影响孟加拉国年轻母亲产后护理利用的因素。
Factors affecting the utilisation of postpartum care among young mothers in Bangladesh.
机构信息
Department of Community and Global Health, University of Tokyo, Tokyo, Japan.
出版信息
Health Soc Care Community. 2011 Mar;19(2):138-47. doi: 10.1111/j.1365-2524.2010.00953.x. Epub 2010 Sep 29.
This article addresses the hypothesis that predisposing, enabling and need factors of households influence utilisation of postpartum care among the young mothers according to the timing and type of providers. To reach our goal Bangladesh Demographic and Health Survey of 2007 data (n = 2376) were used. Findings revealed that only one-third of the young mothers received postpartum care. Postpartum care by medically trained personnel and within the most critical period (within 48 h after delivery) was found to be very low (25.5 and 16.6%). Regarding postpartum morbidities, only one-fifth to one-half of the women reporting a complication consulted medically trained providers. Indeed, between one third and two thirds did not seek any postpartum care. The highest percentages contacting healthcare providers were for convulsions and the lowest was when the baby's hands or feet came first. The stronger influence of the mother's education and antenatal care on the utilisation of postpartum care is consistent with findings from other studies. Concern of the husband or family about pregnancy complications showed a significant and positive impact on the utilisation of postpartum care. Multivariate analysis showed that mother's age at delivery, residence, education, antenatal care, place of delivery, wealth, husband's occupation, husband's concern about pregnancy complications and mother's permission to go to a health centre alone were likely to affect utilisation of postpartum care services. The results indicate urgent needs in Bangladesh for an awareness-raising program highlighting the importance and availability of postpartum care; for strategies to improve the availability and accessibility of antenatal care services and skilled birth attendance, including focused financial support; for women's education to be given high priority; and to enable women to exercise their rights to control their freedom of movement, own health care and access to economic resources.
本文提出了一个假设,即家庭的倾向因素、促成因素和需求因素会影响年轻母亲产后护理的利用,具体表现为利用时间和提供者类型。为了实现这一目标,我们使用了 2007 年孟加拉国人口与健康调查的数据(n=2376)。研究结果显示,只有三分之一的年轻母亲接受了产后护理。调查发现,接受医学培训的人员在产后最关键的 48 小时内提供的产后护理非常低(分别为 25.5%和 16.6%)。至于产后发病情况,只有五分之一到一半报告有并发症的妇女咨询了医学培训提供者。事实上,三分之一到三分之二的人没有寻求任何产后护理。寻求医疗服务的妇女比例最高的是抽搐,比例最低的是婴儿的手或脚先出来的情况。母亲的教育和产前护理对产后护理利用的影响最强,这与其他研究的结果一致。丈夫或家庭对妊娠并发症的关注对产后护理的利用有显著的积极影响。多变量分析显示,产妇分娩时的年龄、居住地、教育程度、产前护理、分娩地点、财富、丈夫的职业、丈夫对妊娠并发症的关注以及母亲单独去卫生中心的许可都可能影响产后护理服务的利用。研究结果表明,孟加拉国迫切需要开展一项提高认识的方案,强调产后护理的重要性和可获得性;需要制定战略,提高产前护理服务和熟练接生的可及性和可获得性,包括有针对性的财政支持;需要高度重视妇女教育;并使妇女能够行使自己的权利,控制自己的行动自由、拥有自己的医疗保健和获得经济资源。