Division of Academic General Pediatrics, University of Minnesota, Minneapolis, MN, USA.
Trop Med Int Health. 2013 Jun;18(6):678-86. doi: 10.1111/tmi.12098. Epub 2013 Apr 5.
To investigate the influence of antenatal provider type on maternity care in rural Ghana.
An analysis of maternal care by antenatal provider type using the 2008 Ghana Demographic and Health Survey. Study population included rural Ghanaian women aged 15-49 years with report of a live birth between 2003 and 2008. Bivariate chi-square analysis was performed to examine differences in maternal report of WHO Maternal Health Interventions. Multivariate linear and logistic regression were performed to assess differences in antenatal care (ANC) scales and maternal care packages.
Thousand and three hundred and sixty-seven rural women reported a live birth. Provider distribution was: doctor, 15.6%; midwife, 70%; community health officer (CHO), 9.1%; no provider, 5.3%. Women from lower socio-demographic categories were more likely to report midwife or CHO. Report of CHO vs. no provider was positively associated with maternal services (P < 0.01). Report of doctor or midwife vs. CHO was significantly associated with maternal services (P < 0.01).
There is a positive association between antenatal provider length of training and maternal specialization and report of maternal services. Community-based providers are associated with markedly increased report of maternal services compared with no provider. Structural factors appear to underlie some differences in service provision.
调查产前服务提供者类型对加纳农村产妇护理的影响。
利用 2008 年加纳人口与健康调查，对不同产前服务提供者类型的产妇护理情况进行分析。研究对象为年龄在 15-49 岁之间、2003 年至 2008 年间有活产报告的加纳农村女性。采用卡方检验比较 WHO 产妇保健干预措施的报告差异。采用多元线性和逻辑回归分析评估产前保健（ANC）量表和产妇保健包的差异。
共有 1367 名农村妇女报告了活产。提供者分布为：医生，15.6%；助产士，70%；社区卫生官员（CHO），9.1%；无提供者，5.3%。来自社会经济地位较低类别的妇女更有可能报告助产士或 CHO。与无提供者相比，CHO 报告与产妇服务呈正相关（P<0.01）。与 CHO 相比，医生或助产士的报告与产妇服务显著相关（P<0.01）。
产前服务提供者的培训时间和专业化程度与产妇服务的报告呈正相关。与无提供者相比，以社区为基础的提供者明显增加了产妇服务的报告。结构因素似乎是服务提供差异的一些基础。
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