
影响因子：
11.8
作者：
Cordes, Kristina M.;Cookson, Susan T.;Husain, Farah
通讯作者：
Husain, Farah
影响因子：
3.6
作者：
Altare, Chiara;Malembaka, Espoir Bwenge;Spiegel, Paul
通讯作者：
Spiegel, Paul