CIET Trust Botswana, PO Box 1240, Gaborone, Botswana.
BMC Health Serv Res. 2011 Dec 21;11 Suppl 2(Suppl 2):S6. doi: 10.1186/1472-6963-11-S2-S6.
The Maldives faces challenges in the provision of health services to its population scattered across many small islands. The government commissioned two separate reproductive health surveys, in 1999 and 2004, to inform their efforts to improve reproductive and sexual health services.
A stratified random sample of islands provided the study base for a cluster survey in 1999 and a follow-up of the same clusters in 2004. In 1999 the household survey enquired about relevant knowledge, attitudes and practices and views and experience of available reproductive health services, with a focus on women aged 15-49 years. The 2004 household survey included some of the same questions as in 1999, and also sought views of men aged 15-64 years. A separate survey about sexual and reproductive health covered 1141 unmarried youth aged 15-24 years.
There were 4087 household respondents in 1999 and 4102 in 2004. The contraceptive prevalence rate (CPR) for modern methods was 33% in 1999 and 34% in 2004. Antenatal care improved: more women in 2004 than in 1999 had at least four antenatal care visits (90.0% v 65.1%) and took iron supplements (86.7% v 49.6%) during their last pregnancy. The response rate for the youth survey was only 42% (varying from 100% in some islands to 12% in sites in the capital). The youth respondents had some knowledge gaps (one third did not know if people with HIV could look healthy and less than half thought condoms could protect against HIV), and some unhelpful attitudes about gender and reproductive health.
The two household surveys were commissioned as separate entities, with different priorities and data capture methods, rather than being undertaken as a specific research study. The direct comparisons we could make indicated an unchanged CPR and improvements in antenatal care, with the Maldives ahead of the South Asia region for antenatal care. The low response rate in the youth survey limited interpretation of the findings. But the survey highlighted areas requiring attention. Surveys not undertaken primarily for research purposes have important limitations but can provide useful information.
马尔代夫在向分布在众多小岛上的民众提供医疗服务方面面临挑战。政府委托进行了两次独立的生殖健康调查，分别是 1999 年和 2004 年，旨在为改善生殖和性健康服务提供信息。
对岛屿进行分层随机抽样，为 1999 年的群组调查和 2004 年对同一群组的后续调查提供了基础。1999 年的家庭调查询问了相关知识、态度和做法，以及对现有生殖健康服务的看法和经验，重点关注 15-49 岁的女性。2004 年的家庭调查包括了 1999 年的一些相同问题，并征求了 15-64 岁男性的意见。一项关于性健康和生殖健康的单独调查涵盖了 1141 名 15-24 岁的未婚青年。
1999 年有 4087 户家庭受访者，2004 年有 4102 户。现代避孕方法的避孕普及率（CPR）在 1999 年为 33%，2004 年为 34%。产前护理有所改善：2004 年有更多的妇女进行了至少四次产前护理（90.0%比 65.1%），在最后一次怀孕时服用了铁补充剂（86.7%比 49.6%）。青年调查的回应率仅为 42%（在某些岛屿达到 100%，而在首都的一些地点则为 12%）。青年受访者存在一些知识空白（三分之一的人不知道 HIV 感染者是否可能看起来健康，不到一半的人认为避孕套可以预防 HIV），并且对性别和生殖健康存在一些无益的态度。
这两项家庭调查是作为独立实体委托进行的，具有不同的重点和数据采集方法，而不是作为特定的研究进行。我们能够进行的直接比较表明，CPR 保持不变，产前护理有所改善，马尔代夫在南亚地区的产前护理方面处于领先地位。青年调查的低回应率限制了对调查结果的解释。但是，该调查突出了需要关注的领域。主要不是为研究目的而进行的调查具有重要的局限性，但可以提供有用的信息。
