尼日利亚妇幼保健领域的传统助产士:古老习俗与现代建议

Ibama As, Unamba Bc, Jaja E, Ogbonna C, Onawola Rm, Ugwuoke A, Ibulubo Ri, Ibulubo Tg
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摘要

背景:关于传统助产士(TBAs)在母婴保健中的作用以及是否能降低母婴发病率和死亡率的争论一直存在。本文试图探讨传统助产士的古老做法,并在此基础上提出有助于改善母婴健康状况的现代建议。方法:采用的方法是从开放存取期刊和谷歌学术数据库中查阅相关文献,以及发展中国家有关该主题变量的研究报告。结果研究结果表明,在超过 70% 人口居住的农村地区,传统助产士工作负担的重叠根源包括社会福利差、医疗设施和服务不足。循证报告显示,即使有 93% 的农村妇女登记了产前护理,仍有 49% 的妇女在家中由传统助产士接生,73% 的妇女因胎盘滞留和出血而向传统助产士求助。此外,41%的育龄妇女表示,母婴感染是与使用传统助产士服务相关的风险,32.8%的妇女表示,产中和产后出血同样是与传统助产士提供的孕产妇保健服务相关的风险。这种服务情况与有害做法有关,会给接受服务的母亲和孩子带来健康和医疗并发症。然而,传统助产士的有益做法包括:家访以促进母婴健康(9.84%)、坐浴(17.20%)、鼓励母乳喂养至 2 岁(18.90%)等。现代建议针对有害做法和相关负面影响采取补救措施,以改善尼日利亚的母婴健康指数。结论为了合理、可持续地减少尼日利亚妇幼保健工作中传统助产士的做法所带来的负担,有必要进行有针对性的培训和持续指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Traditional Birth Attendant in the Maternal and Child Health Space in Nigeria: Ancient Practices and Modern Recommendations
Background: Arguments on the usefulness of Traditional Birth Attendants (TBAs) in maternal and child health care and the reduction of maternal and child morbidity and mortality indices or not, persist. This paper sought to explore the ancient practices of TBAs and to strike a balance to portray modern recommendations that would contribute to improved maternal and child health status. Methods: The method used was review of relevant literatures from open-access journals and google scholar data base, as well as research reports on variables of the subject in developing countries. Results: Findings revealed that the overlapping root of TBAs’ practice burden include poor social amenities, inadequate health facilities and services in rural areas where over 70% of the population reside. While evidencebased report showed that even when 93% of rural women registered for Ante-Natal Care, 49% were delivered at home by TBAs and 73% has sought help from them for retained placenta with bleeding. Also, 41% of women of child bearing age indicated that maternal and child infection is a risk associated with the patronage of TBAs, whereas 32.8% indicated that bleeding during and after delivery were equally risks associated with TBA-provided maternal health services. Such circumstances of service were associated with harmful practices with attendant health and medical complications to recipient mother and child. However, helpful ancient practices of TBAs include; home visiting to promote well-being of mother and child (9.84%), sitz bath (17.20%), encouraging breastfeeding up to 2years (18.90%) etc. The modern recommendations, x-rayed the remedial actions on the harmful practices and associated negative consequences to improving maternal and child health indices in Nigeria. Conclusion: For reasonable and sustainable reduction in the burden associated with the practices of TBAs in maternal and child health care in Nigeria, contextual focused training and continuous mentoring is a necessity.
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