Palamuleni Martin
North West University, Mafikeng Campus.
Malawi Med J. 2011 Dec;23(4):104-8.
Malawi has one of the highest maternal mortality ratios in the world. One of the factors contributing to high maternal mortality is the non-use of health facilities during pregnancy and delivery. The aim of this study is to examine the factors associated with non-institutional deliveries in Malawi. Data from 2004 Malawi Demographic and Health Survey and multinomial logistic regression were used to assess the association between place of delivery and selected socio-economic factors. The study population comprised of 7,218 women, who had at least one child, aged less than five years, at the time the survey. Of these women, 58% delivered at a health facility, 29.4% delivered at home and 12.6% delivered at the home of a traditional birth attendant. Multivariate analysis indicate that region (OR = 1.29 for Central Region), place of residence (OR=0.319 for urban areas), wealth status (OR=6.289 for poor, OR=4.683 for middle), education (OR=3.823 for no education, OR=2.265 for primary education), number of prenatal visits (OR=4.732 no visits, OR=1.696 1-3 visits) and ever use of family (OR=1.29 for never used) showed significant association with non-institutional deliveries. These factors should be considered in designing strategies to improve the maternal health care system in Malawi.
马拉维是世界上孕产妇死亡率最高的国家之一。导致孕产妇死亡率高的因素之一是在怀孕和分娩期间不使用卫生设施。本研究的目的是调查马拉维与非机构分娩相关的因素。利用2004年马拉维人口与健康调查的数据和多项逻辑回归来评估分娩地点与选定的社会经济因素之间的关联。研究人群包括7218名妇女，在调查时她们至少有一个年龄小于五岁的孩子。在这些妇女中，58%在卫生设施分娩，29.4%在家中分娩，12.6%在传统助产士家中分娩。多变量分析表明，地区（中部地区的比值比为1.29）、居住地点（城市地区的比值比为0.319）、财富状况（贫困者的比值比为6.289，中等者的比值比为4.683）、教育程度（未受过教育者的比值比为3.823，小学教育程度者的比值比为2.265）、产前检查次数（未进行产前检查者的比值比为4.732，进行1 - 3次产前检查者的比值比为1.696）以及是否曾经使用过计划生育服务（从未使用者的比值比为1.29）与非机构分娩存在显著关联。在设计改善马拉维孕产妇保健系统的策略时应考虑这些因素。
