Vecino-Ortiz Andrés Ignacio
Young researcher, School of Economics, Universidad del Rosario, Cl 14 No 4-69 Bogotá D.C., Colombia.
Health Policy. 2008 May;86(2-3):363-72. doi: 10.1016/j.healthpol.2007.12.002. Epub 2008 Jan 16.
In recent years, interest on researching on antenatal care issues and other health promotion and prevention interventions has increased. However, even though there is a growing interest in publishing about antenatal care use, evidence concerning which, and how socioeconomic conditions influence whether a pregnant woman demands or not antenatal consultations on the assumption that the theoretical access to this service has not entry barriers, is still limited. In order to generate this evidence, a two-stage analysis was performed with data gathered on the Demographic and Health Survey (DHS) carried out by Profamilia in Colombia during 2005. The first stage was run as a logistic regression model showing the marginal effects on the probability of attending the first visit and an ordinary least squares model was performed for the second stage accounting for the absences to antenatal consultations once at least one visit was carried out. It was found that mothers living in the Pacific Ocean region as well as young mothers seem to have a lower probability of attending the first visit but these factors are not related to the number of absences to antenatal consultation once the first visit has been achieved. The effect of health insurance was surprising because of the differing effects that the health insurers showed. Some familiar and personal conditions such as willingness to have the last children and number of previous children, demonstrated to be important in the determination of demand. The effect of mother's educational attainment was proved as important whereas the father's educational achievement was not. This paper provides some elements for policy making in order to increase the demand inducement of antenatal care, as well as stimulating research on demand for specific issues on health.
近年来，对产前护理问题以及其他健康促进与预防干预措施的研究兴趣有所增加。然而，尽管人们对发表有关产前护理利用情况的兴趣日益浓厚，但关于在假定理论上获得这项服务没有准入障碍的情况下，社会经济状况如何以及何种社会经济状况影响孕妇是否要求进行产前咨询的证据仍然有限。为了获取这方面的证据，利用2005年普罗法米利亚在哥伦比亚开展的人口与健康调查（DHS）收集的数据进行了两阶段分析。第一阶段采用逻辑回归模型展示对首次就诊概率的边际效应，第二阶段则针对至少进行过一次就诊后产前咨询的缺勤情况进行普通最小二乘法模型分析。研究发现，生活在太平洋地区的母亲以及年轻母亲首次就诊的概率似乎较低，但这些因素与首次就诊后产前咨询的缺勤次数无关。健康保险的影响令人惊讶，因为不同的健康保险公司表现出不同的影响。一些家庭和个人状况，如生育最后一个孩子的意愿和之前孩子的数量，在需求的决定因素中显示出重要性。母亲的教育程度的影响被证明是重要的，而父亲的教育成就则不然。本文为政策制定提供了一些要素，以增加产前护理的需求诱导，并促进对特定健康问题需求的研究。
