PDF(Pubmed)
Abstract：
BACKGROUND: Reliable methods for identifying prematurity and low birth weight (LBW) are crucial to ending preventable deaths in newborns. This study explored healthcare providers\' (HCPs) knowledge, practice, perceived barriers in assessing gestational age and birth weight and their referral methods for preterm and LBW infants. The study additionally assessed the potential of using a mobile app for the identification and referral decision of preterm and LBW.
METHODS: This qualitative descriptive study was conducted in Thatta District, Sindh, Pakistan. Participants, including doctors, nurses, lady health visitors, and midwives, were purposefully selected from a district headquarter hospital, and private providers in the catchment area of Global Network\'s Maternal and Newborn Health Registry (MNHR). Interviews were conducted using an interview guide after obtaining written informed consent. Audio recordings of the interviews were transcribed and analyzed using NVIVO® software with an inductive approach.
RESULTS: The HCPs had extensive knowledge about antenatal and postnatal methods for assessing gestational age. They expressed a preference for antenatal ultrasound due to the perceived accuracy, though accept practical barriers including workload, machine malfunctions, and cost. Postnatal assessment using the Ballard score was only undertaken sparingly due to insufficient training and subjectivity. All HCPs preferred electronic weighing scales for birth weight Barriers encountered included weighing scale calibration and battery issues. There was variation in the definition of prematurity and LBW, leading to delays in referral. Limited resources, inadequate education, and negative parent past experiences were barriers to referral. Foot length measurements were not currently being used. While mobile apps are felt to have potential, unreliable electricity supply and internet connectivity are barriers.
CONCLUSIONS: The HCPs in this study were knowledgeable in terms of potential tools, but acknowledged the logistical and parental barriers to implementation.
METHODS: This qualitative descriptive study was conducted in Thatta District, Sindh, Pakistan. Participants, including doctors, nurses, lady health visitors, and midwives, were purposefully selected from a district headquarter hospital, and private providers in the catchment area of Global Network\'s Maternal and Newborn Health Registry (MNHR). Interviews were conducted using an interview guide after obtaining written informed consent. Audio recordings of the interviews were transcribed and analyzed using NVIVO® software with an inductive approach.
RESULTS: The HCPs had extensive knowledge about antenatal and postnatal methods for assessing gestational age. They expressed a preference for antenatal ultrasound due to the perceived accuracy, though accept practical barriers including workload, machine malfunctions, and cost. Postnatal assessment using the Ballard score was only undertaken sparingly due to insufficient training and subjectivity. All HCPs preferred electronic weighing scales for birth weight Barriers encountered included weighing scale calibration and battery issues. There was variation in the definition of prematurity and LBW, leading to delays in referral. Limited resources, inadequate education, and negative parent past experiences were barriers to referral. Foot length measurements were not currently being used. While mobile apps are felt to have potential, unreliable electricity supply and internet connectivity are barriers.
CONCLUSIONS: The HCPs in this study were knowledgeable in terms of potential tools, but acknowledged the logistical and parental barriers to implementation.
摘要：
背景：确定早产和低出生体重（LBW）的可靠方法对于终止可预防的新生儿死亡至关重要。这项研究探索了医疗保健提供者(HCP)的知识，实践,评估胎龄和出生体重的感知障碍及其对早产和LBW婴儿的转诊方法。该研究还评估了使用移动应用程序进行早产和LBW的识别和转诊决定的潜力。
方法：这项定性的描述性研究是在Thatta区进行的，信德省,巴基斯坦。参与者,包括医生,护士,女士健康访客，和助产士,是有目的地从地区总部医院挑选的，以及全球网络孕产妇和新生儿健康登记处（MNHR）集水区的私人提供者。在获得书面知情同意书后，使用访谈指南进行访谈。采用归纳法使用NVIVO®软件对访谈的录音进行转录和分析。
结果：HCP对评估胎龄的产前和产后方法有广泛的了解。由于感知的准确性，他们表达了对产前超声的偏好，尽管接受包括工作量在内的实际障碍，机器故障，和成本。由于培训和主观性不足，仅很少进行使用Ballard评分的产后评估。所有HCP首选用于出生体重的电子称重秤遇到的障碍包括称重秤校准和电池问题。早产和LBW的定义存在差异，导致延迟转诊。资源有限,教育不足,父母过去的负面经历是转诊的障碍。目前没有使用脚长测量。虽然移动应用程序被认为有潜力，不可靠的电力供应和互联网连接是障碍。
结论：本研究中的HCP在潜在工具方面非常熟悉，但承认实施的后勤和家长障碍。
方法：这项定性的描述性研究是在Thatta区进行的，信德省,巴基斯坦。参与者,包括医生,护士,女士健康访客，和助产士,是有目的地从地区总部医院挑选的，以及全球网络孕产妇和新生儿健康登记处（MNHR）集水区的私人提供者。在获得书面知情同意书后，使用访谈指南进行访谈。采用归纳法使用NVIVO®软件对访谈的录音进行转录和分析。
结果：HCP对评估胎龄的产前和产后方法有广泛的了解。由于感知的准确性，他们表达了对产前超声的偏好，尽管接受包括工作量在内的实际障碍，机器故障，和成本。由于培训和主观性不足，仅很少进行使用Ballard评分的产后评估。所有HCP首选用于出生体重的电子称重秤遇到的障碍包括称重秤校准和电池问题。早产和LBW的定义存在差异，导致延迟转诊。资源有限,教育不足,父母过去的负面经历是转诊的障碍。目前没有使用脚长测量。虽然移动应用程序被认为有潜力，不可靠的电力供应和互联网连接是障碍。
结论：本研究中的HCP在潜在工具方面非常熟悉，但承认实施的后勤和家长障碍。
