Nội dung được dịch bởi AI, chỉ mang tính chất tham khảo
Các can thiệp chăm sóc sức khỏe và xã hội có định hướng cho phụ nữ và trẻ sơ sinh chịu ảnh hưởng không tương xứng bởi bất bình đẳng về sức khỏe ở các quốc gia thu nhập cao: một khảo sát hệ thống
Tóm tắt
Các nhóm dân cư thiệt thòi (chẳng hạn như phụ nữ từ các nhóm dân tộc thiểu số và những người có hoàn cảnh xã hội phức tạp) có nguy cơ cao hơn về kết quả và trải nghiệm kém. Bất bình đẳng trong kết quả sức khỏe bao gồm sinh non, tình trạng ốm đau và tử vong mẹ và chu sinh, và chăm sóc kém chất lượng. Tác động của các can thiệp đối với nhóm dân cư này chưa rõ ràng ở các quốc gia thu nhập cao (HIC). Mục tiêu của khảo sát là xác định và đánh giá các bằng chứng hiện có liên quan đến các can thiệp dịch vụ chăm sóc sức khỏe và xã hội có định hướng tại HICs, có thể cải thiện bất bình đẳng sức khỏe mà phụ nữ mang thai và trẻ sơ sinh đối mặt với nguy cơ kém. Mười hai cơ sở dữ liệu đã được tìm kiếm để thu thập các nghiên cứu trên toàn bộ các HIC, từ bất kỳ thiết kế phương pháp nào. Cuộc tìm kiếm kết thúc vào ngày 8 tháng 11 năm 2022. Các tiêu chí bao gồm các can thiệp nhắm đến nhóm dân cư thiệt thòi mà cung cấp một phần chăm sóc lâm sàng khác với chăm sóc sản khoa tiêu chuẩn. Bốn mươi sáu nghiên cứu chỉ số đã được bao gồm. Các quốc gia bao gồm Australia, Canada, Chile, Hồng Kông, Vương quốc Anh và Hoa Kỳ. Một phân tích tường thuật đã được thực hiện, và kết quả cho thấy ba loại can thiệp: các mô hình chăm sóc do nữ hộ sinh, chăm sóc liên ngành, và dịch vụ trung tâm cộng đồng. Các loại can thiệp này đã được thực hiện riêng lẻ nhưng cũng kết hợp với nhau cho thấy các đặc điểm chồng chéo. Nhìn chung, kết quả cho thấy các can thiệp có mối liên hệ tích cực với các kết quả sơ cấp (tử vong mẹ, chu sinh, và trẻ sơ sinh) và thứ cấp (trải nghiệm và sự hài lòng, độ phủ chăm sóc antenatal, khả năng tiếp cận chăm sóc, chất lượng chăm sóc, chế độ sinh, việc sử dụng giảm đau trong khi sinh, sinh non, cân nặng lúc sinh thấp, nuôi con bằng sữa mẹ, kế hoạch hóa gia đình, tiêm chủng) tuy nhiên sự quan trọng và tác động khác nhau. Các mô hình chăm sóc do nữ hộ sinh đã tiếp cận một cách cá nhân và toàn diện khi họ tập trung vào liên tục trong chăm sóc, thăm nhà, sự phù hợp về văn hóa và ngôn ngữ, và khả năng tiếp cận. Chăm sóc liên ngành đã thực hiện cách tiếp cận có cấu trúc, để điều phối chăm sóc cho phụ nữ cần nhiều dịch vụ y tế và xã hội từ nhiều cơ quan. Các dịch vụ trung tâm cộng đồng đã thực hiện cách tiếp cận dựa trên địa điểm với các can thiệp phù hợp với nhu cầu và các quy tắc của cộng đồng. Các can thiệp mục tiêu tồn tại ở các HIC, nhưng những can thiệp này khác nhau theo ngữ cảnh và cơ sở hạ tầng của chăm sóc sản khoa tiêu chuẩn. Các phương pháp can thiệp đa dạng có thể cải thiện cách tiếp cận có định hướng cho các nhóm dân cư có nguy cơ, đặc biệt là việc kết hợp các mô hình chăm sóc do nữ hộ sinh với các cách tiếp cận trung tâm cộng đồng, để tăng cường khả năng tiếp cận, tham gia sớm hơn và tăng cường sự có mặt.
Từ khóa
#bất bình đẳng sức khỏe #can thiệp chăm sóc sức khỏe #phụ nữ mang thai #trẻ sơ sinh #quốc gia thu nhập cao #dịch vụ chăm sóc cộng đồngTài liệu tham khảo
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