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Addressing Discrimination and Healthcare Disparities for Sexual and Gender Minorities in South Africa: A Human Rights-Based Perspective 解决南非性少数群体和性别少数群体在医疗保健方面的歧视和差异:基于人权的视角
IF 2.3 Q2 Medicine Pub Date : 2024-06-07 DOI: 10.1177/09720634231216025
E. Scherf
Sexual and gender minority (SGM) populations—including, but not limited to, people who identify as lesbian, gay, bisexual, transgender, queer, intersex and/or asexual—have been, under different contexts, historically discriminated against in housing, healthcare and social security, not to mention the daily acts of macro- and micro-aggressions they often face. Discriminatory practices against SGM individuals, who might be already experiencing positions of rightlessness and vulnerability, further increase health inequities and might have larger implications for the protection of human rights and the reproduction of social injustice. In the African continent more specifically, many countries have a poor record when it comes to protecting and enforcing LGBT rights. In South Africa, on the other hand, despite relatively strong legislation on the rights of the LGBTQIA+ community, violence and discrimination against SGM individuals still is a huge challenge. On that account, this research article aims to describe and analyse discriminatory practices in healthcare affecting SGMs in South Africa in relation to access to and quality of care, alongside the implications for health management and human rights in particular. This is an exploratory research article that addresses the situation of healthcare access and delivery to SGM populations in South Africa from a human rights-based and intersectional approach. The study challenges ongoing bias-motivated and discriminatory practices in healthcare settings and pinpoints how these practices can negatively affect the health and well-being of diverse populations, with a focus on sexual and gender diversity.
性与性别少数群体(SGM)--包括但不限于被认定为女同性恋、男同性恋、双性恋、变性人、同性恋者、双性人和/或无性恋者--在不同的背景下,历来在住房、医疗保健和社会保障方面受到歧视,更不用说他们经常面临的日常宏观和微观侵害行为。对 SGM 个人的歧视性做法进一步加剧了健康方面的不平等,并可能对人权保护和社会不公的再生产产生更大的影响。更具体地说,在非洲大陆,许多国家在保护和落实男女同性恋、双性恋和变性者权利方面的记录不佳。而在南非,尽管有关 LGBTQIA+ 群体权利的立法相对有力,但针对 SGM 个人的暴力和歧视仍然是一个巨大的挑战。有鉴于此,本研究文章旨在描述和分析南非医疗保健领域的歧视性做法,这些做法影响了 SGM 获得医疗保健的机会和医疗保健的质量,尤其对医疗保健管理和人权产生了影响。这是一篇探索性的研究文章,从基于人权和交叉性的角度探讨了南非女性同性恋者获得和提供医疗服务的情况。该研究对医疗机构中持续存在的偏见和歧视性做法提出了质疑,并指出了这些做法如何对不同人群的健康和福祉产生负面影响,重点关注性和性别多样性。
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引用次数: 0
Real-time Vital Signs Monitoring and Data Management Using a Low-Cost IoT-based Health Monitoring System 使用低成本物联网健康监测系统进行生命体征实时监测和数据管理
IF 2.3 Q2 Medicine Pub Date : 2024-05-23 DOI: 10.1177/09720634241246926
Antim Dev Mishra, Bindu Thakral, Alpana Jijja, Nitin Sharma
This study describes the creation and evaluation of a low-cost internet of things (IoT)-based health monitoring system for the continuous monitoring of vital signs such as temperature, pulse rate, oxygen saturation (SpO2) and blood pressure (BP) (both systolic and diastolic). Along with an organic light-emitting diode (OLED) display and an ESP8266 microcontroller, the system includes BP, non-contact temperature, SpO2 and electrocardiogram (ECG) sensors. Using the visual programming tool, Node-RED, the data from these sensors are gathered, processed and transmitted to the Google Cloud platform for archival and visualisation. The process involved mounting the sensors and microcontrollers on a special printed circuit board and designing the circuit with EasyEDA. The device measures systolic, diastolic and pulse rates from the BP sensor, as well as temperature, ECG and SpO2 values. The system works by using three push switches to read and display these values on demand. The gathered data are simultaneously shown on the OLED and sent to the Node-RED dashboard, where it is then sent to a Google Spreadsheet for archiving and analysis. This research article gives a thorough overview of the health monitoring system, the way it was implemented, and how it was successfully validated in a real-time setting. This study examines certain vital signs but additional health measures, such as respiration rate or glucose monitoring, could be included. Machine learning algorithms could also be used for predictive analytics. This would uncover data anomalies and trends early, improving healthcare management.
本研究介绍了一种基于物联网(IoT)的低成本健康监测系统的创建和评估,该系统可对体温、脉搏、血氧饱和度(SpO2)和血压(BP)(收缩压和舒张压)等生命体征进行连续监测。除了有机发光二极管(OLED)显示屏和 ESP8266 微控制器外,该系统还包括血压、非接触式温度、SpO2 和心电图(ECG)传感器。利用可视化编程工具 Node-RED,可以收集、处理这些传感器的数据,并将其传输到谷歌云平台进行存档和可视化。这一过程包括将传感器和微控制器安装在一块特殊的印刷电路板上,并使用 EasyEDA 设计电路。该设备通过血压传感器测量收缩压、舒张压和脉搏,以及温度、心电图和 SpO2 值。系统的工作原理是使用三个按钮开关按需读取和显示这些值。收集到的数据同时显示在 OLED 上,并发送到 Node-RED 仪表板,然后再发送到谷歌电子表格进行存档和分析。这篇研究文章全面概述了健康监测系统、实施方式以及如何在实时环境中成功验证该系统。本研究对某些生命体征进行了检查,但还可以包括其他健康测量,如呼吸频率或血糖监测。机器学习算法也可用于预测分析。这将及早发现数据异常和趋势,改善医疗保健管理。
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引用次数: 0
Does COVID-19 Influence the Urban Household’s Food Security in Horo Guduru Wollega Zone, Ethiopia? COVID-19 是否影响埃塞俄比亚 Horo Guduru Wollega 区城市家庭的粮食安全?
IF 2.3 Q2 Medicine Pub Date : 2024-05-23 DOI: 10.1177/09720634241251574
Bacha Gebissa, Agama Daba, Tamiru Yazew, Seid Hassen, Tolesa Tesema, Hika Wana, Amanuel Birhanu
Household food insecurity is an important variable for understanding the nutritional status of children and women in low-income countries. This study was therefore initiated to determine household food insecurity status and to analyse the impact of COVID-19 on household food security in a selected number of households in the Horo Guduru Wollega Region of Ethiopia. Multistage sampling methods were used in this study. First, 4 were randomly selected from 12 found in the Horo Guduru Wollega area. The population/size ratio is then used to select households in each city. Finally, the eligible households for the study were randomly selected. Accordingly, 360 sample data were collected from 5,710 poor households in four urbans in the Horo Guduru Wollega zone. Both qualitative (in-depth interview) and quantitative data (structured questionnaires) were included in this study. The data collected were analysed using the propensity score matching model. The result of the concordant estimation of the propensity score showed supportive indications for improving the food security standard of living. All consistent test methods used for analysis showed that there was a statistically significant difference in the assessment of dietary diversity between safe and unsafe foods. This study concludes that the COVID-19 pandemic is affecting household food security in the study area. Therefore, all concerned bodies are responsible to overcome the problem of food insecurity that occurred due to the COVID-19 in the region and nationally. The data analysed to know impact COVID-19 on food security in the study area. The propensity score matching estimation result has shown supportive evidence about the improvements of the living standard of food security. All of the matching test methods employed for the analysis showed that there was statistically significant dietary diversity scores difference between food secure and insecure. In general, this study revealed that COVID-19 pandemic affects household food insecurity status in study area.
家庭粮食不安全是了解低收入国家儿童和妇女营养状况的一个重要变量。因此,本研究旨在确定埃塞俄比亚 Horo Guduru Wollega 地区部分家庭的粮食不安全状况,并分析 COVID-19 对家庭粮食安全的影响。本研究采用了多阶段抽样方法。首先,从 Horo Guduru Wollega 地区的 12 个家庭中随机抽取 4 个。然后,根据人口/规模比在每个城市选择家庭。最后,随机抽取符合研究条件的家庭。因此,从霍罗古杜鲁沃勒加地区四个城市的 5,710 个贫困家庭中收集了 360 个样本数据。定性数据(深度访谈)和定量数据(结构化问卷)都包含在本研究中。收集到的数据采用倾向得分匹配模型进行分析。倾向得分的一致性估算结果显示了提高粮食安全生活水平的支持性迹象。所有用于分析的一致检验方法都表明,安全食品和不安全食品在膳食多样性评估方面存在显著的统计学差异。本研究得出结论,COVID-19 大流行正在影响研究地区的家庭食品安全。因此,所有相关机构都有责任克服 COVID-19 在该地区和全国造成的粮食不安全问题。数据分析旨在了解 COVID-19 对研究地区粮食安全的影响。倾向得分匹配估算结果显示了粮食安全生活水平提高的支持性证据。分析中使用的所有匹配测试方法都表明,粮食安全和不安全之间的膳食多样性得分差异在统计学上具有显著性。总体而言,本研究揭示了 COVID-19 大流行对研究地区家庭粮食不安全状况的影响。
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引用次数: 0
Does Parental Out-migration Affect Nutritional Health Status and Morbidity Among Children? Evidence From India Human Development Survey Data for the Empowered Action Group States 父母向外移民会影响儿童的营养健康状况和发病率吗?来自印度授权行动小组各邦人类发展调查数据的证据
IF 2.3 Q2 Medicine Pub Date : 2024-03-23 DOI: 10.1177/09720634241236843
Monalisha Chakraborty, Subrata Mukherjee
In India, despite having high economic growth, considerable inter-state inequality exists across states in terms of per capita income as well as employment opportunities. The eight Empowered Action Group (EAG) states, which have performed poorly on different accounts of social and physical infrastructure, are also characterised by large inter-state migration for employment. Parental out-migration from these states affects different aspects of child well-being. The present study tries to assess nutritional health status, morbidity and health care utilisation among children based on their parents’ migration status. The results show that parents’ migration status plays a vital role in influencing the prevalence of common childhood diseases and malnutrition among children in EAG states. Multi-prolonged and decentralised strategies are required towards developing and implementing comprehensive nutrition and nutrition-related education programme for the children in these states.
在印度,尽管经济高速增长,但各邦之间在人均收入和就业机会方面仍存在相当大的不平等。授权行动小组(EAG)的八个邦在社会和物质基础设施的不同方面表现不佳,其特点也是大量人口跨邦迁移就业。父母从这些邦向外移民会影响儿童福祉的不同方面。本研究试图根据父母的移民状况来评估儿童的营养健康状况、发病率和医疗保健使用情况。结果表明,父母的移民状况对东亚和太平洋地区各州儿童常见病和营养不良的发病率起着至关重要的影响作用。需要采取多管齐下的分散战略,为这些州的儿童制定和实施全面的营养和营养相关教育计划。
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引用次数: 0
Peer Influence and Factors Associated with Personal Network Size of Underage Drinkers Recruited Through Respondent-driven Sampling 
in Dibrugarh District of Assam, India 印度阿萨姆邦迪布鲁加尔地区通过受访者驱动抽样招募的未成年饮酒者的同伴影响以及与个人网络规模相关的因素
IF 2.3 Q2 Medicine Pub Date : 2024-03-21 DOI: 10.1177/09720634241237590
S. K. Phukan, Jiten Hazarika
Personal networks significantly contributed to initiating risky behaviours among emerging youth. The study aimed to assess the personal network characteristics and factors associated with the personal network size of underage alcohol users. 200 underage drinkers were recruited through respondent-driven sampling in Dibrugarh, Assam using five seeds. Transition probability matrices and homophily indices were used to describe underage drinkers’ network characteristics and network patterns. The weighted logistic regression model was performed to observe the association. Personal network size differed significantly with respect to demographic profile and alcohol consumption patterns of the respondents. A higher proportion of participants used cannabis (77.0%), drank for more than 3 years (40.7%) and liked to drink with peers (51.1%). The affiliation pattern of educational status shows a trend of homophily and interaction between new and older underage drinkers. Students (OR 3.17, 95% CI 1.32, 7.62) who like to drink with peers (OR 3.45, 95% CI 1.24, 9.62) were found significantly associated with larger personal network size in weighted multiple binary logistic regression. The findings will be helpful to understand the network pattern of underage drinkers. The study highlighted the need for effective prevention and intervention programmes for this population and suggested further research in this area.
在新出现的青少年中,个人网络是引发危险行为的重要因素。本研究旨在评估未成年饮酒者的个人网络特征以及与个人网络规模相关的因素。研究人员在阿萨姆邦迪布鲁加尔通过受访者驱动的抽样方法,使用五种种子选手招募了 200 名未成年饮酒者。采用过渡概率矩阵和同亲指数来描述未成年饮酒者的网络特征和网络模式。采用加权逻辑回归模型观察两者之间的关联。个人网络规模与受访者的人口统计学特征和饮酒模式存在明显差异。使用大麻(77.0%)、饮酒超过 3 年(40.7%)和喜欢与同伴一起喝酒(51.1%)的参与者比例较高。教育状况的隶属模式显示出新老未成年饮酒者之间的同质性和互动性趋势。在加权多元二元逻辑回归中发现,喜欢与同伴一起喝酒的学生(OR 3.17,95% CI 1.32,7.62)(OR 3.45,95% CI 1.24,9.62)与较大的个人网络规模显著相关。研究结果将有助于了解未成年饮酒者的网络模式。该研究强调了针对这一人群开展有效预防和干预计划的必要性,并建议在这一领域开展进一步研究。
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引用次数: 0
Vulnerability Index to COVID-19 for Brazilian States 巴西各州 COVID-19 脆弱性指数
IF 2.3 Q2 Medicine Pub Date : 2024-03-21 DOI: 10.1177/09720634241236833
Claudiomar Matias Rolim Filho, M. Tessmann
This present article brings a vulnerability index to COVID-19 for Brazilian states. The COVID-19 pandemic is the largest since the great flu of 1918, and Brazil, which already has major supply limitations in health provision, is experiencing additional stress on the health system caused by the excess demand caused by the pandemic. Thus, this index is composed of a weighted average of state indicators, which are human development index (HDI), net current revenue per capita, health expenditure per capita, percentage of households with more than six residents, percentage of elderly population, access to basic sanitation, total population, the number of ICUs and the number of doctors and respirators per hundred thousand inhabitants. The results indicate that the states best placed in the vulnerability ranking are the Federal District and São Paulo, while the states with the worst ranking are Alagoas and Amapá. In the medium term, there is an association between the number of accumulated cases and the hospital vulnerability index. The same association exists, although at a lower level, between the hospital vulnerability index and the number of deaths per capita.
本文介绍了巴西各州 COVID-19 的脆弱性指数。COVID-19 大流行是自 1918 年大流感以来规模最大的一次,而巴西在提供医疗服务方面已经存在严重的供应限制,此次大流行造成的过量需求又给医疗系统带来了额外的压力。因此,该指数由各州指标的加权平均值组成,这些指标包括人类发展指数(HDI)、人均经常性净收入、人均医疗支出、6 人以上家庭所占百分比、老年人口所占百分比、基本卫生设施的普及率、总人口、重症监护室的数量以及每十万居民中医生和呼吸机的数量。结果表明,脆弱性排名最好的州是联邦区和圣保罗州,排名最差的州是阿拉戈斯州和阿马帕州。从中期来看,累积病例数与医院脆弱性指数之间存在关联。医院脆弱性指数与人均死亡人数之间也存在同样的联系,但程度较低。
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引用次数: 0
Perinatal Mental Disorders: The ‘Non Liquet’ 
Facet of Mental Health Legislative Instruments 
in India 围产期精神障碍:印度精神卫生立法文书中的 "非利凯 "部分
IF 2.3 Q2 Medicine Pub Date : 2024-03-19 DOI: 10.1177/09720634241236834
Ritika Behl, V. Nemane, Deborah Sims
Due to the impetus provided by the Millennium Development Goals and the Sustainable Development Goals, maternal health has become the subject matter of various legislative instruments worldwide. However, perinatal mental disorders have remained an underestimated public health issue in many countries. High prevalence rates of such perinatal disorders in India have been reported by various evidence-based studies. This makes it imperative to analyse the provisions of the mental healthcare legislative instruments that have been brought into force in India. This article aims to evaluate and analyse coverage of perinatal mental disorders under the provisions of the legislative instruments, especially statutes, providing for mental health in India. Websites of the Government of India, various Indian Ministries and other government agencies were visited to obtain relevant documents regarding the mental health policy and legislation. None of the mental health legislative instruments in India underscore perinatal mental disorders as a public health concern, whereby failing to identify the unique characteristics of perinatal mental disorders. They consequently do not provide for nationwide detection and treatment measures. There is an immediate and pertinent need to highlight perinatal mental disorders through legislative instruments. The National Mental Health Policy, 2014 provides for comprehensive healthcare services; however, it excludes measures for perinatal mental health services. The Mental Healthcare Act, 2017 should be amended to explicitly include women during the perinatal period, along with originally provided mental health services for children and elderly individuals.
在千年发展目标和可持续发展目标的推动下,孕产妇保健已成为全球各种法律文书的主题。然而,在许多国家,围产期精神障碍仍然是一个被低估的公共卫生问题。据各种循证研究报告,印度围产期精神障碍的发病率很高。因此,有必要对印度已生效的精神卫生保健法律文书的条款进行分析。本文旨在评估和分析印度精神卫生法律文书,特别是法规中有关围产期精神障碍的规定。我们访问了印度政府、印度各部委和其他政府机构的网站,以获取有关精神卫生政策和立法的相关文件。印度的精神卫生法律文书均未强调围产期精神障碍是一个公共卫生问题,因此未能确定围产 期精神障碍的独特性。因此,它们没有规定全国范围内的检测和治疗措施。当务之急是通过立法文书强调围产期精神障碍。2014 年《国家精神卫生政策》规定了全面的医疗保健服务;然而,该政策并不包括围产期精神卫生服务措施。应修订 2017 年《精神保健法》,明确将围产期妇女以及原先为儿童和老年人提供的精神保健服务包括在内。
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引用次数: 0
Are Palestinian Nurses Burned Out or Engaged: The Impact of Job Demands on Job Performance? 巴勒斯坦护士是倦怠还是投入?工作要求对工作表现的影响?
IF 2.3 Q2 Medicine Pub Date : 2024-03-19 DOI: 10.1177/09720634241235496
Anas Mahmoud Salem Abukhalifa, Nurul Liyana Mohd Kamil
The impact of job demands on job performance is not always straightforward but relies on whether employees are burned out or engaged. Although such relationships were established previously based on job demands–resources (JD-R) theory in Western developed countries, evidence from Eastern developing countries is very limited. During the peak of COVID-19, this study was conducted to examine the impact of job demands on nurses’ job performance via the mediating role of work burnout and work engagement. By employing the tenets of the JD-R theory, the theory was tested through collecting data from 202 nurses who were working in Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. The findings disclosed that work burnout was negatively related to job performance, and work engagement was positively related to job performance. Unexpectedly, job demand had a negative relationship with work burnout and a positive relationship with work engagement. However, work burnout and work engagement mediated the relationship between job demand and job performance. A discussion of the findings, contributions, implications, limitations and future directions is provided.
工作需求对工作绩效的影响并不总是直截了当的,而是取决于员工是倦怠还是投入。虽然之前西方发达国家基于工作需求-资源(JD-R)理论建立了这种关系,但来自东方发展中国家的证据非常有限。在 COVID-19 高峰期,本研究旨在通过工作倦怠和工作投入的中介作用,探讨工作需求对护士工作绩效的影响。本研究采用 JD-R 理论的原则,通过收集在巴勒斯坦工作的 202 名护士的数据对该理论进行了检验。使用 SPSS 统计软件(25 版)和偏最小二乘法结构方程模型(PLS-SEM)对收集到的数据进行了分析。研究结果表明,工作倦怠与工作绩效呈负相关,而工作投入与工作绩效呈正相关。出乎意料的是,工作需求与工作倦怠呈负相关,而与工作投入呈正相关。然而,工作倦怠和工作投入对工作需求和工作绩效之间的关系起到了中介作用。本文对研究结果、贡献、影响、局限性和未来方向进行了讨论。
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引用次数: 0
Numbing Effect of Emotional Exhaustion on COVID-19 Fear and Contrasting Effect on 
Job Satisfaction and Quality of Work Life 
Among Indian Healthcare Workers 情绪衰竭对 COVID-19 恐惧的麻木效应以及对印度医护人员工作满意度和工作生活质量的对比效应
IF 2.3 Q2 Medicine Pub Date : 2024-03-19 DOI: 10.1177/09720634241236831
Garima Saini, S. Dash, L. K. Jena
The study conceptualises COVID-19 fear among healthcare workers as a job resource (meaningfulness of work) and job demand (physical and emotional demands), while exploring its effect on healthcare workers’ job satisfaction and quality of work life. The potential numbing effect of emotional exhaustion on COVID-19 fear is studied in the proposed framework. Data were collected from 202 Indian healthcare workers using standardised scales and analysed using Smart PLS 2.0. The results indicate that COVID-19 fear has a significant positive relationship with job satisfaction and a significant negative association with quality of work. The study results validate the hypotheses that COVID-19 fear simultaneously acts as a job resource and job demand. COVID-19 fear had an indirect, negative effect on job satisfaction via reduced quality of work. Emotional exhaustion in healthcare workers reduced healthcare workers’ COVID-19 fears, suggesting a numbing effect of emotional exhaustion on the arousal of emotions. The study is among the first, to the best of our knowledge, that identify the same factor (COVID-19 fear) as both a job resource as well as a job demand for an occupational group (healthcare workers). The ability of COVID-19 fear to simultaneously increase the meaningfulness of the job for healthcare workers and reduce their quality of work life suggests that healthcare administrators need to espouse policies that simultaneously enable healthcare workers to perceive strong emotions that make the meaning of their job salient and buffer them from the emotional, cognitive and physical demands consequences.
本研究将医护人员的 COVID-19 恐惧概念化为一种工作资源(工作意义)和工作需求(身体和情感需求),同时探讨其对医护人员工作满意度和工作生活质量的影响。在提出的框架中研究了情绪衰竭对 COVID-19 恐惧的潜在麻木效应。使用标准化量表从 202 名印度医护人员处收集了数据,并使用 Smart PLS 2.0 进行了分析。结果表明,COVID-19 恐惧与工作满意度呈显著正相关,与工作质量呈显著负相关。研究结果验证了 COVID-19 恐惧同时作为工作资源和工作需求的假设。COVID-19 恐惧通过降低工作质量对工作满意度产生间接的负面影响。医护人员的情绪衰竭降低了医护人员的 COVID-19 恐惧感,这表明情绪衰竭对唤醒情绪有麻木作用。据我们所知,这项研究是首次将同一因素(COVID-19 恐惧)同时作为一个职业群体(医护人员)的工作资源和工作需求的研究。COVID-19 恐惧能够同时增加医护人员的工作意义并降低他们的工作生活质量,这表明医护管理人员需要制定政策,使医护人员能够同时感知到强烈的情绪,从而突出他们的工作意义,并使他们免受情绪、认知和身体需求后果的影响。
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引用次数: 0
Factors Impacting Quality of Skilled Birth Attendant Services in Rural India 影响印度农村地区熟练助产士服务质量的因素
IF 2.3 Q2 Medicine Pub Date : 2024-03-19 DOI: 10.1177/09720634241229557
Shreekant Iyengar, Ravindra H. Dholakia, Nirupam Bajpai
Availability of skilled birth attendant (SBA) is a crucial factor in reducing mortality rates among mothers and children. The lower- and middle-income countries show low use of these service causing increased risk of maternal and child mortality. While there has been a remarkable improvement in the coverage of SBA-monitored deliveries in India, its impact on outcome indicators such as perinatal and neonatal mortality rates have not been significant. Although the country performs better than the world average in the former, its performance is poor in the latter. This raises question on the quality of SBA services in India. The present study examines SBA services in the context of availability of attendants, infrastructural support and level of training of the SBAs in the rural areas of the four large states in India—Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh. The findings are that SBA lack sufficient training to provide the services effectively. The effectiveness of their services is also hampered by the absence of the essential infrastructure at public health facilities. Moreover, there is congestion and overcrowding at the higher level of facilities such as PHCs and CHCs as compared to village level sub-centres.
熟练助产士(SBA)的可用性是降低母婴死亡率的关键因素。在中低收入国家,这些服务的使用率很低,导致孕产妇和儿童死亡风险增加。虽然印度由 SBA 监控的分娩覆盖率有了显著提高,但其对围产期死亡率和新生儿死亡率等结果指标的影响并不明显。虽然印度在围产期和新生儿死亡率方面的表现优于世界平均水平,但在围产期和新生儿死亡率方面的表现却差强人意。这不禁让人对印度的 SBA 服务质量产生疑问。本研究对印度四个大邦(比哈尔邦、中央邦、拉贾斯坦邦和北方邦)农村地区的助产士、基础设施支持和助产士培训水平进行了研究。研究结果表明,SBA 缺乏足够的培训,无法有效地提供服务。公共卫生设施缺乏必要的基础设施也影响了他们服务的有效性。此外,与村级分中心相比,公共卫生中心和社区卫生中心等较高级别的设施存在拥挤和人满为患的现象。
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引用次数: 0
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