ABSTRACT

Background

Low-birthweight (LBW) infants (<2500 g) are at greatest risk of mortality in the neonatal period, particularly in low- and middle-income countries. Timely access to quality healthcare averts adverse outcomes.

Aim:

To explore caregiver experiences and healthcare provider perspectives of accessing healthcare for LBW infants in rural Kenya.

Methods

This qualitative study was undertaken in Homa Bay County of in rural western Kenya in June 2019. In-depth interviews with eleven caregivers and four healthcare providers were conducted by a trained research assistant. All interviews were transcribed verbatim, and transcripts in the local languages were translated into English. A thematic framework was used to analyse the data.

Results

At the community and individual level,community misconceptions about LBW infants, inadequate infant care practices after discharge, lack of maternal support networks, long distances from healthcare facilities and lack of financial support were key challenges. In addition, long hospital waiting times, healthcare worker strikes and the apparent inadequate knowledge and skills of healthcare providers were disincentives among caregivers. Among healthcare providers, health system deficiencies (staff shortages and inadequate resources for optimal assessment and treatment of LBW infants) and maternal illiteracy were key challenges. Education by staff during antenatal visits and community support groups were enablers.

Conclusion

Accessing healthcare for LBW infants in this community is fraught with challenges which have implications for their post-discharge outcome. There is an urgent need to develop and test strategies to address the barriers at the community and health system level to optimise outcome..

中文翻译：

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照顾者的经验和医疗保健工作者对低出生体重者获得医疗保健的看法

摘要

背景

低出生体重 (LBW) 婴儿 (<2500 g) 在新生儿期的死亡风险最高，尤其是在低收入和中等收入国家。及时获得优质医疗保健可以避免不良后果。

目标：

探索肯尼亚农村地区 LBW 婴儿获得医疗保健的护理人员经验和医疗保健提供者的观点。

方法

这项定性研究于 2019 年 6 月在肯尼亚西部农村的霍马湾县进行。一名训练有素的研究助理对 11 名护理人员和 4 名医疗保健提供者进行了深入访谈。所有采访都被逐字转录，当地语言的成绩单被翻译成英文。使用主题框架来分析数据。

结果

在社区和个人层面，社区对 LBW 婴儿的误解、出院后婴儿护理实践不足、缺乏孕产妇支持网络、远离医疗机构和缺乏经济支持是主要挑战。此外，医院等待时间过长、医护人员罢工以及医疗保健提供者的知识和技能明显不足，这些都阻碍了护理人员的积极性。在医疗保健提供者中，卫生系统缺陷（人员短缺和对 LBW 婴儿进行最佳评估和治疗的资源不足）和产妇文盲是主要挑战。产前检查期间工作人员的教育和社区支持小组是促成因素。

结论

在这个社区为 LBW 婴儿获得医疗保健充满挑战，这些挑战对其出院后的结果有影响。迫切需要制定和测试策略来解决社区和卫生系统层面的障碍以优化结果。