Department of Humanities and Social Sciences, Indian Institute of Technology Roorkee (IITR), Roorkee, Uttarakhand, India.
PLoS One. 2013 Jul 23;8(7):e69094. doi: 10.1371/journal.pone.0069094. Print 2013.
India, with a population of more than 1.21 billion, has the highest maternal mortality in the world (estimated to be 56000 in 2010); and adolescent (aged 15-19) mortality shares 9% of total maternal deaths. Addressing the maternity care needs of adolescents may have considerable ramifications for achieving the Millennium Development Goal (MDG)-5. This paper assesses the socioeconomic differentials in accessing full antenatal care and professional attendance at delivery by adolescent mothers (aged 15-19) in India during 1990-2006.
Data from three rounds of the National Family Health Survey of India conducted during 1992-93, 1998-99, and 2005-06 were analyzed. The Cochran-Armitage and Chi-squared test for linear and non-linear time trends were applied, respectively, to understand the trend in the proportion of adolescent mothers utilizing select maternity care services during 1990-2006. Using pooled multivariate logistic regression models, the probability of select maternal healthcare utilization among women by key socioeconomic characteristics was appraised. After adjusting for potential socio-demographic and economic characteristics, the likelihood of adolescents accessing full antenatal care increased by only 4% from 1990 to 2006. However, the probability of adolescent women availing themselves of professional attendance at delivery increased by 79% during the same period. The study also highlights the desolate disparities in maternity care services among adolescents across the most and the least favoured groups.
Maternal care interventions in India need focused programs for rural, uneducated, poor adolescent women so that they can avail themselves of measures to delay child bearing, and for better antenatal consultation and delivery care in case of pregnancy. This study strongly advocates the promotion of a comprehensive 'adolescent scheme' along the lines of 'Continuum of Maternal, Newborn and Child health Care' to address the unmet need of reproductive and maternal healthcare services among adolescent women in India.
印度拥有超过 12.1 亿的人口，其孕产妇死亡率位居世界第一（据估计，2010 年为 56000 人）；而青少年（15-19 岁）的死亡率占孕产妇总死亡人数的 9%。满足青少年的孕产保健需求可能对实现千年发展目标 5（MDG-5）具有重要影响。本文评估了 1990-2006 年期间印度 15-19 岁青少年母亲获得全面产前护理和专业分娩服务的社会经济差异。
分析了印度三次全国家庭健康调查（1992-93 年、1998-99 年和 2005-06 年）的数据。应用 Cochran-Armitage 和 Chi-squared 检验分别用于线性和非线性时间趋势，以了解 1990-2006 年期间青少年母亲利用特定孕产保健服务的比例趋势。使用多变量逻辑回归模型评估了不同社会经济特征的妇女获得特定产妇保健服务的概率。在调整潜在社会人口学和经济特征后，青少年接受全面产前护理的可能性在 1990 年至 2006 年仅增加了 4%。然而，同期青少年获得专业分娩护理的可能性增加了 79%。该研究还突出了最有利和最不利群体之间青少年孕产保健服务的明显差距。
印度的孕产妇保健干预措施需要针对农村、教育程度低、贫困的青少年妇女制定专门方案，以便她们能够采取措施推迟生育，并在怀孕时获得更好的产前咨询和分娩护理。本研究强烈主张按照“孕产妇、新生儿和儿童保健连续体”的思路，推广全面的“青少年计划”，以满足印度青少年妇女对生殖和孕产妇保健服务的未满足需求。
