Frankenberg Elizabeth, Buttenheim Alison, Sikoki Bondan, Suriastini Wayan
Terry Sanford Institute of Public Policy, Duke University, 302 Towerview Road, RH 110, Durham, NC 27705, USA.
Stud Fam Plann. 2009 Mar;40(1):27-38. doi: 10.1111/j.1728-4465.2009.00184.x.
Data from the Indonesia Family Life Survey are used to investigate the impact of a major expansion in access to midwifery services on women's use of antenatal care and delivery assistance. Between 1991 and 1998, Indonesia trained some 50,000 midwives, placing them in poor communities that were distant from health-care centers. We analyze information from pregnancy histories to relate changes in the choices that individual women make across pregnancies to the arrival of a trained midwife in the village. We show that regardless of a woman's educational level, the placement of village midwives in communities is associated with significant increases in women's receipt of iron tablets and in their choices about care during delivery--changes that reflect their moving away from reliance on traditional birth attendants. For women with relatively low levels of education, the presence of village midwives has the additional benefit of increasing use of antenatal care during the first trimester of pregnancy. The results of the study suggest that bringing services closer to women can change their patterns of use.
印度尼西亚家庭生活调查的数据被用于研究助产服务可及性的大幅提升对女性产前护理和分娩协助使用情况的影响。1991年至1998年间，印度尼西亚培训了约5万名助产士，并将她们安置在远离医疗中心的贫困社区。我们分析了妊娠史信息，以将个体女性在不同孕期所做选择的变化与村里有经过培训的助产士的情况联系起来。我们发现，无论女性的教育水平如何，在社区安置乡村助产士都与女性铁剂的摄入量显著增加以及她们在分娩时护理选择的变化相关——这些变化反映出她们不再依赖传统接生员。对于教育水平相对较低的女性而言，乡村助产士的存在还有额外的好处，即增加了她们在怀孕头三个月对产前护理的利用。该研究结果表明，使服务更贴近女性可以改变她们的使用模式。
