Institute of Tropical Medicine and Infectious Diseases, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya.
BMC Public Health. 2011 May 21;11:360. doi: 10.1186/1471-2458-11-360.
A measure of the proportion of deliveries assisted by skilled attendants is one of the indicators of progress towards achieving Millennium Development Goal (MDG) 5, which aims at improving maternal health. This study aimed at establishing delivery practices and associated factors among mothers seeking child welfare services at selected health facilities in Nyandarua South district, Kenya to determine whether mothers were receiving appropriate delivery care.
A hospital-based cross-sectional survey among women who had recently delivered while in the study area was carried out between August and October 2009. Binary Logistic regression was used to identify factors that predicted mothers' delivery practice.
Among the 409 mothers who participated in the study, 1170 deliveries were reported. Of all the deliveries reported, 51.8% were attended by unskilled birth attendants. Among the deliveries attended by unskilled birth attendants, 38.6% (452/1170) were by neighbors and/or relatives. Traditional Birth Attendants attended 1.5% (17/1170) of the deliveries while in 11.7% (137/1170) of the deliveries were self administered. Mothers who had unskilled birth attendance were more likely to have <3 years of education (Adjusted Odds ratio [AOR] 19.2, 95% confidence interval [CI] 1.7 - 212.8) and with more than three deliveries in a life time (AOR 3.8, 95% CI 2.3 - 6.4). Mothers with perceived similarity in delivery attendance among skilled and unskilled delivery attendants were associated with unsafe delivery practice (AOR 1.9, 95% CI 1.1 - 3.4). Mother's with lower knowledge score on safe delivery (%) were more likely to have unskilled delivery attendance (AOR 36.5, 95% CI 4.3 - 309.3).
Among the mothers interviewed, utilization of skilled delivery attendance services was still low with a high number of deliveries being attended by unqualified lay persons. There is need to implement cost effective and sustainable measures to improve the quality of maternal health services with an aim of promoting safe delivery and hence reducing maternal mortality.
熟练接生员接生比例是衡量实现千年发展目标 5（旨在改善产妇健康）进展情况的指标之一。本研究旨在确定在肯尼亚南恩达鲁阿地区选定卫生机构寻求儿童保健服务的母亲的分娩实践和相关因素，以确定母亲是否接受了适当的分娩护理。
2009 年 8 月至 10 月间，在该研究地区进行了一项基于医院的横断面调查，对象为近期分娩的妇女。采用二项逻辑回归分析确定预测母亲分娩实践的因素。
在 409 名参与研究的母亲中，报告了 1170 次分娩。在所报告的所有分娩中，51.8%由非熟练接生员接生。在由非熟练接生员接生的分娩中，38.6%（452/1170）由邻居和/或亲属接生。传统接生员接生了 1.5%（17/1170）的分娩，而 11.7%（137/1170）的分娩由产妇自行处理。接受非熟练接生的母亲更有可能接受不到 3 年的教育（调整后的优势比[OR]19.2，95%置信区间[CI]1.7-212.8）和一生中分娩次数超过 3 次（OR 3.8，95%CI 2.3-6.4）。认为熟练和非熟练接生员在分娩护理方面相似的母亲与不安全的分娩实践有关（OR 1.9，95%CI 1.1-3.4）。在安全分娩知识得分较低的母亲中，更有可能接受非熟练的分娩（OR 36.5，95%CI 4.3-309.3）。
在所采访的母亲中，熟练接生员接生服务的利用率仍然较低，大量分娩由不合格的非医务人员接生。需要采取具有成本效益和可持续的措施来提高孕产妇保健服务的质量，以促进安全分娩，从而降低产妇死亡率。
