Sharma Sharad Kumar, Sawangdee Yothin, Sirirassamee Buppha
Institute for Population and Social Research, Mahidol University, Thailand.
J Biosoc Sci. 2007 Sep;39(5):671-92. doi: 10.1017/S0021932007001952. Epub 2007 Mar 15.
With the objective of reducing maternal and neonatal mortality, the Safe Motherhood Program was implemented in Nepal in 1997. It was launched as a priority programme during the ninth five-year plan period, 1997-2002, with the aim of increasing women's access to health care and raising their status. This paper examines the association of access to health services and women's status with utilization of prenatal, delivery, and postnatal care during the plan period. The 1996 Nepal Family Health Survey and the 2001 Nepal Demographic and Health Survey data were pooled and the likelihood of women's using maternal health care was examined in 2001 in comparison with 1996. Multiple logistic regression analysis indicates that the utilization of maternal health services increased over the period. Programme interventions such as outreach worker's visits, radio programmes on maternal health, maternal health information disseminated through various mass media sources and raising women's status through education were able to explain the observed change in utilization. Health worker visits and educational status of women showed a large association, but radio programmes and other mass media information were only partially successful in increasing use of maternal health services. Socioeconomic and demographic variables such as household economic status, number of living children and place of residence showed stronger association with use of maternal health services then did intervention programmes.
为降低孕产妇和新生儿死亡率，尼泊尔于1997年实施了安全孕产计划。该计划作为1997 - 2002年第九个五年计划期间的重点项目启动，旨在增加妇女获得医疗保健的机会并提高其地位。本文研究了计划期间获得医疗服务和妇女地位与产前、分娩及产后护理利用情况之间的关联。对1996年尼泊尔家庭健康调查和2001年尼泊尔人口与健康调查的数据进行了汇总，并将2001年与1996年相比妇女使用孕产妇保健服务的可能性进行了考察。多元逻辑回归分析表明，在此期间孕产妇保健服务的利用率有所提高。诸如外联工作人员家访、关于孕产妇健康的广播节目、通过各种大众媒体渠道传播的孕产妇健康信息以及通过教育提高妇女地位等项目干预措施能够解释观察到的利用率变化。卫生工作者家访与妇女的教育状况显示出很强的关联性，但广播节目和其他大众媒体信息在增加孕产妇保健服务使用方面仅取得部分成功。家庭经济状况、存活子女数量和居住地点等社会经济和人口统计学变量与孕产妇保健服务使用的关联性比干预项目更强。
