KOVID-19 U TRUDNOĆI: PUTEVI ZDRAVSTVENE ZAŠTITE I IZAZOVI ZDRAVSTVENOG SISTEMA U KAZAHSTANU – KVALITATIVNA STUDIJA
Sažetak
Uvod: Međunarodne studije sprovedene tokom KOVID-19 pandemije pokazale su da su trudnice često nailazile na značajne prepreke u ostvarivanju blagovremene i adekvatne zdravstvene zaštite. Međutim, veliki deo postojećih dokaza potiče iz kvantitativnog nadzora ili iz okruženja sa dobro uspostavljenom digitalnom infrastrukturom i standardizovanim kliničkim protokolima, što možda ne odražava realnost mnogih zdravstvenih sistema u zemljama sa srednjim dohotkom. Cilj ove studije je da se kvalitativno istraže iskustva trudnica i zdravstvenih radnika u vezi sa putevima zdravstvene zaštite kod KOVID-19 oboljenja, uključujući prepoznavanje simptoma, ambulantno lečenje i hospitalizaciju, u gradu Almatiju, u Kazahstanu.
Metode: U ovoj studiji je primenjen kvalitativni, deskriptivni, fenomenološki dizajn kako bi se istražila iskustva trudnica obolelih od KOVID-19 oboljenja i zdravstvenih radnika u domenu organizacije zdravstvene zaštite tokom pandemije. U studiju je uključeno 24 učesnika iz lokalnih domova zdravlja i bolničkih ustanova u gradu Almatiju, u Kazahstanu. Petnaest zdravstvenih radnika i devet trudnica, odnosno porodilja dobrovoljno i anonimno je dalo informisani pristanak za detaljne polustrukturisane intervjue, bilo uživo ili putem konferencijskog video poziva sa bezbednom vezom, u periodu od maja do avgusta 2023. godine.
Rezultati: Zdravstveni radnici su izvestili da je KOVID-19 pandemija značajno izmenila zdravstvenu zaštitu trudnica i porodilja zbog povećanog obima posla, straha od infekcije i prelaska na daljinsku zdravstvenu zaštitu. Neizvesnost u vezi sa kliničkim smernicama specifičnim za trudnoću i standardnim operativnim procedurama (SOP) doprinela je tome da se zdravstveni radnici oslanjanju na opšte protokole i neformalne prakse, dok je odložena hospitalizacija bila povezana sa poricanjem simptoma, strahom od prijema u bolnicu, samolečenjem i sistemskim ograničenjima. Trudnice i porodilje su često pogrešno tumačile KOVID-19 simptome kao simptome povezane sa trudnoćom ili kao znake blagog oblika bolesti, što je dovelo do samolečenja i odlaganja traženja pomoći. Lekarsko praćenje je u velikoj meri bilo nestrukturirano i zasnovano na komunikaciji putem telefona ili poruka. Iskustvo u ostvarenoj zdravstvenoj zaštiti je variralo, od blagovremene kliničke podrške do nedoslednog nadzora i davanja prednosti kućnom lečenju.
Zaključak: Studija pruža detaljan uvid u krhki i fragmentirani put zdravstvene zaštite trudnica obolelih od KOVID-19 u sklopu primarne i bolničke zdravstvene zaštite u Almatiju. Nekoliko prioriteta za jačanje organizacije zdravstvene zaštite za trudnice obolele od KOVID-19 i za buduće javnozdravstvene vanredne situacije uključuju poboljšanje kontinuiteta zdravstvene zaštite, smanjenje kašnjenja u eskaliranju zdravstvene zaštite i unapređenje bezbednosti zdravstvenih usluga za trudnice i porodilje tokom izbijanja zaraznih bolesti.
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