Office of the MOH, Vavuniya, Sri Lanka.
Public Health Nurs. 2009 Nov-Dec;26(6):512-22. doi: 10.1111/j.1525-1446.2009.00809.x.
To assess utilization of antenatal care (ANC) and its determinants in a conflict-affected area in Northern Sri Lanka.
A cross-sectional study was conducted among pregnant mothers who had completed 36 weeks of gestation, and were admitted or referred to 2 leading hospitals in Vavuniya district.
Data were collected from 392 mothers using an interviewer-administered questionnaire.
55% of the respondents reported that their families were affected directly by conflict. Approximately 68% of mothers were registered by public health midwife (PHM) for ANC; 31.4% were registered before 12 weeks of gestation; 38.5% were visited at home by PHM; 37.8% had the first clinic visit before 12 weeks; and 90.1% made at least 4 clinic visits. The average number of antenatal visits to specialist clinics (5.34, 95%CI: 5.03-5.65) was significantly higher than field clinics (2.97, 95%CI: 2.69-3.25). On average, a pregnant woman was seen by PHM at home 1.47 times. ANC utilization was significantly poor in women whose families were affected by conflict, living in active conflict areas and urban regions, had a lower education level, and were not involved in decision making on ANC.
Provision of field antenatal clinics, early entry to ANC, and domiciliary care by PHM need improvement.
评估斯里兰卡北部受冲突影响地区的产前保健（ANC）利用情况及其决定因素。
在瓦武尼亚区的 2 家主要医院，对已完成 36 周妊娠且住院或转院的孕妇进行了横断面研究。
使用访谈式问卷从 392 位母亲那里收集数据。
55%的受访者表示其家庭受到冲突的直接影响。大约 68%的母亲由公共卫生助产士（PHM）注册接受 ANC；31.4%在 12 周前注册；38.5%由 PHM 家访；37.8%在 12 周前进行了首次就诊；90.1%至少进行了 4 次就诊。前往专科诊所的平均产前就诊次数（5.34，95%CI：5.03-5.65）明显高于到实地诊所就诊的次数（2.97，95%CI：2.69-3.25）。一般来说，孕妇在家中被 PHM 家访 1.47 次。家庭受冲突影响、生活在活跃冲突地区和城市地区、教育水平较低以及未参与 ANC 决策的妇女，其 ANC 利用率明显较低。
需要改进实地产前诊所的提供、早期进入 ANC 以及 PHM 的家访服务。
