Shimazaki Azusa, Honda Sumihisa, Dulnuan Marcelyn M, Chunanon Jennylene B, Matsuyama Akiko
Graduate School of International Health Development, Nagasaki University, 1-12-4, Sakamoto, Nagasaki 852-8523, Japan.
Asia Pac Fam Med. 2013 Oct 24;12(1):5. doi: 10.1186/1447-056X-12-5.
The maternal mortality ratio (MMR) in the Philippines is higher than in most other Southeast Asian countries, and home delivery is a major factor contributing to the high MMR. This study aims to explore the determinants for choice of delivery location in Ifugao Province, where people have poor access to health services.
A household interview survey using a structured questionnaire was conducted to identify the factors associated with delivery location among 354 women. In all, 44.4% of the respondents delivered at a health facility. Using logistic regression analysis, parity (odds ratio [OR] 3.0, 95% confidence interval [C.I.] 1.6-5.6), higher education (OR 5.9, 95% C.I. 2.7-12.9), distance to a health facility (OR 6.9, 95% C.I. 3.4-14.2), health problems identified at antenatal care (OR 2.4, 95% C.I. 1.3-4.6), and the person deciding on the delivery location (e.g., for the husband OR 3.2, 95% C.I. 1.1-9.4) were found to be statistically associated with facility-based delivery.
Involving the husband and other people in the decision regarding delivery location may influence a woman's choice to use facility-based delivery services. Our findings have useful implications for improving the existing Safe Motherhood program in the Philippines.
菲律宾的孕产妇死亡率高于大多数其他东南亚国家，家庭分娩是导致高孕产妇死亡率的一个主要因素。本研究旨在探讨伊富高省分娩地点选择的决定因素，该省居民获得医疗服务的机会有限。
采用结构化问卷进行了一项家庭访谈调查，以确定354名妇女中与分娩地点相关的因素。共有44.4%的受访者在医疗机构分娩。使用逻辑回归分析发现，产次（比值比[OR]3.0，95%置信区间[C.I.]1.6 - 5.6）、高等教育程度（OR 5.9，95% C.I. 2.7 - 12.9）、到医疗机构的距离（OR 6.9，95% C.I. 3.4 - 14.2）、产前检查发现的健康问题（OR 2.4，95% C.I. 1.3 - 4.6）以及决定分娩地点的人（例如，丈夫决定时OR 3.2，95% C.I. 1.1 - 9.4）在统计学上与医疗机构分娩相关。
让丈夫和其他人参与分娩地点的决策可能会影响女性选择使用医疗机构的分娩服务。我们的研究结果对改进菲律宾现有的安全孕产计划具有有益的启示。
