طراحی بسته‌ خدمات سلامت مادر و کودک بر اساس مدل تطبیقی کشورهای توسعه‌ یافته

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانش‌آموخته دکترای تخصصی، گروه مدیریت خدمات بهداشتی درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

2 دانشیار گروه مدیریت خدمات بهداشتی درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

3 استاد گروه مدیریت خدمات بهداشتی درمانی، واحد علوم و تحقیقات، دانشگاه آزاد اسلامی، تهران، ایران.

4 دانشیار گروه مدیریت خدمات بهداشتی درمانی، دانشکده مدیریت و اطلاع‌رسانی پزشکی، دانشگاه علوم پزشکی ایران، تهران، ایران.

چکیده

مقدمه: سلامت زنانجامعهبهدلایلمختلفآسیب‌پذیرترازمرداناستکهعلاوهبر ویژگی‌های بیولوژیکی،تحتتأثیرعواملتعیین‌گرفرهنگی،اجتماعی،اقتصادیوسیاسیقراردارد. امروزه موضوعمدیریتتوسعهسلامتمادران درزمرهاولویت‌هایسازمانجهانیبهداشت قراردارد. مطالعه حاضر با هدف بهبود بسته خدمات سلامت مادر و کودک ارائه ‌شده در ایران از طریق ارائه متغیرهای برگرفته از مطالعه تطبیقی کشورهای توسعه‌ یافته منتخب انجام شد.
روش‌کار: در این مطالعه تطبیقی کشورهای مورد مطالعه (سنگاپور، استرالیا، انگلستان، ژاپن) با مقایسه شاخص‌های بهداشت مادر و کودک کشورها به روش نمونه‌گیری خوشه‌ای از قاره‌های مختلف انتخاب ‌شده و با مطالعه بسته خدمات سلامت مادر و کودک در آن‌ها از طریق رجوع به اسناد معتبر بهداشتی، متغیرهای مهم و ابعاد مورد نظر شناسایی‌ و بر اساس آن و جدول تطبیقی طراحی‌ شده، نتیجه‌گیری شد.
یافته‌ها: کلاس‌های رایگان آموزشی و ورزشی با شرکت همسران، شبکه‌ گسترده‌ اورژانس مادران به‌صورت شبانه‌روزی و تخصصی، تنوع وسایل نقلیه برای انتقال به مراکز اورژانس، بسته‌های حمایت روحی مادران، ویزیت و زایمان در منزل، امکانات جراحی و مراقبت رایگان نوزادان، امکانات غربالگری مادران باردار به ‌صورت رایگان، وجود کتابچه راهنما و ثبت خدمات به‌ صورت متحدالشکل در کل مراکز کشور را می‌توان از عوامل شناسایی ‌شده در بسته موفق خدمات سلامت مادر و کودک معرفی کرد.
نتیجه‌گیری: نقش برخی عوامل شناسایی‌ شده نظیر ویزیت و زایمان در منزل در بسته خدمات سلامت ایران کم است و یا وجود ندارد. اجرای موارد پیشنهادی می‌تواند نقش مؤثری در ارتقاء شاخص‌های سلامت مادر و کودک ایران داشته باشد.

کلیدواژه‌ها


عنوان مقاله [English]

Designing the maternal and child health services package based on comparative study of developed countries models

نویسندگان [English]

  • Mojgan Neinavae 1
  • Amir Ashkan Nasiripour 2
  • Seyed Jamaledin Tabibi 3
  • Pouran Raeissi 4
1 PhD, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran.
2 Associate Professor, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran.
3 Professor, Department of Health Services Management, Science and Research Branch, Islamic Azad University, Tehran, Iran
4 Associate Professor, Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
چکیده [English]

Introduction: Community women's health is more vulnerable than men due to various reasons, in addition to biological characteristics; it is influenced by cultural, social, economic and political factors. Nowadays,managing maternal health development is one of the World Health Organization priorities.This study was performed with aim to improve maternal and child health service package in Iran by providing variables derived from a comparative study conducted in selected developed countries.
Methods: In thiscomparative study, the studied countries(Singapore, Australia, England and Japan) wereselectedby comparingmaternal-child healthindicators from different continentsusing cluster sampling and with studying of their maternal and child health service package through referring to valid health documents, important variablesanddimensions were identified, and based on itand designed comparative tables, the conclusion was made.
Results: Free sportsandtraining classeswiththe husbands' presence, extensive maternal network emergency as specialized and boarding, varietyof vehicles fortransportto emergency centers,emotional supportpackages, home visit and delivery, newbornsfreesurgical facilitiesandcare, pregnant womenscreeningfacilitiesfor free, guideline booklet and unifiedrecording of servicesin allcountrycenters are the factorsidentified in successfulmaternal- child health servicespackage.
Conclusion: The role ofsome identified factors such as home visit and deliveryis loworabsent in Iran health service package. Implementation ofthesuggested factors canplay an important rolein promotingmaternal-child healthindicators inIran.

کلیدواژه‌ها [English]

  • Comparative Study
  • Developed Countries
  • Health Services
  • Maternal -child health services
  • Model
  1. Houweling TA, Ronsmans C, Campbell OM, Kunst AE. Huge poor–rich inequalities in maternity care: an international comparative study of maternity and child care in developing countries. Bull World Health Organ 2007; 85(10):745-52.
  2. Vashishtha VM. The State of the World's Children 2009: maternal health is the key to achieve MDGs 4 and 5. Indian Pediatr 2009; 46(3):233-4.
  3. Silal SH, Penn-Kekana L, Harris B, Birch S, McIntyre D. Exploring inequalities in access to and use of maternal health services in South Africa. BMC Health Serv Res 2012; 12:120.
  4. Azemikhah A, Emamiafshar N, Jalilvand P. National program to promote maternal health. Tehran: Ministry of Health and Medical Education; 2001. P. 2. (Persian).
  5. Ahmadi B. The pattern of development of women's health. J Soci Welfare 2006; 5(21):10. (Persian).
  6. World Health Organization. Neonatal and perinatal mortality: country, regional and global estimates. Geneva: World Health Organization; 2006. P. 69.
  7. Turner KE, Fuller S. Patient-held maternal and/or child health records: meeting the information needs of patients and healthcare providers in developing countries? Online J Public Health Inform 2011; 3(2):1-48.
  8. Bhutta ZA, Chopra M, Axelson H, Berman P, Boerma T, Bryce J, et al. Countdown to 2015 decade report (2000-10): taking stock of maternal, newborn, and child survival. Lancet 2010; 375(9730):2032-44.
  9. Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA. Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics 2005; 115(2):519-617.
  10. Lozano R, Wang H, Foreman KJ, Rajaratnam JK, Naghavi M, Marcus JR, et al. Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis. Lancet 2011; 378(9797):1139-65.
  11. Azar A. Selection of general population census results. Tehran: Deputy of strategic planning and monitoring of statistical center; 2013. P. 29. (Persian).
  12. Barati Marnani A, Gudaki H. Comparative study on privatization of health care provision on contract basis. J Health Administ 2005; 8(21):105-10. (Persian).
  13. Safdari R, Ghazisaeedi M, Goodini A, Monajemi F.Study comparative payment mechanism health insurance in United State of America, Australia and Iran. Teb Tazkieh 2011; 77:41-51. (Persian).
  14. Karimi I, Salarian A, Anbari Z. A comparative study on equity in access to health services in developed countries and designing a model for Iran. Arak Med Univ J 2010; 12(4):92-104. (Persian).
  15. World Health Organization. Trends in maternal mortality: 1990–2008. Geneva: World Health Organization; 2010.
  16. Public Information Officers (ALHW). Healthy mothers, healthy babies program. Program description. Victoria: Department Of Health; 2012. P. 4.
  17. Australian Institute of Health. Canberra: Australia’s Health; 2012. P. 16.
  18. Australian Health Ministers’ Advisory Council (AHMAC). Primery maternity services in Australia: a framework for implementation. Canberra: AHMAC; 2008.
  19. Australian Health Ministers’ Advisory Council. Clinical practice guidelines: antenatal care – module 1. Canberra: Australian Government Department of Health and Ageing; 2012.
  20. Comptroller and auditor General. Maternity services in England. London: Stationery Office; 2013. P. 1-40.
  21. Department of Health/Partnerships for Children, Families and Maternity. Maternity matters: choice, access and continuity of care in a safe service. London: Department of Health; 2007. P. 2-56.
  22. Daubaras A. Midwifery in Singapore: The EMMa care programme. Singaporemotherhood. Available at: URL: http://singaporemotherhood.com/articles/2013/06/midwifery-in-singapore-the-emma-care-programme/; 2013.
  23. http://webda.behdasht.gov.ir/(1392).index.aspx?siteid=326&pageid=32628&newsview=56432&pro=nobak
  24. Midwives Associations Directory. Japanese Nursing Association (JNA), Tokyo. Available at: URL: http://www.internationalmidwives.org/our-members/?aid=50; 2014.
  25. The Japanese Nursing Association in Action. Japanese Nursing Association (JNA). Available at: URL: http:// www.nurse.or.jp /jna/English; 2016.
  26. Training Guide for New Graduate Midwives. Japanese Nursing Association (JNA). Available at: URL: https://www.nurse.or.jp/jna/english/midwifery/pdf/mij2014.pdf; 2012.
  27. Japan's Experiences in Public Health and Medical Systems. JICA Research Institute. Available at: URL: http://jicari.jica.go.jp/IFIC_and_JBICI Studies/english/publications/reports/study/topical/health/pdf/health_01.pdf; 2005.
  28. Kobayashi Y. Five decades of universal health insurance coverage in Japan: lessons and future challenges. Japan Med Assoc 2009; 52(4):263-8.
  29. Monastery of Health. Commonwealth Health Online. Available at: URL: http://www.commonwealthhealth.org/asia/Singapore/child-and-maternal-health-in-singapore; 2014.
  30. Toughyani R, Ramezani MA, Izadi M, Shahidi S, Motie Z. The effect of prenatal care group education on pregnant mothers' knowledge, attitude and practice. Iran J Med Educ 2008; 7(2):317-24. (Persian).
  31. Jamilian M, Mobsery S, Vakilian K, Jamilian H. Effect of childbirth preparation classes on the duration of admission and satisfaction of mothers. J Ilam Univ Med Sci 2013; 21(2):44-50. (Persian).
  32. Firozbakht M, Nikpour M, Asadi S. The effect of prenatal education classes on the process of delivery. J Health Breeze 2013; 2(1):45-52. (Persian).
  33. Mirmolaei T, Amel Valizadeh M, Mahmoodi M, Tavakkol Z. The effect of postpartum care at home on maternal received and satisfaction. J Evidenc Bas Care 2011; 1(1):35-50. (Persian).
  34. Di Cesare M, Saattes R, Lewin KM. A double prevention: how maternal education can effect maternal mental health, child health and child cognitive development. Longt Life Course Stud 2013; 4(3):166-79.
  35. Rayegan SR, Khodakarami N, Hassanzadeh MK, Akbarzadeh AR. Assess the mental health of mothers with high-risk and low-risk pregnancy. J Med Council Islamic Republic Iran 2012; 4(30):329-34. (Persian).
  36. Mortazavi F. The study of male involvement in prenatal care in shahroud and sabzevar, Iran. Qom Univ Med Sci J 2012; 6(1):1-9. (Persian).
  37. Mortazavi F, Mirzaie K. Reason of, barriers to, and outcomes of husbands’ involvement in prenatal and intrapartum care program based on midwives’ experiences: a qualitative study. Arak Univ Med Sciv J 2011; 15(1):104-15. (Persian).
  38. Mohamadi M, Farahpour N, Komar V, Alemzadeh M, Alard P. The effects of exercise during pregnancy on fetus and on mother"s recovery after the delivery. Res Sport Sci 2005; 2(5):95-106. (Persian).
  39. Hajikazemi ES, Heydari M, Feizi Z, Haghani H. Effect of physical exercise on pregnancy outcome. Iran J Nurs 2001; 13(25):15-22. (Persian).
  40. Rahimi S, SeyyedRasooli A. Pregnant women and exercise. Iran J Nurs 2005; 17(40):6-10. (Persian).
  41. Moosavi SE, Koushki Jahromi M, Alborzi M. The Relationship between physical activity before and during pregnancy and identifying the most important period predictor of physical activity during pregnancy. Appl Stud Biol Sci Sports 2014; 2(3):38-46. (Persian).
  42. Zarei A. Development of home care services. J Hospital 2004; 5(2):28-30. (Persian).
  43. Mirmolaei ST, Moshrefi M, Kazemnejad AN, Farivar F, Morteza H. The effect of nutrition education on nutritional behaviors in pregnant women. J Hayat 2010; 15(4):35-42. (Persian).
  44. Forood F, Forood A. The effect of postpartum home visit programs on continuation of breast. J Rafsanjan Univ Med Sci. 2003; 1(4):267-74. (Persian).
  45. Pabarja F, Farivar K, Kordi M, Khadivzadeh T, Mazloom SR. The effect of postpartum home care on infant nutrition. J Nurs Midwifery 2004; 5(15-16):24-31. (Persian).
  46. Mirmolaei ST, Amelvalizadeh M, Mahmoudi M, Tavakol Z. Effect of home postpartum care on quality of life of low risk mothers. J Hayat 2011; 17(2):42-5. (Persian).
  47. Gupta N, Maliqi B, França A, Nyonator F, Pate MA, Sanders D, et al. Human resources for maternal, newborn and child health: from measurement and planning to performance for improved health outcomes. Hum Resour Health 2011; 9(16):1-7.
  48. Khavandizadeh Aghdam S, Abedi P. Comparative assess of home birth and hospital birth in primigravid women. Med J Hormozgan Univ 2007; 12(1):61-7. (Persian).
  49. Rad PF, Marani FA, Safavi SH, Haghani H. The reasons of home delivery in Koohdasht city. Iran J Nurs 2006; 18(44):23-9. (Persian).
  50. Bakouei F. The assessment of knowledge, attitude and propensity of pregnant women regarding homebirth, Babol, 2003. J Babol Univ Med Sci 2005; 7(2):70-4. (Persian).
  51. Farajolahi M, Khanjari S, Molla F, Hosseini F. Prenatal care and the factors influencing it from the perspective of the care recipient. Iran J Neonatol 2006; 19(45):37-46. (Persian).
  52. Mohamadirizi S, Bahadoran P, Fahami F. Comparison between the impacts of e-learning and booklet education on nulliparous women’s satisfaction about postpartum care. Iran J Obstet Gynecol Infertil 2013; 16(61):1-8. (Persian).
  53. Moradi S, Roozbeh N, Abadi AM, Hasani MT, Hosseinpoor M, Rajaei M, et al. Prevalence and effective factors of maternal mortality in Hormozgan Province from 2007 until 2011. Hormozgan Med J 2015; 19(1):59-64. (Persian).
  54. Nasrollahpour Shirvani D, Ashrafian Amiri H, Motlagh ME, Kabir MJ, Maleki, MR, Shabestani Monfared A, et al. Evaluation of the function of referral system in family physician program in Northern provinces of Iran: 2008. J Babol Univ Med Sci 2010; 11(6):46-52. (Persian).
  55. Malqvist M, Yuan B, Trygg N, Selling K, Thomsen S. Targeted interventions for improved equity in maternal and child health in low and middle income settings: systematic review and meta analysis. Plos One 2013; 6(8):e66453.
  56. Hossein-Nezhad A, Larijani B. Cost analysis of screening and diagnostic methods in gestational diabetes mellitus. Iran J Diaetes Metab 2001; 1(1):31-40. (Persian).