Departamento de Economía, Pontificia Universidad Javeriana Cali, Cali, Colombia.
Medical Faculty, Martin Luther University Halle-Wittenberg, Halle, Germany.
Cad Saude Publica. 2014 May;30(5):1079-92. doi: 10.1590/0102-311x00073513.
This paper examined the association between individual and local level factors and the number of antenatal care visits completed by women in Colombia using data from the 2010 Colombian Demographic and Health Survey and multilevel logistic regression models. Our findings suggest that, in addition to maternal socioeconomic status, contextual factors influence whether pregnant women complete the minimum recommended number of antenatal care visits. These factors include: level of women's autonomy in the community, regional inequalities and access barriers caused by distance (OR = 0.057), costs of services (OR = 0.035), and/or a lack of confidence in doctors (OR = 0.036). Our results highlight the existence of inequalities in access to antenatal care and the importance of considering the local context in the design of effective maternal care policies in Colombia. Furthermore, our findings regarding individual factors corroborate the evidence from other countries and offer new insights into the association between local level factors and number of antenatal care visits.
本文利用 2010 年哥伦比亚人口与健康调查数据和多层次逻辑回归模型，研究了个体和地方层面因素与哥伦比亚妇女完成产前检查次数之间的关系。研究结果表明，除了孕产妇社会经济地位外，情境因素也会影响孕妇是否完成最低推荐的产前检查次数。这些因素包括：妇女在社区中的自主权水平、地区不平等以及距离造成的获取障碍（OR=0.057）、服务费用（OR=0.035）和/或对医生缺乏信心（OR=0.036）。研究结果突显了产前护理获取方面存在的不平等现象，同时也强调了在哥伦比亚制定有效的孕产妇保健政策时，需要考虑当地情况。此外，关于个体因素的研究结果与其他国家的证据相吻合，为地方层面因素与产前检查次数之间的关系提供了新的见解。
