Hawley Nicola L, Brown Carolyn, Nu'usolia Ofeira, Ah-Ching John, Muasau-Howard Bethel, McGarvey Stephen T
The Alpert Medical School, Brown University, Providence, RI, USA,
Matern Child Health J. 2014 Dec;18(10):2284-92. doi: 10.1007/s10995-013-1368-9.
The objective of this study is to describe the utilization of prenatal care in American Samoan women and to identify socio-demographic predictors of inadequate prenatal care utilization. Using data from prenatal clinic records, women (n = 692) were categorized according to the adequacy of prenatal care utilization index as having received adequate plus, adequate, intermediate or inadequate prenatal care during their pregnancy. Categorical socio-demographic predictors of the timing of initiation of prenatal care (week of gestation) and the adequacy of received services were identified using one way analysis of variance and independent samples t tests. Between 2001 and 2008 85.4 % of women received inadequate prenatal care. Parity (P = 0.02), maternal unemployment (P = 0.03), and both parents being unemployed (P = 0.03) were negatively associated with the timing of prenatal care initiation. Giving birth in 2007-2008, after a prenatal care incentive scheme had been introduced in the major hospital, was associated with earlier initiation of prenatal care (20.75 vs. 25.12 weeks; P < 0.01) and improved adequacy of received services (95.04 vs. 83.8 %; P = 0.02). The poor prenatal care utilization in American Samoa is a major concern. Improving healthcare accessibility will be key in encouraging women to attend prenatal care. The significant improvements in the adequacy of prenatal care seen in 2007-2008 suggest that the prenatal care incentive program implemented in 2006 may be a very positive step toward addressing issues of prenatal care utilization in this population.
本研究的目的是描述美属萨摩亚妇女产前护理的利用情况，并确定产前护理利用不足的社会人口学预测因素。利用产前诊所记录的数据，根据产前护理利用指数的充足程度，将692名妇女分为孕期接受了充足加、充足、中等或不足的产前护理。使用单因素方差分析和独立样本t检验确定了产前护理开始时间（孕周）和所接受服务充足程度的分类社会人口学预测因素。2001年至2008年期间，85.4%的妇女接受的产前护理不足。产次（P = 0.02）、母亲失业（P = 0.03）以及父母双方均失业（P = 0.03）与产前护理开始时间呈负相关。在主要医院引入产前护理激励计划后，于2007 - 2008年分娩的妇女，产前护理开始时间更早（20.75周对25.12周；P < 0.01），所接受服务的充足程度也有所提高（95.04%对83.8%；P = 0.02）。美属萨摩亚产前护理利用情况不佳是一个主要问题。改善医疗服务可及性将是鼓励妇女接受产前护理的关键。2007 - 2008年产前护理充足程度的显著改善表明，2006年实施的产前护理激励计划可能是朝着解决该人群产前护理利用问题迈出的非常积极的一步。
