Ifakara Health Institute, Plot 463, Kiko Avenue, Off Mwai Kibaki Road, Mikocheni, P,O, Box 78373, Dar es Salaam, Tanzania.
Int J Equity Health. 2014 Jun 16;13:48. doi: 10.1186/1475-9276-13-48.
Globally, health facility delivery is encouraged as a single most important strategy in preventing maternal and neonatal morbidity and mortality. However, access to facility-based delivery care remains low in many less developed countries. This study assesses facilitators and barriers to institutional delivery in three districts of Tanzania.
Data come from a cross-sectional survey of random households on health behaviours and service utilization patterns among women and children aged less than 5 years. The survey was conducted in 2011 in Rufiji, Kilombero, and Ulanga districts of Tanzania, using a closed-ended questionnaire. This analysis focuses on 915 women of reproductive age who had given birth in the two years prior to the survey. Chi-square test was used to test for associations in the bivariate analysis and multivariate logistic regression was used to examine factors that influence institutional delivery.
Overall, 74.5% of the 915 women delivered at health facilities in the two years prior to the survey. Multivariate analysis showed that the better the quality of antenatal care (ANC) the higher the odds of institutional delivery. Similarly, better socioeconomic status was associated with an increase in the odds of institutional delivery. Women of Sukuma ethnic background were less likely to deliver at health facilities than others. Presence of couple discussion on family planning matters was associated with higher odds of institutional delivery.
Institutional delivery in Rufiji, Kilombero, and Ulanga district of Tanzania is relatively high and significantly dependent on the quality of ANC, better socioeconomic status as well as between-partner communication about family planning. Therefore, improving the quality of ANC, socioeconomic empowerment as well as promoting and supporting inter-spousal discussion on family planning matters is likely to enhance institutional delivery. Programs should also target women from the Sukuma ethnic group towards universal access to institutional delivery care in the study area.
在全球范围内，鼓励利用医疗机构提供服务，这是预防孕产妇和新生儿发病率和死亡率的最重要策略之一。然而，在许多欠发达国家，获得基于机构的分娩护理的机会仍然很低。本研究评估了坦桑尼亚三个地区机构分娩的促进因素和障碍。
数据来自一项关于妇女和 5 岁以下儿童健康行为和服务利用模式的横断面调查，在 2011 年于坦桑尼亚的 Rufiji、Kilombero 和 Ulanga 区进行，使用封闭式问卷。本分析重点关注在调查前两年内分娩的 915 名育龄妇女。卡方检验用于检验二变量分析中的关联，多变量逻辑回归用于检验影响机构分娩的因素。
总体而言，915 名妇女中有 74.5%在调查前两年内在医疗机构分娩。多变量分析显示，产前护理（ANC）质量越好，机构分娩的几率越高。同样，更好的社会经济地位与机构分娩几率的增加有关。Sukuma 族裔背景的妇女在医疗机构分娩的可能性低于其他族裔。夫妻之间就计划生育问题进行讨论与机构分娩的几率增加有关。
坦桑尼亚 Rufiji、Kilombero 和 Ulanga 区的机构分娩相对较高，且显著依赖 ANC 的质量、更好的社会经济地位以及夫妻之间关于计划生育的沟通。因此，提高 ANC 的质量、社会经济赋权以及促进和支持夫妻之间关于计划生育问题的讨论，可能会提高机构分娩的比例。该计划还应针对 Sukuma 族裔的妇女，以实现该研究区域内所有妇女都能获得机构分娩护理。
