Centre for Global Health, Population, Poverty and Policy, Department of Social Science, University of Southampton, University Rd, Southampton, Hampshire, SO17 1BJ, United Kingdom.
Int J Equity Health. 2013 Mar 6;12:17. doi: 10.1186/1475-9276-12-17.
In countries such as Bangladesh many women may only seek skilled care at birth when complications become evident. This often results in higher neonatal mortality for women who give birth in institutions than for those that give birth at home. However, we hypothesise that this apparent excess mortality is concentrated among less advantaged women. The aim of this paper is to examine the association between place of birth and neonatal mortality in Bangladesh, and how this varies by socio-economic status.
The study is based on pooled data from four Bangladesh Demographic and Household Surveys, and uses descriptive analysis and binomial multivariate logistic regression. It uses regression models stratified for place of delivery to examine the impact of socio-economic status and place of residence on neonatal mortality.
Poor women from rural areas and those with no education who gave birth in institutions had much worse outcomes than those who gave birth at home. There is no difference for more wealthy women. There is a much stronger socio-economic gradient in neonatal mortality for women who gave birth in institutions than those who delivered at home.
In Bangladesh babies from lower socio-economic groups and particularly those in rural areas have very poor outcomes if born in a facility. This suggests poorer, rural and less educated women are failing to obtain the timely access to quality maternal health care services needed to improve newborn outcomes.
在孟加拉国等国家，许多妇女只有在出现并发症时才会寻求熟练的分娩护理。这通常导致在机构中分娩的妇女的新生儿死亡率高于在家中分娩的妇女。然而，我们假设这种明显的超额死亡率集中在社会经济地位较低的妇女中。本文旨在探讨孟加拉国的分娩地点与新生儿死亡率之间的关联，以及这种关联如何因社会经济地位而异。
本研究基于来自孟加拉国四次人口和家庭调查的汇总数据，采用描述性分析和二项多元逻辑回归进行分析。它使用按分娩地点分层的回归模型来检查社会经济地位和居住地对新生儿死亡率的影响。
来自农村地区的贫困妇女和没有受过教育的妇女，如果在机构中分娩，其结果比在家中分娩的妇女差得多。而对于更富裕的妇女则没有差异。在机构中分娩的妇女的新生儿死亡率存在更强的社会经济梯度，而在家中分娩的妇女则没有。
在孟加拉国，如果在机构中分娩，来自社会经济地位较低群体的婴儿，特别是来自农村地区的婴儿，其结果非常差。这表明，贫困、农村和受教育程度较低的妇女未能及时获得改善新生儿结局所需的优质产妇保健服务。
