Berti Peter R, Sohani Salim, Costa Edith da, Klaas Naomi, Amendola Luis, Duron Joel
HealthBridge, Ottawa, Canada.
Canadian Red Cross, Ottawa, Canada.
Rev Panam Salud Publica. 2015 Feb;37(2):90-7.
To determine the impact that a 6-year maternal and child health project in rural Honduras had on maternal health services and outcomes, and to test the effect of level of father involvement on maternal health.
This was a program evaluation conducted through representative household surveys administered at baseline in 2007 and endline in 2011 using 30 cluster samples randomly-selected from the 229 participating communities. Within each cluster, 10 households having at least one mother-child pair were randomly selected to complete a questionnaire, for a total of about 300 respondents answering close to 100 questions each. Changes in key outcome variables from baseline to endline were tested using logistic regression, controlling for mother's education and father's involvement.
There were improvements in most maternal health indicators, including an increase in women attending prenatal checkups (84% to 92%, P = 0.05) and institutional births (44% to 63%, P = 0.002). However, the involvement of the fathers decreased as reflected by the percentage of fathers accompanying mothers to prenatal checkups (48% to 41%, P = 0.01); the fathers' reported interest in prenatal care (74% to 52%, P = 0.0001); and fathers attending the birth (66% to 54%, P = 0.05). There was an interaction between the fathers' scores and the maternal outcomes, with a larger increase in institutional births among mothers with the least-involved fathers.
Rather than the father's involvement being key, changes in the mothers may have led to increased institutional births. The project may have empowered women through early identification of pregnancy and stronger social connections encouraged by home visits and pregnancy clubs. This would have enabled even the women with unsupportive fathers to make healthier choices and achieve higher rates of institutional births.
确定洪都拉斯农村地区一项为期6年的母婴健康项目对孕产妇保健服务及结局的影响，并检验父亲参与程度对孕产妇健康的影响。
这是一项项目评估，通过2007年基线期和2011年终期进行的代表性家庭调查开展，从229个参与社区中随机选取30个整群样本。在每个整群中，随机选取10户至少有一对母婴的家庭完成问卷，共有约300名受访者，每人回答近100个问题。使用逻辑回归检验从基线期到终期关键结局变量的变化，并对母亲的教育程度和父亲的参与程度进行控制。
大多数孕产妇健康指标都有所改善，包括进行产前检查的女性比例增加（从84%增至92%，P = 0.05）以及机构分娩比例增加（从44%增至63%，P = 0.002）。然而，父亲的参与度有所下降，表现为陪母亲进行产前检查的父亲比例下降（从48%降至41%，P = 0.01）；父亲报告的对产前护理的兴趣下降（从74%降至52%，P = 0.0001）；以及父亲参与分娩的比例下降（从66%降至54%，P = 0.05）。父亲的得分与孕产妇结局之间存在交互作用，父亲参与度最低的母亲中机构分娩的增加幅度更大。
导致机构分娩增加的可能是母亲自身的变化，而非父亲的参与。该项目可能通过早期识别怀孕以及家访和怀孕俱乐部所鼓励的更强的社会联系赋予了女性权力。这使得即使是父亲不支持的女性也能做出更健康的选择并实现更高的机构分娩率。
