肯尼亚夸莱县服务不足地区孕产妇、新生儿和儿童保健服务瓶颈分析。

IF 2.5 Q2 HEALTH CARE SCIENCES & SERVICES
Health Services Insights Pub Date : 2025-09-24 eCollection Date: 2025-01-01 DOI:10.1177/11786329251374553
Fatihiyya Wangara, Janne Estill, Hillary Kipruto, Caroline Perrin, Juma Ngudo, Khadija Nuru, Olivia Keiser
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引用次数: 0

摘要

背景:2017年至2020年期间,肯尼亚的孕产妇死亡率上升了55%。虽然全球目标尚未实现,但新生儿和婴儿死亡率多年来有所改善,但新生儿死亡率下降的速度缓慢。产妇死亡率居高不下,新生儿和婴儿死亡率改善缓慢,因此有必要对保健服务的提供、质量和吸收情况进行定期调查。目的:我们评估了肯尼亚夸莱县获得生殖、孕产妇、新生儿和儿童健康(RMNCH)服务的瓶颈。设计:我们采用了横截面混合方法。方法:我们采用Tanahashi模型来评估RMNCH服务,使用5个关键指标来反映服务提供连续体的不同阶段:服务的可用性;可访问性;与卫生系统的初次接触;持续利用;以及高质量的报道。二级定量数据收集自《2022年肯尼亚人口与健康调查》、《2023年肯尼亚卫生设施普查报告》和其他同行评议出版物。从20个焦点小组讨论中收集了主要的定性数据,其中包括176名成员,包括非专业社区成员、社区卫生促进者(CHPs)和传统助产士。主要数据是在2022年10月至11月的1个月期间收集的。结果:从供给侧发现的主要瓶颈是医护人员数量有限和态度消极。核心卫生工作者的可及性为13/10 000人,低于全国平均水平和世界卫生组织(世卫组织)的建议。从供应方面看,卫生知识普及程度低、性别规范和财政限制是助长不良求医行为的主要因素。结论:夸莱县需要优先投资于卫生、宣传、沟通和社会动员方面的人力资源。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Bottleneck Analysis of Maternal, Newborn and Child Health Services in Underserved Areas of Kwale County, Kenya.

Background: Kenya experienced a 55% increase in maternal mortality between the years 2017 and 2020. While the global targets are yet to be realized, neonatal and infant mortality has improved over the years, but the rate of decline for neonatal mortality has been slow. The persistent high maternal mortality and slow improvements in neonatal and infant mortality warrant regular inquiries into health service provision, its quality and uptake.

Objective: We assessed bottlenecks in accessing reproductive, maternal, newborn and child health (RMNCH) services in Kwale County, Kenya.

Design: We used a cross sectional mixed methods approach.

Methods: We adapted the Tanahashi model to evaluate RMNCH services using 5 key measures that reflect different stages along the service delivery continuum: availability of services; accessibility; initial contact with the health system; continued utilization; and quality coverage. Secondary quantitative data was collected from the Kenya Demographic and Health Survey 2022, Kenya Health Facility Census Report 2023 and other peer reviewed publications. Primary qualitative data was collected from 20 focus group discussions with 176 members including lay community members, community health promoters (CHPs) and traditional birth attendants. Primary data was collected over a 1 month period, between October and November 2022.

Results: The main bottleneck identified from the supply side was the limited number and negative attitude of the healthcare workers. Access to core health workers was at 13/10 000 people, lower than the national average and World Health Organization (WHO) recommendation. From the supply side, low health literacy, gender norms and financial constraints were the major factors fueling the poor health seeking behavior.

Conclusion: Kwale County needs to prioritize investments in human resources for health, advocacy, communication and social mobilization.

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来源期刊
Health Services Insights
Health Services Insights HEALTH CARE SCIENCES & SERVICES-
CiteScore
3.60
自引率
0.00%
发文量
47
审稿时长
8 weeks
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