Bbaale Edward
Visiting Fellow, Centre for Global Development, Washington DC, USA.
Australas Med J. 2011;4(8):431-8. doi: 10.4066/AMJ.2011.729. Epub 2011 Aug 31.
Over 99% of mothers who die of complications related to pregnancy and childbirth each year are found in developing countries.3 In Uganda, maternal mortality is estimated at 435 deaths per 100,000 live births. We sought to understand the factors influencing frequency and timing of antenatal care in Uganda in order to inform policy on the key aspects that need to be influenced.
We used data from the Uganda Demographic and Health Survey (UDHS) 2006 and employed both descriptive and quantitative approaches (probit estimation). After a probit estimation, we generated marginal effects to interpret the results as probabilities of utilisation of antenatal care given particular background characteristics.
On average, only 17% and 47% of mothers initiate the first antenatal visit in the first trimester and attain at least four antenatal visits, respectively. The timing and frequency of antenatal visits were significantly associated with education of the mother and her partner, wealth status, regional disparities, religious differences, access to media, maternal autonomy in taking a health decision, occupations of the mother and her partner, timing of pregnancy, birth histories, and birth order.
Efforts are needed to educate girls beyond secondary level, establishment village outreach clinics with qualified staff to attract the hard-to-reach women, and to ensure universal access to prenatal care services irrespective of the ability to pay. Media penetration should also be increased amongst the population and this channel can be used to disseminate a standard piece of information concerning what pregnant women should expect and do during the prenatal period.
每年死于与妊娠和分娩相关并发症的母亲中,超过99%出现在发展中国家。在乌干达,孕产妇死亡率估计为每10万例活产中有435例死亡。我们试图了解影响乌干达产前检查频率和时间的因素,以便为需要施加影响的关键方面提供政策依据。
我们使用了2006年乌干达人口与健康调查(UDHS)的数据,并采用了描述性和定量方法(概率估计)。在进行概率估计后,我们生成边际效应,将结果解释为在特定背景特征下进行产前检查的概率。
平均而言,分别只有17%和47%的母亲在孕早期开始首次产前检查并至少进行四次产前检查。产前检查的时间和频率与母亲及其伴侣的教育程度、财富状况、地区差异、宗教差异、媒体接触情况、母亲在做出健康决策方面的自主权、母亲及其伴侣的职业、怀孕时间、生育史和产次显著相关。
需要努力对中学以上的女孩进行教育,设立配备合格工作人员的乡村外展诊所,以吸引难以接触到的妇女,并确保无论支付能力如何都能普遍获得产前护理服务。还应提高媒体在人群中的渗透率,并且可以利用这个渠道传播关于孕妇在孕期应该期待什么和做什么的标准信息。