Department of Community and Global Health, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan.
Womens Health Issues. 2012 Mar;22(2):e171-80. doi: 10.1016/j.whi.2011.08.004. Epub 2011 Oct 2.
OBJECTIVE: To examine the linkage between the possible influences of the extent of autonomy on young mothers use of reproductive health care services. METHODS: This paper used data from the 2007 Bangladesh Demographic Health Survey. The analyses were based on responses of 1,778 currently married women aged 15 to 24 years, living with at least one 0- to 35-month-old child. Utilization of antenatal health services (ANC) services by amount and type of provider, and utilization of delivery assistance according to provider type were used as proxy outcome variables of reproductive health care utilization. Descriptive statistics and multivariate logistic regression methods were employed in the analysis. RESULTS: Approximately one third (31%) of the currently married young women in Bangladesh had a higher level of overall decision-making autonomy. Only 24.0% of the sampled women received sufficient ANC; 54% and 18% received ANC and assisted deliveries from a medically trained provider. respectively. In adjusted models, young women who had a higher level of overall autonomy were more likely to receive sufficient ANC (adjusted odds ratio [AOR], 1.64; 95% confidence interval [CI], 1.17-2.23) and receiving ANC from medically trained provider (AOR, 1.91; 95% CI, 1.42-2.45). Women who had medium overall autonomy were 1.40 times more likely (95% CI, 1.03-1.98) to have deliveries assisted by a medically trained provider than women who had low autonomy. CONCLUSION: Association between young mother's autonomy and reproductive health care utilization suggest that maternal autonomy needs to be considered as an important sociocultural determinant for the higher utilization of reproductive health care services for young mothers in Bangladesh.
目的:探讨自主权程度对年轻母亲使用生殖保健服务的可能影响之间的联系。
方法:本文使用了 2007 年孟加拉国人口健康调查的数据。分析基于至少有一个 0-35 个月大的孩子的 1778 名目前已婚的 15-24 岁年轻女性的回应。利用产前保健服务(ANC)的数量和提供者类型,以及根据提供者类型利用分娩援助作为生殖保健利用的替代结果变量。在分析中采用了描述性统计和多变量逻辑回归方法。
结果:孟加拉国目前已婚的年轻女性中,大约有三分之一(31%)具有较高的总体决策自主权。只有 24.0%的抽样妇女接受了足够的 ANC;54%和 18%分别接受了来自医学培训提供者的 ANC 和辅助分娩。在调整后的模型中,具有较高总体自主权的年轻女性更有可能接受足够的 ANC(调整后的优势比[OR],1.64;95%置信区间[CI],1.17-2.23)和接受医学培训提供者的 ANC(OR,1.91;95% CI,1.42-2.45)。具有中等总体自主权的女性比具有低自主权的女性更有可能由医学培训提供者协助分娩(OR,1.40;95% CI,1.03-1.98)。
结论:年轻母亲自主权与生殖保健服务利用之间的关联表明,在孟加拉国,母亲自主权需要被视为年轻母亲更高利用生殖保健服务的一个重要社会文化决定因素。
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