TAP CHi NGHIEN CU'U Y HQC '
Hanoi City from November, 2011 to April, 2012. Results Our data showed that children of over- weight parents had a greater risk of becoming obese than lean parents. School children having one ovenweight parents or both overweight parents were 3.5 and 6.7 times more likely to be overweight themselves than children with normal weight parents We also identified that greedy, fast eating, over eating, and extra meals were some of the risk factors of these ovemveight school children Over eating is the greatest risk factor that contributed to 6 0 times more nsk of being ovenweighl, followed by fast eating {3 8 times), extra meals (2 9 limes), and greedy for food (2 5 times) Extra consumption of high fat content food (2 2 times), sugary food (2,6 times), and less consumption of vegetables and fruit (2 0 time) also contnbuted to children obesity Regular physical activity reduced the risk of overweight and obesity School children with less physical activ- ity had 2.1 time higher risk of overweight and obesity than children with regular physical activity Keywords: Risk of overweight and obesity, school children, food intake and physical activity
KI^N THU'C, THLTC HANH CHAM SOC TRONG VA SAU SINH CUA CAC BA ME CO CON N H 6 DU'ai 2 TU6l
TAI TiNH BO L! KHAM XAY, LAO 2010
K h a m p h a n h P r a b o u a s o n e \ Ngo Van T o a n ^ Le Anh T u a n ^ Biii Van Nhcn^
'Oai hoc Y Khoa Lao, ^ Trudng Dei hoc YHa Ndi. ^Benh vien Phu san Trung wong Nghien ciru dwoc thwc bien nhdm md td kidn thirc va thwc hdnh cham sdc trong va sau sinh cua cdc ba me cd con nhd dwdi 2 tuoi tai tinh Bo Lj Khdm Xay. Lao nam 2010 Kdt qua cho thdy kidn thirc chdm sdc trong vd sau sinh cdn thdp ty 1$ bd me bidt vd cdc ddu hidu nguy hidm xay ra trong vd sau sinh thap.
khoang 1/2 sd bd me khong bidt ddu hidu nguy hidm cd the xay ra trong va sau smh. 59.0% bd me cd kidn thirc ve cho tre bu ldn ddu tien tn^ng vdng mdt gid sau sinh Thwc hanh chdm sdc trong va sau smh chua tdt:
54.7% bd me smh con t$i ca sd y id. 56,3% bd me dwoc nhan vien yteddde trong idnsinh vira qua. 56.1%
ba me cho tre bu ldn dau tien trong vdng 1 gid ddu ngay sau smh vd ch! cd 25.3% bd me di khdm l$i trong vong 42 ngdy sau sinh kidn thirc vd thwc hdnh chdm sdc Irong vd sau sinh cua cac ba me cdn chwa tdt.
TCr khoa: cham soc trong sinh, chcim soc sau sinh, dSu hi^u nguy hi4m, kham lai sau sinh, bu \dn 6du tien
I. DAT V A N D ^ todn khde manh trong suot thdi gian mang thai, trong khi sinh va sau sinh Theo To chirc Lam me an loan la tat ca phu ntr deu du'oc
nhdn sy cham sde can thiel de du'oe hodn
Dia Chilian h$. Khamphanh Prabouasone . Khoa Y t6
Y te Thd gidi, de dam bao an toan cho me va eon trong qua trinh mang thai, chuyen da va sau sinh, phu nu phai du'oc can bd y te ed trinh do chuyen mdn eham sdc vd theo ddi.
cong cdng. Bai hoc Y Khoa Lao . „ , .. , : , , , ,
r- , ,K u Lir,««^ u ^^c tinh moi nam cd khoanq 585 000 phu nu Email- khamphanh2000@yahoo com ^ " " " ^^ "
Ngay nhdn 25/11/2012 tli vong CO Nen quan den thai nghdn va smh Ngay duoc chdp thuan 26/04/2013 de [1]. Tai Lao, ty Id tir vong cua Ire em du'di 166 , TCNCYH 82 (2)-2013
- TAP CHI NGHIEN CU'U Y HOC mot tuoi trong nam 2007 la 72/1000 tre de
song cao hon nhieu so vdi cac nuoe trong Khu vyc Ddng Nam A va tren the gioi, ty le li> vong me rdt eao vdi 405/100 000 tre de s6ng 12]
Nguyen nhan chii yeu la do tmh trang sue khoe ba me kem trong qua trmh mang thai va cac bien chirng cd lien quan den thai nghen, sinh ae va sau smh, dac biel la do cac bien chiing, lai bien san khoa xay ra trong chuyen da va sau smh H l u het cac tru'dng hop tir vong me vd con nay deu cd the tranh du'O'c b^ng each cham soc sue khoe toan didn cho iM ca cac ba me trong qua trinh thai nghen, aac biet la cham soc theo ddi tot cho cac ba me trong chuyen da va sau khi smh [1] Oe thuc hien tot dieu nay thi kien thu'c va thuc hanh cCia cac ba me ve cham soc trong smh va sau smh co mot vai tro rat quan trong Chinh VI nhu'ng ly do tren nghien CLTU nay flwac thyc hien nh^m md ta kien thu'c va thuc hanh cham soc trong va sau sinh cua cac ba meco con nhd duoi 2 tuoi tai tinh Bo Li Kham Xay, Lao nam 2010
II. D 6 | T U g N G VA P H U a N G PHAP
I.Dja diem nghien CLFUBo Ll Kham Xay la mdt tinh thuoc vung duyen hai B i c Nam Bd cua Lao, co quoc 16 13 chay qua Tinh co 6 don vi hanh chinh vo'i 64% dien tich la doi nui va 34% la dong bang Pak Xan la mdt huyen dong bang va Kham Kot la mdt huyen midn nui, nam giu'a 2 huyen nay la huyen Pakkadmg
2. Doi tu'O'ng
NhO'ng ba me dang nuoi con nho du'oi 24 thang tuoi tai 2 huyen Pak Xan va Kham Kot cua tinh Bo Li Kham Xay, Lao nam 2010
3. Phu'O'ng phap
'Thietke nghien CIJ'U: Da^^ la mot nghien
CU'U mo ta cat ngang nham mo ta kien thi>c va thu'c hanh cham sdc trong va sau smh cua cac ba me tai tinh Bo Li Kham Xay, Lao nam 2010
* Ca miu nghien ciru:
-1.7, X p q d^
Trong do
n CO' mau toi thieu, Zj,.,,;?) he sd tin cay {VO'I do tm cay 95% thi Z = 1,96), p ty le ba me dl kham lai sau smh trong vong 7 ngay a ca so y te tai Bangladesh = 10,0% [3], d do chinh xac mong muon (chon d = 2%)
C d mau tinh duoc la n = 865, trong nghien CU'U nay da tien hanh phong van duo'c 869 ba me
* Chpn mau nghten ciru: Ap dung ky thuat chon m i u nhieu bac bac 1 chon chu dich 2 huyen Pak Xan va Kham Kat thudc tinh Bo Ll Kham Xay, bac 2 chgn 18 xa tai 2 huyen, bac 3 m6i xa chon ngau nhien 5 thdn, bac 4 chon ngdu nhien do'n tai moi thdn theo danh sach da duoe lap tuy thude vao sd luo'ng cac ba me co con nho duoi 2 tuoi trong moi thon
Cdng cu nghien ciru. Bo cdng cu nghien cuu du'oc thiet ke theo huong dan chuan ve lam me an toan cua Quy Dan so Lien hop quoc. To chuc Y te The gioi va da duoc chuan hoa tai Lao
' Dao dire nghien cwu nghien cuu da thong qua uy ban dao due trong nghien cu'u quocgia va Bo Y t e Lao s6 313/NECHR
III. KET QUA
1 - Mot s d dae tru-ng ca nhan Oa sd ba me a do tuoi 20 - 29, chiem 61,6% Tudi trung bmh ciia cac ba me tham gia nghien eu'u la 27,1 • 5,9 tuoi Trong do ba me cd tuoi thap nhat la 16, tuoi cao nhat la 47
TCNCYH 82 (2)-2013 167
TAP CHi NGHlfiN CIJU Y HQC
Ty 10 bS me ngu'i'i Lcio LCjm chi6m da s6 Id 85,5%, cbn l^i 14 ngu'di dan tOc MOng, Khs Mu Mi dan 16c khac chi^m ty 1$ 14,5%. Kk q u i cung cho th^y c6 > 1/2 s6 ba me s6ng 6- viing mi6n niii, chi6m ty la 51,3%, ty l# ba me s i n g vijng a6ng bang la 48,7% H^u li^t cac ba me nbi thanh th?o tidng Lao, chidm ty le 89.6%, c6n 1^1 10.4% ba me ngu'di dan tOc n6i kh6 khan hoac khflng ndi di^p'c tidng Lao
Ph^n Idn cac ba me m d i hoc het tieu hoc va trung hpc co- s d , chiem ty 10 7 9 , 1 % . C6 8,5% ba me cd trinh do hpc van tCJ trung hoc pho thdng t r d I6n. Ty la mu chO a oac ba me la 12,4%. Da s6 cac ba me tham gia nghiSn CU'U ddu iam ndng nghidp. chiem ty 1$ 8 1 , 1 % Cdn lai cac ba me iam nghd khac chidm ty 10 18,9%. bao gdm ndi tro, budn ban. can bd va cdng nhan.
Kidn t h u x Cham s d c t r o n g s i n h va sau s i n h cua cac ba m e
B i n g 1 . K i i n thu'c v d d j u h i e u n g u y h i d m k h i c h u y d n da c u a ba m ?
Kidn thu'c ve dau hi0u n g u y
Ngdi thai bat thudng Sa day rau
h i d m kh
Rau khong ra trong vdng 30 phut khi sii Dau bungler ddi
Chay nhidu mau nhidu
set
Dau ddu. m d mat. CO giat Ngdt xiu
i chl
i h j y d n da -
Bidt Tdn s d
242 111 20 31 154
34 86 62
%
27,9 12,8 2.3 3.6 17.7 3.9 9.9 7,1
K h o n g T j n s d
627 758 849 838 715 835 783 807
bidt
%
72,1 87.2 97.7 96.4 82,3 9 6 1 90.1 92,9
Ket qua eho thdy cde bd me biet ve dau hidu nguy hiem khi chuyen dg Id ngdi thai bat thu'dng chidm ty Id eao nhat {27,9%), tiep den la chay mdu nhieu (17,7%), sa ddy rau (12,8%) vd dau dau, m d mat, co gigt (9,9%) Cdc bd me biet dau hieu nguy hiem kh^c xay ra khi chuyen da chiem ty Id thap
Ket qua eung eho th^y, 42,2% bd me biet 1 - 2 dau hidu nguy hiem vd 9,3% bd m? bidl tir 3 dau hieu nguy hiem trd ldn xay ra doi vdi san phy trong khi chuyen da Tuy nhien v i n edn 48,5%
b^ me khdng biet bat ky dau hidu nguy hiem nao xay ra trong chuyen da
<y bang 2 eho lhay kel qua eho th^y ba me biel ve dau hidu nguy hiem sau sinh Id ehay mdu nhidu chiem ty id cao nhat (33,0%); tiep ddn la dau bung keo dai va tang len (10,7%), ngdt/cogiat (8,6%) Cdc bd me biel vd ede dau hi$u nguy hiem khae ehidm ly Id thdp
Kdl qua cung eho thay ly le bd me bidl it nhdi 3 ddu hi^u nguy hiem xay ra sau sinh ehiem 8 , 1 % Cde bd me biel 1 - 2 d^u hidu nguy hiem xay ra sau smh chidm ty id 35,6%. Tuy nhidn edn 56,3%p bd me khdng biet bat ky mdt dau hieu nguy hiem ndo cd the xay ra sau khi sinh
TCNCYH 82 (2)-2013
- t i J P C H T N G H l i N CCPU Y HQC Bang 2. Kidn thi^c vd ddu h i i u nguy hidm sau khi s i n h cua ba me
Kiln thtk: vd ddu hieu nguy hidm s khi sinh Chay nhleu mau Ra dich am dao cd mCii hdi Sot cao kdo dai Dau bung keo dai, tang lan Phu mat, tay. chan Dau ddu Ngdt/co giat
Bang 3. Kidr Kien thi>c vd nudi con
au Bidt
Tdn sd 287
9 27 93 59 41 75
1 thti'C vd nudi con bdng sOa me l^u diem cua vide cho tre bu me sdm sau
Tre khoe manh
Tang cudng tinh cam gdn bo giu£
Phong chay mau sau smh cho ba Khdng bidt
1 me me
smh
va con
%
33,0 1.0 3.1 10.7
6,8 4,7 8.6
bdng sira
Khdng bidt Tdn s6
582 860 842 776 810 828 794
me Tdn sd
640 346 205 39
%
67,0 99.0 96.9 89.3 93,2 96,3 91,4
%
73.7 40.1 23.6 4.5 Kidn thirc vd thdi gian cho tre bu lan ddu tien sau sinh
Trong vdng 30 phOt Tu' 30 phut ddn 1 gid Trong vdng ngay dau sau sinh Mudn hdn (> 1 ngay sau sinh) Khdng bidt
175 338 284 67
5
20.1 38.9 32,7 7,7 0.6 Phdn Idn ba me ddu bidt uu diem cua viSc cho tre bu me sdm sau sinh se giup cho tre khoe manh (73,7%) Ty le ba me biet cho tre bu sdm sau smh lam tang cu'ong tinh cam gdn bd giOa me »a con chidm 40.1 % Cd 23,6% ba me cho rdng cho tre bu sdm sau sinh se phdng duoc chay mail sau smh doi vdl cac ba me BSn canh dd. vdn cdn 4,5% ba me khdng biet vd loi Ich cua cho tre bij sdm.
Ket qua cho thdy, ty 16 ba me cd kidn thuc cho tre bu Idn ddu tidn trong vdng ngay ddu sau smh la 91,7% Trong dd, cd 59.0% ba me cd kidn thuc ve cho tre bu Idn dau tien trong vdng mdt g * sau sinh.
TCNCYH 82 (2)-2013
TAP CHi NGHIEN CLPU Y HQC '—
3. Thi^c hdnh chdm sdc trong sinh Vci sau sinh cua cdc ba m^
Bdng 4. T h v c hdnh vh chpn n c i sinh vd ngu'd'i dd* de cho cdc bd me
Th^^c hanh T d n s d
%
N O I smh con cua cac ba me Tai nha
C o s d y td nha n u d c C d s d y td t u nhan
394 473 2
45,3 64,6 0,2 Ngudi d d dd cho ba me trong ldn sinh vua qua
Nhan vl6n y td Mu v u d n
Ngudl khac {me, chong, ban bd..,)
489 118 262
56,3 13,6 30,1 Ket qua cho lhay da so bd me da sinh eon tai co sd" y te chidm ty Id 54,7%; irong do hau het Id sinh con lai eo so y te nhd nu-dc (54,5%), chi cd 0,2% bd me smh eon tai y le tu' nhdn Ty Id bd me sinh eon tai nha cdn cao chidm 45,3%
Da sd cdc ba me da du'oe ede nhan vidn y te d d de trong lan sinh vira qua ehidm ly Id 56,3%
Ty id bd me du'oe mu vu'dn d d de Id 13,6% Tuy nhien, cdn ly Id tdn bd me du-oc ngu'di khdc dd de (nhu' me, ehong, ban bd ), chidm 3 0 , 1 %
Bang 5. Thirc hanh cho tre bu ldn ddu tien cua cdc ba me T h y c hanh cho tre bu ldn
Trong vdng 30 phut ngay sau sinh T u 30 phut den 1 gid Trong ngay dau (sau gid ddu tidn) Trong ngay thd 2 sau sinh
Khdng cho tre bu ldn dau tidn ngay sau s ddu tien
inh
Tdn sd 196 293 287 43 5 1 .
%
22,4 33,7 33,8 4,9 6.0 Ket qua cho thdy hau hdt cac ba me ddu cho tre bu Idn ddu tiSn trong vdng ngay ddu sau smh, chidm ty 10 8 9 , 1 % , trong dd ty IS ba me cho tre bu lan ddu tiSn trong vdng 1 gid dau ngay sau smh la 5 6 , 1 % Cd 4,9% ba me cho tre bu Idn dau tiSn trong ngay t h u 2 sau smh Tuy nhiSn, cdn 6.0% ba me khdng cho tre bu lan dau tiSn ngay sau smh
Kdt qua cho thdy ty 10 ba me di kham lai trong vdng 42 ngay sau sinh la 25,3%. Trong dd, da so cac ba me ddu d u p c can bd y td chSm sdc sau smh chidm ty IS 82,7%, od 16,8% ba me dupc ba mu v u d n cham sdc sau sinh va 0,5% ba me d u o c nhSn viSn y td thdn/ban chSm sdc Trong sd cac ba me dl kham lai sau smh thi da so ba me di kham trong vdng 7 ngay ddu sau smh chidm ty
TCNCYH 82 (2) - 2013
• TJfliP CHi NGHIEN CCPU Y HQC 1$ 68,6%, tidp den la ty Id bd m? di khdm lai trong vdng 8 - 28 ngdy sau sinh vdi 25,5% vd cd 5,9% bd me di khdm lgi trong vdng 29 - 42 ngdy sau sinh (bang 6),
Bdng 6. Thi^c hdnh c h d m sdc sau sinh cua cdc bd m ^
TIILK: hdnh khdm 1^1 sau sinh
Tdnsd %
ea me kham lel sau smh (n = 869) Oa dl kham lai sau sinh Khdng di kham lai
220 649
25,3 74,7 Ngifdi Cham sdc cho cac ba me sau smh (n = 220)
can bd y td Nhan vidn y te thdn/ban Ba mu vudn
182 1 37
82,7 0,5 16,8 Thdi gian ba me di kham lai sau smh {n = 220)
Trong vdng 7 ngay Trong vdng 8 - 28 ngay Trong vdng 29 - 42 ngay
151 56 13
68,6 25,5 5,9
IV. BAN LUAN
Chuyen da Id mdt qud trinh quan trong Qud trinh nay rdt de xay ra eae lai bien eho ea me va thai nhi Vi vdy, bd me can du'o'c theo doi chuydn da tai ccr s o y le de du'oe ehdm sdc chu dao nhdm han ehd toi da ede bien eo nhir ehay mdu, sa ddy rau, v d 6i sdm, kidl sifc khi chuyen da . S y hidu biet ve cdc dau hi§u nguy hiem xay ra vdi ngu'di me trong qua trinh chuyen da td rat quan trpng, giup phal hign sdm vd kip thdi xi> tri cdc ddu hidu nguy hiem cd the xay ra, trdnh nhirng hdu qua ddng ti^c cho me vd con, Kdl qua nghidn eiru eho thay cd 9,3% bd me bidt tCr 3 dau hidu nguy hiem trd ldn xay ra doi vdi san phy trong khi chuyen da, eao hon so vdi kdt qua didu Ira vd thu-c trang eung edp dich vy vd chdm sde sire khoe tai 7 tmh do UNFPA tidn hdnh vdo ndm 2005 tai Viet Nam vdi 7,9% nam gidi vd 4,7%
m gidi biel l i i 3 ddu hidu nguy hiem tro len [4]. Tuy nhidn, nghidn ciru cung ehi ra rdng cd 48,5% bd me khdng bidt bat ky'dau hidu nguy hiem nao xay ra trong chuyen da, eao hon so vdi nghien eCru cua UNFPA lai Vidt Nam ndm 2005 vdi ty le nay a nam gidi Id 44,3%, nu' gidi Id 33,7% [4]. Va kel qua ndy cao han bao eao didu tra eo ban vd chu'cng trinh lu- vong me vd tCr vong so smh vdi ly le 41,9% phu nCr khdng bidl bdt ky mdt ddu hieu nguy hidm ndo khi chuyen da [5] Mdc dCi ty id edc bd me bidt lir 3 ddu hidu trd len cao hon mdt so nghidn eiru nhu'ng sd bd me khdng bidt bdt ky dau hieu nguy hiem ndo trong nghidn eiru ndy cdn rat eao (chidm gan 1/2 so bd me). Vi vdy, cdn cd nhOng bidn phap can thidp cd hieu qua de trang bi ede kidn thirc co ban ve ddu hieu nguy hiem trong chuyen da cho cac ba me Qua do giiip cdc ba me ed the tu' nhdn bidt
TCNCYH 82 (2) - 2013
TfiP CHl NGHIEN CLKU Y HQC
sdm du'p'c mdt s6 dau hidu nguy hidm ed Ihd xay ra, gdp phdn hgn ehd tdi da edc lai bidn doi vdl bd me vd thai nhi trong khi ehuydn dg Kdl qud eOng cho thdy ddu hi§u nguy hidm khi chuydn dg md nhidu bd me bidt ddn Id ngdi thai bdt thu'dng chidm ty Id cao nhdt (27,9%);
liep ddn Id ehdy mdu nhidu (17,7%), sa ddy rau (12,8%) vd dau ddu, m d mdt, co gidt (9,9%). Trong khi dd ty 1$ edc bd m? bidt ddu hidu nguy hidm khdc xay ra khi chuydn dg chidm ty Id rat thap Didu dd cho thdy, kidn thire eua edc bd me vd tirng ddu hi$u nguy hidm xay ra trong ehuydn da cdn rat Ihap Ddc bidt, chi cd 17,7% bd me bidt ehay mdu nhidu Id mdt trong nhO'ng dau hidu nguy hidm khi ehuydn da, trong khi ddy chinh Id nguydn nhdn hang dau dan den lu' vong me trong khi smh Ty Id nay thdp hon nhieu so vdi mdt s6 nghien eiru a nuac ngodi nhu"' Mesay Hailu vd edng sir nghidn eiru lai midn Nam Ethiopia ndm 2010 thi ty le nay Id 55,0% [6], theo Warren C va Liambila W nghien ciru tai Kenya nam 2004 tlii Xy le ndy Id 37,0% [7]
Cae bd me biel 1 - 2 ddu hidu nguy hidm xay ra sau sinh chidm ty Id 35,6%, thap hon so vdl nghidn eiru cua tdc gia Mesay Hailu vd cdng su' tai mien Nam Ethiopia ndm 2010 [6]
vd kdt qua bdo eao dieu tra vd thu'c trgng eung cap vd sir dung dich vu chdm sdc sire khde tai 7 tinh eua UNFPA ndm 2005 [4] Nghidn ciru ndy eho lhay ed 56,3% bd me khdng bidt bat ky mdt dau hieu nguy hidm ndo ed the xay ra sau khi sinh, eao hon rat nhidu so vdi 29,7%
theo didu Ira eua UNFPA ndm 2005. [4] vd 35,8% theo bdo cdo eua BO Y td ndm 2009 [5]. Kel qua cQng cho lhay ly 1$ ba me bidt it nhat 3 ddu hieu nguy hidm xay ra sau smh chidm 8 , 1 % , Ddu hieu nguy hiem sau sinh md bd me bidt den nhidu nhat Id chay mdu nhidu chiem 33,0%, thdp han kel qua nghien ciru tai Ethiopia (50%) vd tai 14 linh d Vidl Nam
(50,7%) [5]. Ddy Id ddu hi$u nguy hidm quan trpng nhdt trong giai doan sau sinh vd Id nguydn nhdn ddn den khoang 30% tu vong me trdn todn thd gidi [6]. Trong khi dd, cdc bd me bidt vd cdc ddu hi$u nguy hidm khdc ehidm ty 1$ thdp. Qua dd cho lhay, kidn thire vd cde ddu hidu nguy hidm sau sinh eua edc bd me cdn thdp Vi vdy rat can nhCi-ng chuang trinh can thidp cd hidu qua dd giilp ndng eao nhdn thire eho edc bd me ve van dd ndy. Can tndn khai edc c h i r a n g trinh gido dye sire khoe sinh san nhdm ndng cao kidn thirc vd thye hdnh cua cde bd me vd cdc dau hi$u nguy hidm nghidm trgng ed the xdy ra sau sinh ket ho'p vd'i ehdm sdc tru'd'c vd Irong smh. Tir dd giiip hp cd the phdt hidn s d m cdc bidn ed bat lt?i vd ed du'OC thu'c hdnh tot trong chdm sdc sire khde me vd con-
Da so bd me deu ed kidn thire vd Ihu'c hdnh tdt vd cho tre bii ldn dau lien trong vdng ngdy dau sau sinh (kidn thirc* 91,7% vd Ihuc hdnh 89,1%) Tuy nhien, kidn thire vd thu-c hdnh vd cho tre bii tan ddu tien trong vdng 1 gid sau smh cdn chu'a tdt, chi cd 59,0% bd me c6 kidn thire vd 5 6 , 1 % bd me cd thyc hdnh dung vd van dd ndy; tu'ang lu' kdl qua nghidn ciru lai Quang Tri ndm 2002 [8] vd bdo cdo cua UNFPA vd nghidn eiru sire khde sinh san tai Vidt Nam giai doan 2000 - 2005 [9] Ty le bd me bidl u'u diem cua vide eho tre bii me s d m sau smh cdn ehu-a cao. 73,7% bd me biel cho Ire bii s d m se giiip eho tre khde mgnh (73,7%), 4 0 , 1 % giiip tang cu'ong linh cam gdn bd giO'a me vd con, 23,6% phdng du'p'c chay mdu sau smh ddi vdi bd'me Bdn canh dd, v i n cdn 4,5% ba me khdng bidt vd lo'i ich cua cho Ire bii s d m . Vi vdy, can lidn hdnh cdc hogt dpng can thidp lap trung nang eao hidu bidt eua bd me ve vide eho Ire bu s d m trong vdng 1 gid sau smh, tuyen truydn cho cde bd me bidt ve U'U diem cua viec tre bu sd'm nggy
TCNCYH 82 (2) - 2013
trong vdng 1 gid sau sinh nhu" cung edp cdc y6u td midn dich cd trong sira non cho Ire, giup tip cung san phu eo tdl, tdng moi quan he me con. . Tir dd giiip tdng cu-dng sire khoe cua tre, eOng nhu- cua cdc bd me.
Kel qua cho thay ty 1$ bd me dd sinh con tai ca sd y te chidm 54,7%, trong dd hau hdt la smh con tai ea s d y le nhd nu'dc (54,5%) Kel qua ngdy thap han kdl qua nghidn ciru cua UNFPA tldn hdnh tai Vidt Nam cho thay ly
\t ba me sinh eon lai ea s d y id nhd nirdc Id 81,7% (ndm 2003) vd 88,2% (ndm 2005) [4].
Hi$n nay, lai da so qude gia trdn thd gidi sinh con d lai ea sd y td hidn trd thdnh lira chon ph6 bien, vi day Id nai cd du cde trang thidt bi y id can thidt va ddi ngu can bd y id cd du trinh dd de ehdm sde lot nhdt cho sire khde cua bd me eung nhu' cua thai nhi. Tuy nhien, ty lg ba me sinh eon lai nha trong nghien ciru n^yeon eao, ehiem 45,3% Ddng thdi, kdt qua cung cho thdy ehi cd 56,3% bd me da du'oe cac nhdn vidn y id d d de trong ldn smh vCra qua, trong khi dd Xy id ba me dirac mu vu'dn as de Id 13,6% vd cdn ly le Idn ba me duac ngirdi khdcdd de (nhu" me, ehdng, ban be ), chi^m 30,1% Nguyen nhan ehu yeu Id do hieu b\k. kidn thirc eua ngu'di dan lai Lao vd vdn fle nay edn thdp, mat khde ed the do cde ca sa y te tai ddy chu'a dap irng du-ae nhu eau cua ngudi dan, Vi vay cdn giao due nang eao kiln thirc cho ngu'di ddn, eung nhu' xay du'ng he thdng ea s d y id dd ddp irng nhu cau dich vu cham sde sire khoe smh san cho ngu'di dan lai dia phu'ang
Kham sau sinh ed vai trd rdt quan trong, giiJp theo ddi ehdl che vd cham soc san phu nhim phal hien sdm nhu'ng bat thu'dng cua ca san phu vd sa sinh, dong thdi giiip cdp ciru sorn cac lai bidn san khoa (ndu cd xay ra), Kdt (lua nghien ciru ndy cho thdy ty le bd me di l<ham lai trong vdng 42 ngay sau sinh la
TAP CHi NGHIEN CCKU Y HpC 25,3%, thdp han so vdi mdt so nghidn ciru tai Palestin Id 36,6% [10], tai Nepal la 34% [11], lai Bangladesh Id 28% [3] vd thap han so vdi kdt qua bdo cdo ve chdm sdc sire khde sinh san tai Vidt Nam giai doan 2000 - 2005 [9] Vi vdy, cdn ed cdc bien phdp nhdm ndng cao kien thirc eho ede bd me lai Ldo vd tam quan Irong eua di khdm lai sau smh trong vdng 42 ngdy, de tCr dd giup hp cd Ihuc hdnh dung trong viec theo dfii vd ehdm sdc sire khde eiia ban thdn minh sau khi sinh, qua do gop phdn ndng cao sire khde eua bd me vd con ciia ho, han chd nhirng lai bien ed the xay ra V. K^T LUAN
Kidn thire vd chdm soe trong vd sau sinh ciia cdc ba me cdn thdp: ty Id bd me biet ve eae dau hieu nguy hiem xay ra trong va sau sinh thdp, khoang 1/2 sd ba me khdng bidt bdt ky ddu hieu nguy hiem nao cd the xay ra trong va sau smh (trong sinh la 48,5% va sau smh la 56,3%), chi cd 59,0% bd me cd kidn thirc vd cho tre bii ldn ddu lien trong vong mdt gid sau smh
Thu'c hdnh vd chdm sdc trong vd sau sinh cua ede ba me ehua tdt 54,7% ba me smh con tai ea sd y td, 56,3% bd me duae nhan Vidn y td d d de trong ldn sinh vCra qua, 56,1%
ba me eho tre bii lan dau tien trong vdng 1 gid ddu ngay sau smh va ehi cd 25,3% ba me di kham lai trong vong 42 ngay sau sinh
TAI LIEU THAM KHAO
1. Khan N . C , Khalid S (2006). WHO Analysis of Causes of Maternal Deaths' A Systematic Revievi/ The Lancet, 367(9516), 1 0 6 6 - 1 0 7 4
2. Mother and child health care centre (2008). Report of statistics and health situation of mother and child health in Lao, Vientiane
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TAP CHi NGHIEN CLFU Y HQC
3. Anwar I S.M., Akhtar N., Chowdhury M.E., Salma U et al (2008). Inequity in mater- nal health-care services, evidence from home - based skilled - birth - attendant programmes in Bangladesh Bull World Health Organ. 86 (4), 252 - 259,
4. UNFPA (2006). Bdo cdo didu tra ban ddu thye trgng cung edp vd sir dyng d|ch vy CSSKSS tgi 7 tinh tham gia Chu'ong trinh Qude gia 7 do UNFPA tdi trp Hd NOi
5. B$ Y td (2009). Bdo cdo ket qua didu tra ca ban Chirang trinh giam tir vong me vd tCr vong sa smh lgi 14 tinh d y dn Hd N0i, 9 - 24
6. Mesay H., Abebe G., Fessahaye A.
(2010). Knowledge about obstetric danger signs among pregnant women in Aleta Wondo district, Sidama Zone, Southern Ethiopia Ethiop J Health Set, 20(1). 25 - 32
7. Warren C , Liambila W.
(2004). Approaches lo providing quality mater- nal care in Kenya, Safe motherhood demon- stration project, western province Nairobi,
Kenya. Ministry of Health, Kenya and Univer- sity of Nairobi.
8. Quyen B.T. (2003). Maternal and Child Health Care Practices among Mothers of un- der 2 Years Children and Related Factors in DaKrong and Huong Hoa, Quang Tn 2002.
Hanoi School of Public Health thesis.
9. UNFPA (2007). Nghien eiru vd sire khde sinh san tai Vidt Nam Bdo cdo rd sodt cdc nghidn ciru giai doan 2000 - 2005 Hd NOi, 9 - 15
10. Dhaher E., Mikolajczyk R.T., Maxwell A.E et al (2007). Factors associated with lack of postnatal care among Palestinian women a cross-seetional study of three clinics in the West Bank BMC Pregnancy Childbirth, 7(19), 180
11. Ohakal S., Chapman G.N., Simkhada P.P. et al (2007). Utilisation of postnatal eare among rural women in Nepal BMC Pregnancy Childbirth, 7(19), 138.
Summary
STUDIES ON THE INTRAPATRUM AND POSTNATAL CARES KNOWLEDGE AND PRACTICES IN MOTHERS IN BOLIKHAMXA!
PROVINCE, LAO
The study was earned out in Bolikhamxai province, Lao in 2010 to investigate the data on the knowledge and practices on the inlrapatrum and postnatal care in Laotian mothers with children under 2 years old Results: Our data showed that Laotian mothers in Bolikhamxai province had low understanding and knowledge about inlrapatrum and postnatal care for their children Most of these mothers did not understand the danger signs occurred during labor and after delivery Only 59% of the mothers knew about first breastfeeding lime within the 1^' hour of birth Many mother knew about the practices of inlrapatrum and postnatal care Only 54 7% of the mothers gave birth in a health facilities, 56.3% of the mothers received help by the healthcare stuffs, 56 1 % of the mothers breastfeed their babies the first lime within the first of of birth, and 25 3%i of the mothers came back for a check-up within 42 days after giving birth Conclusions Most mothers in Bolik- hamxai province, Lao did nol understand inlrapatrum and postnatal cares to to take care of their children and themselves property
Keyworks: intrapatrum care, postnatal care, danger signs, re-examination after birth, the first breastfeeding
TCNCYH 82 (2) - 2013
