London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, UK.
Confl Health. 2011 Apr 12;5:5. doi: 10.1186/1752-1505-5-5.
Maternal mortality can be particularly high in conflict and chronic emergency settings, partly due to inaccessible maternal care. This paper examines associations of refugee-led health education, formal education, age, and parity on maternal knowledge, attitudes, and practices among reproductive-age women in refugee camps in Guinea.
Data comes from a 1999 cross-sectional survey of 444 female refugees in 23 camps. Associations of reported maternal health outcomes with exposure to health education (exposed versus unexposed), formal education (none versus some), age (adolescent versus adult), or parity (nulliparous, parous, grand multiparous), were analysed using logistic regression.
No significant differences were found in maternal knowledge or attitudes. Virtually all respondents said pregnant women should attend antenatal care and knew the importance of tetanus vaccination. Most recognised abdominal pain (75%) and headaches (24%) as maternal danger signs and recommended facility attendance for danger signs. Most had last delivered at a facility (67%), mainly for safety reasons (99%). Higher odds of facility delivery were found for those exposed to RHG health education (adjusted odds ratio 2.03, 95%CI 1.23-3.01), formally educated (adjusted OR 1.93, 95%CI 1.05-3.92), or grand multipara (adjusted OR 2.13, 95%CI 1.21-3.75). Main reasons for delivering at home were distance to a facility (94%) and privacy (55%).
Refugee-led maternal health education appeared to increase facility delivery for these refugee women. Improved knowledge of danger signs and the importance of skilled birth attendance, while vital, may be less important in chronic emergency settings than improving facility access where quality of care is acceptable.
在冲突和长期紧急情况下，孕产妇死亡率可能特别高，部分原因是孕产妇保健服务不可及。本文研究了在几内亚难民营中，以难民为主导的健康教育、正规教育、年龄和生育次数对育龄妇女的孕产妇知识、态度和实践的关联。
数据来自于 1999 年对 23 个难民营的 444 名女性难民的横断面调查。采用逻辑回归分析报告的孕产妇健康结局与接受健康教育（暴露与未暴露）、正规教育（无与有）、年龄（青少年与成年）或生育次数（初产妇、经产妇、多产妇）之间的关联。
孕产妇知识或态度方面没有显著差异。几乎所有受访者都说孕妇应参加产前护理，并且知道破伤风疫苗接种的重要性。大多数人认为腹痛（75%）和头痛（24%）是孕产妇危险信号，并建议出现危险信号时应去医疗机构就诊。大多数人最近一次分娩是在医疗机构（67%），主要是出于安全原因（99%）。接受 RHG 健康教育（调整后的优势比 2.03，95%CI 1.23-3.01）、接受过正规教育（调整后的优势比 1.93，95%CI 1.05-3.92）或多产妇（调整后的优势比 2.13，95%CI 1.21-3.75）的人更有可能在医疗机构分娩。选择在家分娩的主要原因是距离医疗机构远（94%）和隐私问题（55%）。
以难民为主导的孕产妇健康教育似乎增加了这些难民妇女在医疗机构分娩的比例。在长期紧急情况下，提高对危险信号的认识和熟练助产的重要性虽然至关重要，但改善可接受的护理质量的服务获取可能比改善服务获取更为重要。
