Moyer Cheryl A, Dako-Gyeke Phyllis, Adanu Richard M
Global REACH and Department of Medical Education, University of Michigan Medical School, 5115 Med Sci 1, 1301 Catherine Street, Ann Arbor, MI 48109-5611, USA.
Afr J Reprod Health. 2013 Sep;17(3):30-43.
Regional variability in facility-based delivery (FBD) rates in sub-Saharan Africa (SSA) is not well understood, nor is the relationship between FBD and national maternal and early neonatal mortality rates. A systematic literature review identified studies documenting the factors associated with FBD, stratified by region. Rates of skilled birth attendance, facility delivery, maternal mortality, and early neonatal mortality were compared across nations and regions. 70 articles met inclusion criteria, reflecting wide variability in the number, type, and quality of studies by region. Within-country differences were most pronounced in nations where multiple studies were conducted. Correlation between FBD and maternal mortality rates throughout SSA was -0.69 (p=.008), and the correlation between facility delivery rates and early neonatal mortality rates was -0.41 (p=0.08). This study demonstrates the need to attend to regional differences both across and within SSA nations if facility delivery rates are to be improved to reduce maternal and early neonatal mortality.
撒哈拉以南非洲地区（SSA）基于医疗机构的分娩（FBD）率的区域差异尚未得到充分了解，FBD与国家孕产妇和早期新生儿死亡率之间的关系也不清楚。一项系统的文献综述确定了按地区分层的记录与FBD相关因素的研究。对各国和各地区的熟练助产率、医疗机构分娩率、孕产妇死亡率和早期新生儿死亡率进行了比较。70篇文章符合纳入标准，反映出各地区研究的数量、类型和质量存在很大差异。在进行了多项研究的国家，国内差异最为明显。整个SSA地区FBD与孕产妇死亡率之间的相关性为-0.69（p = 0.008），医疗机构分娩率与早期新生儿死亡率之间的相关性为-0.41（p = 0.08）。这项研究表明，如果要提高医疗机构分娩率以降低孕产妇和早期新生儿死亡率，就需要关注SSA国家之间和内部的区域差异。
