在马达加斯加利用移动保健提高产前保健的质量:卡塔尔世界杯8强波胆分析五年横断面研究%A Benski,Anne Caroline %A Schmidt,Nicole %A Viviano,Manuela %A stananelli,Giovanna %A Soaroby,Adelia %A Reich,Michael R %+ Takemi国际卫生项目，哈佛大学陈TH公共卫生学院，677 Huntington Ave, Boston, MA, 02115，美国，1 787397261，cbenski@hsph.harvard.edu %K移动保健%K孕产妇保健%K产前保健%K护理质量%K移动电话%D 2020 %7 8.7.2020 %9背景:尽管做出了许多努力，但在大多数发展中国家，孕产妇死亡率仍然是一个主要负担。移动医疗(mHealth)有潜力通过帮助患者和提供者的应用程序改善获得产科护理的机会。目的:本研究旨在利用移动医疗为马达加斯加农村地区的1446名孕妇提供产前护理(ANC)，并评估旨在改变提供者和患者行为的移动医疗系统提供的ANC质量。方法:我们使用名为妊娠和新生儿诊断评估(PANDA)的移动健康系统，纳入了2015年至2019年在马达加斯加农村参加ANC就诊的1446名妇女。这项横断面研究使用了来自不同参与者的数据，并收集了数年的信息，以分析随时间推移与ANC质量相关的输出。具体来说，我们检查了第一次ANC访问的时间，访问时间与孕妇风险因素之间的关系，以及每位妇女的ANC访问次数。结果:在2015年移动医疗系统实施后，我们观察到女性在第一次ANC就诊时开始提前;与前几年相比，2019年在妊娠中期参加第一次产前检查的妇女人数更多(P< 0.001)。 In 2019, fewer women attended their first ANC visit in the third trimester (57/277, 20.6%) than in 2015 (147/343, 42.9%). There were statistically significant associations between the ANC visit durations and the risk factors, including age (>35 years; 25.0 min, 95% CI 24.0-25.9), educational level (longer visit for women with lower than primary education and for women who attended university and shorter for women with primary school–level education; 40.7 min, 95% CI 30.2-51.3 and 25.3 min, 95% CI 24.4-26.3 vs 23.3 min, 95% CI 22.9-23.8; P=.001), experience of domestic violence during pregnancy, gravidity, parity, infectious diseases (HIV, malaria, and syphilis), and level of anemia. Statistically significant associations were observed for all quality indicator variables. We observed a statistically significant increase in the number of ANC visits per woman over time from 2015 to 2017; the number of ANC visits per woman then became stable after the third year of implementing the PANDA mHealth system. Conclusions: This study shows the potential of an mHealth system to improve the quality of ANC, change provider behavior by standardizing ANC visits, and change patient behavior by increasing the willingness to return for subsequent visits and encouraging ANC attendance early in pregnancy. As this is an exploratory study, further studies are necessary to better understand how mHealth can change behavior and identify the conditions required for behavioral changes to persist over time. %M 32673263 %R 10.2196/18543 %U https://mhealth.www.mybigtv.com/2020/7/e18543 %U https://doi.org/10.2196/18543 %U http://www.ncbi.nlm.nih.gov/pubmed/32673263