Feasibility and readiness to implement Robson classification to monitor caesarean sections in public hospitals in Myanmar: Formative research.

Autor:	Show KL; Department of Medical Research, Ministry of Health, Yangon, Myanmar.; Department of Epidemiology and Biostatistics Department, Doctor of Epidemiology and Biostatistics Program, Khon Kaen University, Khon Kaen, Thailand., Maung TM; Department of Medical Research, Ministry of Health, Yangon, Myanmar., Phyo AP; Department of Medical Research, Ministry of Health, Yangon, Myanmar., Aung KT; Department of Medical Research, Ministry of Health, Yangon, Myanmar., Ngamjarus C; Faculty of Public Health, Department of Epidemiology and Biostatistics, Khon Kaen University, Khon Kaen, Thailand., Aye NS; Independent Expert, Yangon, Myanmar., Tunçalp Ö; Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland., Betrán AP; Department of Sexual and Reproductive Health and Research, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland., Ku SK; Department of Obstetrics and Gynaecology, University of Medicine 2, Yangon, Myanmar., Lumbiganon P; Faculty of Medicine, Department of Obstetrics and Gynaecology, Khon Kaen University, Khon Kaen, Thailand., Tin KN; Department of Public Health, Maternal and Reproductive Health Division, Ministry of Health, Naypyitaw, Myanmar., Mon NO; Nassau University Medical Center, New York, New York, United States of America., Bohren MA; Gender and Women's Health Unit, Centre for Health Equity, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2023 Jan 30; Vol. 3 (1), pp. e0001388. Date of Electronic Publication: 2023 Jan 30 (Print Publication: 2023).
DOI:	10.1371/journal.pgph.0001388
Abstrakt:	Recent years have demonstrated an increase in caesarean section (CS) in most countries worldwide with considerable concern for the potential consequences. In 2015, WHO proposed the use of Robson classification as a global standard for assessing, monitoring and comparing CS rates. Currently, there is no standardized method to assess CS in Myanmar. The aim of this study was to explore health provider's perceptions about the feasibility, acceptability and readiness to implement the Robson classification in public hospitals across Myanmar. Ten maternities were purposively chosen, including all five teaching hospitals (tertiary referral hospital-level) affiliated to each medical university in Myanmar, which provide maternal and newborn care services, and district/township hospitals. Face-to-face in-depth interviews (IDI) with healthcare providers and facility administrators were conducted using semi-structured discussion guides. Facility and medical records systems were also assessed. We used the thematic analysis approach and Atlas.ti qualitative analysis software. A total of 67 IDIs were conducted. Most participants had willingness to implement Robson classification if there were sufficient human resources and training. Limited human resources, heavy workloads, and infrastructure resources were the major challenges described that may hinder implementation. The focal person for data entry, analysis, or reporting could be differed according to the level of facility, availability of human resources, and ability to understand medical terms and statistics. The respondents mentioned the important role of policy enforcement for the sustainability of data collection, interpretation and feedback. The optimal review interval period could therefore differ according to the availability of responsible persons, and the number of births. However, setting a fixed schedule according to the specific hospital for continuous monitoring of CS rate is required. In Myanmar, implementation of Robson classification is feasible while key barriers mainly related to human resource and training must be addressed to sustain. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Show et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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