COVID-19对肯尼亚医疗保健系统的影响:肯尼亚沿海地区孕产妇保健服务利用的医疗服务提供者经验

S. O. Ombere, Agnetta Adiedo Nyabundi
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摘要

COVID-19大流行使发达国家和发展中国家的卫生系统不堪重负。与其他非洲国家一样,肯尼亚的卫生系统脆弱,这使得应对疫情成为一个问题。最近在COVID-19期间进行的研究表明,肯尼亚的卫生系统要么已达到最大能力,要么在处理患者方面更糟。因此,除非必要,市民们被建议不要去医院。这个建议适用于所有人,包括孕妇。本文利用了对医疗保健系统的人类学描述,将其视为一种依附于社会制度和社会联系形式的特定规定的文化系统。它在起源、结构、功能和意义上都是一个社会文化系统。在每个社会中,卫生保健系统都是社会现实的形式,它们体现了特定的社会角色以及这些角色之间的关系。关于医疗保健提供者如何经历COVID-19对肯尼亚医疗保健系统的影响的信息缺乏,本研究针对的是肯尼亚沿海地区的医疗保健系统。这项快速定性研究利用了来自肯尼亚沿海基利菲县各部门负责的16个有目的地选择的医疗保健提供者的数据。我们利用专题分析和文本描述来展示我们的发现。结果显示,分配给产妇保健方案的资源被挪用,由于保健工作者的资源和设备不足,保健设施暂时关闭,保健工作者缺乏准备,孕妇流量减少,产前和产后诊所没有预定的预约,产妇死亡率增加,母亲求助于传统助产士分娩。这些调查结果表明,孕产妇保健服务受到了负面影响。因此,政府需要制定替代措施,以便在大流行病期间继续获得孕产妇保健服务。我们建议扩大和支持现有的社区助产模式(CMM)。例如,将社区卫生工作者(chw)和其他地方卫生机构(如传统助产士)纳入社区,并在社区建立由训练有素的助产士管理的助产中心。
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Effects of COVID-19 on Kenya’s Healthcare System: Healthcare Providers’ Experiences with Maternal Health Services Utilization in Coastal Kenya
The COVID-19 pandemic overstretched health systems in developed and developing nations. Like other African nations, Kenya has a frail health system, making responding to the pandemic a problem. Recent studies during COVID-19 have shown that Kenya’s health systems were either strained to their maximum capability or worse in handling patients. Therefore, citizens were advised not to go to the hospital unless necessary. This advice applies to all, including pregnant mothers. This article utilized the anthropological description of the healthcare system, viewed as a cultural system attached to particular provisions of social institutions and forms of social connections. It is a social and cultural system in origin, structure, function, and significance. In every society, healthcare systems are forms of social reality in which they embody specific social roles and relationships between these roles. There is a dearth of information on how healthcare providers experienced the effects of COVID-19 on Kenya’s healthcare system, which this study addresses for those in Coastal Kenya. This rapid qualitative study utilized data from sixteen purposefully selected healthcare providers in charge of various departments in Kilifi County of Coastal Kenya. We utilized thematic analysis and textual description to present our findings. It emerged that there was a diversion in resources allocated for maternal health programs, health facilities were temporarily shut down due to inadequate resources and equipment for health workers, there was a lack of preparation by health workers, there was a reduced flow of pregnant mothers and missing scheduled appointments for ante- and postnatal clinics, maternal mortality increased, and mothers resorted to traditional midwives for deliveries. These findings show that maternal health services were negatively affected. Thus, the government needs to institute alternative measures for continued access to maternal health services during pandemics. We recommend expanding and supporting the existing community midwifery model (CMM). For instance, incorporating community health workers (CHWs) and other local health institutions in the community, such as traditional birth attendants (TBAs), and creating midwifery centers managed by trained midwives in communities.
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