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Effect of an integrated maternal health intervention on skilled provider’s care for maternal health in remote rural areas of Bangladesh: a pre and post study

机译:孕产妇综合干预对孟加拉国偏远农村地区熟练服务提供者的孕产妇保健的影响:一项前后研究

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Background An integrated maternal health intervention in a rural sub district of Bangladesh focused on the training and deployment of a required number of Community Based Skilled Birth Attendants (CSBAs). The aim of the study was to assess the effect of the intervention on use of skilled provider care during pregnancy, delivery and after delivery. Methods The effect compared the skilled providers care in low performing areas with high and medium performing areas through pre–and post–intervention surveys. The post-intervention survey was conducted two years after the completion of the intervention. Village clusters, with populations of approximately 3000, were randomly assigned to the surveys. Mothers who had delivered within the 6?months prior to the surveys, were recruited for the structured interviews. Logistic regression was conducted to compare the effect. Results Majority of mothers in the low performing areas belonged to a poor economic quintile. The level of skilled attendance for 4+ Antenatal Care (ANC) and delivery increased sharply from baseline to endline survey in low performing areas (ANC: 1.6% to 15.3%, p?
机译:背景技术孟加拉国农村地区的综合产妇保健干预措施重点在于培训和部署所需数量的社区熟练出生服务员(CSBA)。该研究的目的是评估干预措施对怀孕,分娩和分娩后使用熟练的提供者护理的影响。方法效果通过干预前和干预后的调查,将技术熟练的医疗服务提供者对低绩效地区和中高绩效地区的护理进行了比较。干预后两年进行干预后调查。人口大约为3000的村庄群被随机分配到调查中。在调查之前的6个月内分娩的母亲被招募参加结构化访谈。进行逻辑回归以比较效果。结果低绩效地区的大多数母亲属于贫穷的五分之一人口。在低绩效地区,从基线调查到最终调查的4+产前保健(ANC)和分娩的熟练服务水平急剧上升(ANC:1.6%至15.3%,p≤<0.0001;分娩时熟练的接生服务:12.6%至38.3%,p << 0.0001)。在干预之前,只有不到1%的妇女从熟练的医疗服务提供者那里接受了产后护理(PNC),并且这一比例在干预结束时增加到20%。调整后的赔率表明,在ANC,分娩和PNC期间,干预会对使用熟练的提供者护理的单个执行区域产生影响。相对于高绩效地区的增加[4+来自熟练服务提供者的ANC –或:3.8( 1.9–7.6);熟练接生员–或:2.8(2.1–3.8)]。结论综合的孕产妇保健干预措施侧重于部署所需数量的CSBA,增加了贫困妇女在怀孕期间从熟练的医疗服务提供者中受益的机会。这种综合干预措施可能会改善发展中国家的孕产妇健康状况,在这些国家,通常由不熟练的服务员提供送货上门。

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