Department of Public Health and Family Medicine, Tufts University, Boston, MA, USA.
Glob Public Health. 2011;6(8):890-905. doi: 10.1080/17441692.2011.572081. Epub 2011 Jun 28.
Facility delivery and skilled birth attendance are two of the most effective strategies for decreasing maternal mortality. The objectives of this study were to further define utilisation of these services in Cambodia and to uncover socio-economic or location-specific coverage gaps that may exist.
We performed a cross-sectional analysis of the 2005 Cambodia Demographic Health Survey (CDHS) to determine prevalence, and determinants, of service utilisation.
Out of 6069 women aged 15-49 years, 77% delivered at home, three-fourths without a skilled birth attendant. Poverty, lower education and rural residence were associated with the highest likelihood of poor utilisation of services. Discussion. While there has been an overall increase in facility deliveries and skilled birth attendance since 2000, improvements have been spread unevenly across the population, benefiting mostly urban, wealthier and better educated women. While recent financing initiatives and health system developments appear to have further increased service utilisation since 2005, the extent of their reach to the most vulnerable populations, and their ultimate impact on maternal mortality reduction, remain to be elucidated.
Further expanding successful initiatives, particularly among vulnerable populations, is essential. Longitudinal evaluation of ongoing strategies and their impact remains critical.
医疗机构分娩和熟练接生人员接生是降低产妇死亡率的最有效策略之一。本研究旨在进一步明确柬埔寨对这些服务的利用情况，并揭示可能存在的社会经济或特定地点的覆盖差距。
我们对 2005 年柬埔寨人口与健康调查（CDHS）进行了横断面分析，以确定服务利用的流行率及其决定因素。
在 6069 名年龄在 15-49 岁的妇女中，77%在家中分娩，其中四分之三没有熟练的接生人员。贫困、教育程度较低和农村居住与服务利用不佳的可能性最高相关。讨论。虽然自 2000 年以来，医疗机构分娩和熟练接生人员接生的比例总体上有所增加，但这些改进在人口中的分布不均，主要受益于城市、较富裕和受教育程度较高的妇女。虽然最近的融资举措和卫生系统发展似乎自 2005 年以来进一步增加了服务的利用，但它们对最弱势群体的覆盖程度及其对降低产妇死亡率的最终影响仍有待阐明。
进一步扩大成功的举措，特别是在弱势群体中，是必要的。对正在进行的策略及其影响进行纵向评估仍然至关重要。
