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Abstract：
BACKGROUND: The burden of maternal and child mortality is high in the Democratic Republic of the Congo (DRC). While health workers (HWs) with adequate knowledge and practice of maternal and child health (MCH) are crucial to reduce this burden, the skill level of HWs in charge of MCH in the DRC is currently insufficient. This study aimed to assess the knowledge and practice of HWs towards MCH in Kasai and Maniema, two DRC provinces with very high maternal mortality ratios and under-5 mortality rates.
METHODS: This cross-sectional study was conducted in 96 health facilities of Kasai and Maniema provinces in 2019. All HWs in charge of MCH were eligible for the study. Data were collected using a structured questionnaire containing 76 questions on knowledge and practice of MCH. Analyses were performed using the Wilcoxon-Mann-Whitney test, Kendall\'s correlation test, and a multivariate linear mixed regression model.
RESULTS: Among participating HWs, 42.6% were A2 nurses (lowest qualification), 81.9% had no up-to-date training in MCH, and 48.4% had only 1-5 years of experience in MCH. In the two provinces combined, about half of HWs had poor knowledge (50.6%) and poor practice (53.3%) of MCH. Knowledge and practice scores were higher in Maniema than in Kasai (P < 0.001). Good knowledge and practice scores were significantly associated with high qualification (P = 0.001), continuing up-to-date training in MCH (P = 0.009), and 6 years of experience or more in MCH (P = 0.01).
CONCLUSIONS: In Maniema and Kasai provinces, about half of HWs had poor knowledge and poor practice of MCH. The conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.
This study assessed the knowledge and practice of health workers (HWs) towards maternal and child health (MCH) in Kasai and Maniema, two provinces of the Democratic Republic of the Congo (DRC) with very high maternal and child mortality rates. About half of surveyed HWs had poor knowledge and poor practice of MCH. Good knowledge and good practice were associated with high qualification, up-to-date training, and 6 years of experience or more in MCH. The conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.
METHODS: This cross-sectional study was conducted in 96 health facilities of Kasai and Maniema provinces in 2019. All HWs in charge of MCH were eligible for the study. Data were collected using a structured questionnaire containing 76 questions on knowledge and practice of MCH. Analyses were performed using the Wilcoxon-Mann-Whitney test, Kendall\'s correlation test, and a multivariate linear mixed regression model.
RESULTS: Among participating HWs, 42.6% were A2 nurses (lowest qualification), 81.9% had no up-to-date training in MCH, and 48.4% had only 1-5 years of experience in MCH. In the two provinces combined, about half of HWs had poor knowledge (50.6%) and poor practice (53.3%) of MCH. Knowledge and practice scores were higher in Maniema than in Kasai (P < 0.001). Good knowledge and practice scores were significantly associated with high qualification (P = 0.001), continuing up-to-date training in MCH (P = 0.009), and 6 years of experience or more in MCH (P = 0.01).
CONCLUSIONS: In Maniema and Kasai provinces, about half of HWs had poor knowledge and poor practice of MCH. The conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.
This study assessed the knowledge and practice of health workers (HWs) towards maternal and child health (MCH) in Kasai and Maniema, two provinces of the Democratic Republic of the Congo (DRC) with very high maternal and child mortality rates. About half of surveyed HWs had poor knowledge and poor practice of MCH. Good knowledge and good practice were associated with high qualification, up-to-date training, and 6 years of experience or more in MCH. The conversion of A1 nurses into midwives as well as the provision of up-to-date training in MCH, supervision, and mentorship could improve the skill level of HWs and could thus reduce the burden of MCH in the DRC.
摘要：
背景：刚果民主共和国（DRC）的孕产妇和儿童死亡率负担很高。虽然具有足够的母婴健康知识和实践的卫生工作者（HW）对于减轻这种负担至关重要，目前，刚果民主共和国负责MCH的HW技能水平不足。这项研究旨在评估Kasai和Maniema对妇幼保健的知识和实践，两个刚果民主共和国省的孕产妇死亡率和5岁以下儿童死亡率很高。
方法：这项横断面研究于2019年在开赛和马涅马省的96个医疗机构进行。所有负责MCH的HW均符合本研究的条件。使用结构化问卷收集数据，其中包含76个有关MCH知识和实践的问题。使用Wilcoxon-Mann-Whitney检验进行分析，肯德尔的相关性检验，和多元线性混合回归模型。
结果：在参与的HW中，42.6%是A2护士(最低资格)，81.9%没有接受过最新的妇幼保健培训，48.4%的人只有1-5年的妇幼保健经验。在这两个省的总和中，大约一半的HWs对MCH的知识不足(50.6%)和实践不足(53.3%)。Maniema的知识和实践得分高于Kasai（P<0.001）。良好的知识和实践分数与高资质显著相关(P=0.001)。继续最新的妇幼保健培训（P=0.009），和6年以上的MCH经验（P=0.01）。
结论：在马涅马和开赛省，大约一半的HWs对妇幼保健的知识和实践都很差。将A1护士转变为助产士，并提供最新的妇幼保健培训，监督,和指导可以提高人力资源的技能水平，从而减轻刚果民主共和国妇幼保健的负担。
这项研究评估了开赛和马涅马的卫生工作者对母婴健康（MCH）的知识和实践。刚果民主共和国（DRC）的两个省的孕产妇和儿童死亡率很高。大约一半的接受调查的HWs对MCH的知识和实践都很差。良好的知识和良好的实践与高资质相关，最新的培训，和6年以上的MCH经验。将A1护士转变为助产士，并提供最新的妇幼保健培训，监督,和指导可以提高人力资源的技能水平，从而减轻刚果民主共和国妇幼保健的负担。
方法：这项横断面研究于2019年在开赛和马涅马省的96个医疗机构进行。所有负责MCH的HW均符合本研究的条件。使用结构化问卷收集数据，其中包含76个有关MCH知识和实践的问题。使用Wilcoxon-Mann-Whitney检验进行分析，肯德尔的相关性检验，和多元线性混合回归模型。
结果：在参与的HW中，42.6%是A2护士(最低资格)，81.9%没有接受过最新的妇幼保健培训，48.4%的人只有1-5年的妇幼保健经验。在这两个省的总和中，大约一半的HWs对MCH的知识不足(50.6%)和实践不足(53.3%)。Maniema的知识和实践得分高于Kasai（P<0.001）。良好的知识和实践分数与高资质显著相关(P=0.001)。继续最新的妇幼保健培训（P=0.009），和6年以上的MCH经验（P=0.01）。
结论：在马涅马和开赛省，大约一半的HWs对妇幼保健的知识和实践都很差。将A1护士转变为助产士，并提供最新的妇幼保健培训，监督,和指导可以提高人力资源的技能水平，从而减轻刚果民主共和国妇幼保健的负担。
这项研究评估了开赛和马涅马的卫生工作者对母婴健康（MCH）的知识和实践。刚果民主共和国（DRC）的两个省的孕产妇和儿童死亡率很高。大约一半的接受调查的HWs对MCH的知识和实践都很差。良好的知识和良好的实践与高资质相关，最新的培训，和6年以上的MCH经验。将A1护士转变为助产士，并提供最新的妇幼保健培训，监督,和指导可以提高人力资源的技能水平，从而减轻刚果民主共和国妇幼保健的负担。
