埃塞俄比亚西北部 Beyeda 地区产科急诊和新生儿护理基本服务的忠实执行情况评估:案例研究评估。

IF 2.3 Q2 OBSTETRICS & GYNECOLOGY Frontiers in global women's health Pub Date : 2024-09-03 eCollection Date: 2024-01-01 DOI:10.3389/fgwh.2024.1418338
Hawltu Abeyu Ejigu, Lake Yazachew, Getasew Amare, Chalie Tadie Tsehay, Asebe Hagos, Tesfahun Zemene Tafere
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引用次数: 0

摘要

背景:全世界每天有近 830 名妇女死于妊娠和分娩并发症。其中 99% 的孕产妇死亡发生在中低收入国家。基本紧急产科护理(BEmONC)是降低与妊娠和分娩并发症相关的孕产妇死亡率的一种方法。然而,对其实施的忠实性尚未进行调查。因此,本研究试图评估埃塞俄比亚西北部 Beyeda 地区实施基本紧急产科护理服务的忠实性:评估方法:2022 年 6 月 1 日至 7 月 30 日,采用混合方法进行单一案例研究设计。共进行了 415 次客户退出访谈、14 次关键信息提供者访谈和 423 次回顾性文件审查。本次评估采用了卡罗尔概念框架中的坚持度、参与者响应度和交付质量三个维度,共 21 个指标。根据预先设定的判断标准,BEmONC 服务的总体实施忠实度分为低忠实度、中忠实度和高忠实度:结果:BEmONC 服务的总体实施忠实度为 74.5%。此外,在依从性、服务质量和参与者响应度方面,实施的忠实度分别为 74.7%、77.2% 和 71.5%。未按建议方案使用子宫收缩药物。参与者对新生儿复苏服务的参与度不足。同样,医护人员对客户的尊重也不够。此外,年龄大于 30 岁的妇女、在政府部门工作的妇女和产前检查四次及四次以上的妇女是与 BEmONC 服务质量呈正相关的变量:结论:BEmONC 服务的总体实施保真度被评为中等。结论:BEmONC 服务的总体实施保真度被判定为中等保真度,此外,坚持率、参与者响应度和服务质量也被判定为中等保真度。因此,各级公共卫生部门应努力提高 BEmONC 服务的实施保真度。此外,医疗服务提供者在提供服务时应遵守 BEmONC 实施规程指南。医护管理人员应不断提高母亲对新生儿复苏对新生儿并发症的益处的认识。此外,医护人员在提供服务时应给予产妇应有的尊重。
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Evaluating the implementation fidelity of basic emergency obstetrics and neonatal care services in Beyeda District, Northwest Ethiopia: a case study evaluation.

Background: Worldwide, nearly 830 women die from complications of pregnancy and childbirth daily. Ninety-nine per cent of these maternal deaths take place in low and middle-income countries. Basic Emergency Obstetric Care (BEmONC) is one method of reducing maternal mortality related to pregnancy and childbirth complications. However, the status of its implementation fidelity has not been investigated. Therefore, this study sought to evaluate the implementation fidelity of BEmONC services in Beyeda District, Northwest Ethiopia.

Evaluation methods: A single case study design with mixed method was employed from June 01 to July 30, 2022. 415 client exit interviews, 14 key informants' interviews and 423 retrospective document reviews were conducted. Adherence, participant responsiveness and quality of delivery dimensions from Carroll's conceptual framework, with a total of 21 indicators were used in this evaluation. The overall implementation fidelity status of BEmONC service was judged based on the pre-seated judgmental criteria as; low, medium, and high fidelity.

Results: The overall degree of implementation fidelity of the BEmONC services was 74.5%. Moreover, the implementation fidelity status of adherence, quality of delivery, and participant responsiveness dimensions were 74.7%, 77.2%, and 71.5% respectively. Uterotonic drugs were not administered as per the recommended protocol. Participants' engagement towards the neonatal resuscitation service delivery was inadequate. Likewise, healthcare providers' respect for the clients was not sufficient. Furthermore, women aged >30 years, being government employed and ANC visits four and above were variables positively associated with the quality of delivery of BEmONC services.

Conclusion: The overall implementation fidelity of the BEmONC services was judged as implemented in medium fidelity. Moreover, the adherence, participant responsiveness and quality of delivery dimensions were found to be implemented in medium fidelity. Therefore, public health sectors at all levels should strive to enhance the implementation fidelity of BEmONC services. Moreover, healthcare providers should adhere to the BEmONC implementation protocol guideline during service delivery. Healthcare managers should facilitate a continuous awareness creation for mothers regarding the merit of neonatal resuscitation for neonatal complications. Furthermore, healthcare providers should give due respect to mothers while delivering the services.

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