Azimi Mohammad Daud, Najafizada Said Ahmad Maisam, Khaing Inn Kynn, Hamajima Nobuyuki
Grant and Service Contract Management Unit, Ministry of Public Health, Afghanistan.
PhD Candidate in the Population Health Program, Institute of Population Health, and University of Ottawa, Canada.
Nagoya J Med Sci. 2015 Feb;77(1-2):133-43.
Home delivery in unhygienic environments is common among Afghan women; only one third of births are delivered at health facilities. Institutional delivery is central to reducing maternal mortality. The factors associated with place of delivery among women in Afghanistan were examined using the Afghanistan Mortality Survey 2010 (AMS 2010), which was open to researchers. The AMS 2010 data were collected through an interviewer-led questionnaire from 18,250 women. Odds ratio (OR) and 95% confidence interval (CI) of non-institutional delivery were estimated by logistic regression analysis. When age at survey, education, parity, residency, antenatal care frequency, remoteness, wealth and regions were adjusted, the OR of non-institutional delivery was 8.37 (95% CI, 7.47-9.39) for no antenatal care relative to four or more antenatal care visits, 4.07 (95% CI, 3.45-4.80) for poorest household relative to women from richest household, 2.02 (95% CI, 1.43-2.84) for no education relative to higher education, 1.78 (95% CI, 1.52-2.09) for six or more deliveries relative to one delivery, and 1.50 (95% CI, 1.36-1.67) for rural relative to urban residency. Since antenatal care was strongly associated with non-institutional delivery after adjustment of the other factors, antenatal care service may promote institutional deliveries, which can reduce maternal mortality ratio in Afghanistan.
在不卫生的环境中进行家庭分娩在阿富汗妇女中很常见；只有三分之一的分娩是在卫生机构进行的。机构分娩是降低孕产妇死亡率的关键。利用向研究人员开放的《2010年阿富汗死亡率调查》（AMS 2010）对阿富汗妇女分娩地点的相关因素进行了研究。AMS 2010的数据是通过由访员主导的问卷从18250名妇女中收集的。通过逻辑回归分析估计非机构分娩的比值比（OR）和95%置信区间（CI）。在对调查时的年龄、教育程度、产次、居住地、产前检查频率、偏远程度、财富和地区进行调整后，相对于进行四次或更多次产前检查的妇女，未进行产前检查的非机构分娩的OR为8.37（95%CI，7.47 - 9.39）；相对于最富有家庭的妇女，最贫困家庭的OR为4.07（95%CI，3.45 - 4.80）；相对于受过高等教育的妇女，未受过教育的OR为2.02（95%CI，1.43 - 2.84）；相对于分娩一次的妇女，分娩六次或更多次的OR为1.78（95%CI，1.52 - 2.09）；相对于城市居民，农村居民的OR为1.50（95%CI，1.36 - 1.67）。由于在调整其他因素后，产前检查与非机构分娩密切相关，产前保健服务可能会促进机构分娩，这可以降低阿富汗的孕产妇死亡率。
