Islam Nazrul, Islam Mohammad Tajul, Yoshimura Yukie
School of Population and Public Health, Faculty of Medicine, University of British Columbia, Room# 417, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada.
Reprod Health. 2014 Dec 11;11:86. doi: 10.1186/1742-4755-11-86.
Utilization of Skilled Birth Attendants (SBAs) at birth is low (20%) in Bangladesh. Birth attendance by SBAs is considered as the "single most important factor in preventing maternal deaths". This paper examined the practices and determinants of delivery by SBAs in rural Bangladesh.
The data come from the post-intervention survey of a cluster-randomized community controlled trial conducted to evaluate the impact of limited post-natal care (PNC) services on healthcare seeking behavior of women with a recent live birth in rural Bangladesh (n = 702). Multivariable logistic regression model was used to identify the potential determinants of delivery by SBAs.
The respondents were aged between 16 and 45, with the mean age of 24.41 (± 5.03) years. Approximately one-third (30.06%) of the women had their last delivery by SBAs. Maternal occupation, parity, complications during pregnancy and antenatal checkup (ANC) by SBAs were the significant determinants of delivery by SBAs. Women who took antenatal care by SBAs were 2.62 times as likely (95% CI: 1.66, 4.14; p < 0.001) to have their delivery conducted by SBAs compared to those who did not, after adjusting for other covariates.
Our findings suggest that ANC by SBAs and complications during pregnancies are significant determinants of delivery by SBAs. Measure should be in place to promote antenatal checkup by SBAs to increase utilization of SBAs at birth in line with achieving the Millennium Development Goal-5. Future research should focus in exploring the unmet need for, and potential barriers in, the utilization of delivery by SBAs.
在孟加拉国，分娩时熟练接生员（SBA）的使用率较低（20%）。由熟练接生员接生被视为“预防孕产妇死亡的最重要单一因素”。本文研究了孟加拉国农村地区熟练接生员接生的做法及决定因素。
数据来自一项整群随机社区对照试验的干预后调查，该试验旨在评估有限的产后护理（PNC）服务对孟加拉国农村近期有活产的妇女寻求医疗行为的影响（n = 702）。采用多变量逻辑回归模型来确定熟练接生员接生的潜在决定因素。
受访者年龄在16至45岁之间，平均年龄为24.41（±5.03）岁。约三分之一（30.06%）的妇女上次分娩由熟练接生员接生。产妇职业、胎次、孕期并发症以及熟练接生员进行的产前检查（ANC）是熟练接生员接生的重要决定因素。在调整其他协变量后，与未接受熟练接生员产前护理的妇女相比，接受熟练接生员产前护理的妇女由熟练接生员接生的可能性高出2.62倍（95%置信区间：1.66, 4.14；p < 0.001）。
我们的研究结果表明，熟练接生员进行的产前检查和孕期并发症是熟练接生员接生的重要决定因素。应采取措施促进熟练接生员进行产前检查，以提高分娩时熟练接生员的使用率，从而实现千年发展目标5。未来的研究应着重探索熟练接生员接生方面未满足的需求及潜在障碍。
