Home visits for preterm/low birthweight infants in South Africa: Qualitative evidence synthesis.

IF 1.2 Q4 PRIMARY HEALTH CARE
Sara Cooper, Idriss I Kallon, Denny Mabetha, Amanda S Brand, Tamara Kredo, Shakti Pillay, Gugu Kali, Willem Odendaal
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Abstract

Background: Prematurity and low birth weight (LBW) are the main causes of neonatal mortality in South Africa (SA). Home visits by lay health workers (LHWs) may be effective in addressing this.

Aim: To inform a national guideline on LHW home visits as part of the Global Evidence, Local Adaptation (GELA) project, we conducted a rapid qualitative evidence synthesis exploring the acceptability, feasibility and equitability of this intervention for preterm and LBW babies.

Setting: We included studies conducted in SA.

Methods: We searched PubMed and Embase until 15 September 2023 and identified eligible studies independently and in duplicate. We synthesised evidence using thematic analysis, assessed study quality using an adaptation of the Critical Appraisal Skills Programme tool and assessed confidence in the review findings using GRADE-CERQual.

Results: The 16 eligible studies included diverse settings and populations in SA. Factors facilitating mothers' acceptance included the knowledge and skills gained, the psychosocial support offered and improved healthcare access and relationships with facility staff. Distrust in LHWs and stigma associated with home visits were barriers to acceptance. Lay health workers' acceptance was facilitated by them feeling empowered. The emotional burden of home visits for LHWs, coupled with insufficient training and support, undermined the feasibility of home visits.

Conclusion: A complex range of interacting contextual factors may impact on the implementation of home visit programmes for preterm and LBW infants in SA.

Contribution: This country profile provides insights into how home visits for preterm and LBW infants in SA might be contextually tailored to increase local relevance and in turn effectiveness, with potential relevance for other African countries.

南非早产儿/低出生体重儿的家访:定性证据综合。
背景:早产和低出生体重(LBW)是南非新生儿死亡的主要原因。非专业卫生工作者(LHWs)的家访可能有效地解决这一问题。目的:作为全球证据,当地适应(GELA)项目的一部分,我们进行了快速定性证据合成,探索早产儿和低体重婴儿的可接受性,可行性和公平性。背景:我们纳入了在SA进行的研究。方法:我们检索PubMed和Embase,直到2023年9月15日,并独立和重复地确定符合条件的研究。我们使用专题分析综合证据,使用关键评估技能计划工具评估研究质量,并使用GRADE-CERQual评估综述结果的可信度。结果:16项符合条件的研究包括不同的环境和SA人群。促进母亲接受的因素包括获得的知识和技能、提供的社会心理支持、改善的保健机会以及与设施工作人员的关系。对家庭卫生工作者的不信任和与家访相关的污名是接受他们的障碍。非专业卫生工作者感到被赋予了权力,这促进了他们的接受。家访对社会福利工作者的情感负担,加上缺乏培训和支持,削弱了家访的可行性。结论:一系列复杂的相互作用的背景因素可能影响南澳早产儿和低体重婴儿家访计划的实施。贡献:该国家概况提供了对南非早产儿和低体重婴儿家访如何根据具体情况进行调整的见解,以提高当地的相关性和有效性,并对其他非洲国家具有潜在的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
10.00%
发文量
81
审稿时长
15 weeks
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