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社区主导的大众媒体宣传活动对马拉维农村地区孕产妇保健服务利用情况的影响。

The impact of a community driven mass media campaign on the utilisation of maternal health care services in rural Malawi.

作者信息

Zamawe Collins O F, Banda Masford, Dube Albert N

机构信息

Parent and Child Health Initiative (PACHI), Research Centre, Amina house, Off Chilambula Road, P.O. Box 31686, Capital City, Lilongwe, 3, Malawi.

The Ministry of Health, Lilongwe, Malawi.

出版信息

BMC Pregnancy Childbirth. 2016 Jan 27;16:21. doi: 10.1186/s12884-016-0816-0.

Abstract

BACKGROUND

Mass media is critical in disseminating public health information, improving health knowledge and changing health behaviours. However, most of the mass media public health interventions do not sufficiently engage the local people; they are externally determined. Due to this, very little is known about the effects of locally instigated mass media promotion. Therefore, the aim of this study was to examine the impact of a community driven mass media campaign called Phukusi la Moyo (tips of life) on the utilisation of maternal health care services.

METHODS

A community-based cross-sectional study involving 3825 women of reproductive age (15-49 years) was conducted in rural Malawi to evaluate the Phukusi la Moyo (PLM) campaign. To do this, we compared the utilisation of maternal health care services between women who were exposed to the PLM campaign and those who were not. Respondents were identified using a multistage cluster sampling method. This involved systematically selecting communities (clusters), households and respondents. Associations were examined using Pearson chi square test and a multivariable logistic regression model.

RESULTS

The likelihood of using contraceptives (AOR = 1.61; 95% CI = 1.32-1.96), sleeping under mosquito bed-nets (AOR = 1.65; 95% CI = 1.39-1.97), utilising antenatal care services (AOR = 2.62; 95% CI = 1.45-4.73) and utilising postnatal care services (AOR = 1.59; CI = 1.29-1.95) were significantly higher among women who had exposure to the PLM campaign than those who did not. No significant association was found between health facility delivery and exposure to the PLM campaign.

CONCLUSION

Women exposed to a community driven mass media campaign in rural Malawi were more likely to utilise maternal health care services than their unexposed counterparts. Since, the use of maternal health care services reduces the risk of maternal morbidity and mortality, community-led mass media could play a significant role towards improving maternal health outcomes in low-and-middle-income countries. Therefore, we recommend the use of locally driven mass media in disseminating public health information in limited resource settings.

摘要

背景

大众媒体在传播公共卫生信息、提高健康知识水平和改变健康行为方面至关重要。然而,大多数大众媒体公共卫生干预措施未能充分让当地人参与其中;它们是由外部决定的。因此,对于当地发起的大众媒体宣传的效果知之甚少。因此,本研究的目的是检验一项名为“普吉西拉莫约”(生活小贴士)的社区主导大众媒体宣传活动对孕产妇保健服务利用情况的影响。

方法

在马拉维农村地区开展了一项基于社区的横断面研究,涉及3825名育龄妇女(15 - 49岁),以评估“普吉西拉莫约”(PLM)宣传活动。为此,我们比较了接触PLM宣传活动的妇女和未接触该活动的妇女在孕产妇保健服务利用情况上的差异。采用多阶段整群抽样方法确定受访者。这包括系统地选择社区(群组)、家庭和受访者。使用Pearson卡方检验和多变量逻辑回归模型来检验相关性。

结果

接触PLM宣传活动的妇女使用避孕药具的可能性(调整后比值比[AOR] = 1.61;95%置信区间[CI] = 1.32 - 1.96)、睡在蚊帐下的可能性(AOR = 1.65;95% CI = 1.39 - 1.97)、利用产前保健服务的可能性(AOR = 2.62;95% CI = 1.45 - 4.73)以及利用产后保健服务的可能性(AOR = 1.59;CI = 1.29 - 1.95)显著高于未接触该活动的妇女。在卫生设施分娩与接触PLM宣传活动之间未发现显著关联。

结论

在马拉维农村地区,接触社区主导大众媒体宣传活动的妇女比未接触的妇女更有可能利用孕产妇保健服务。由于使用孕产妇保健服务可降低孕产妇发病和死亡风险,社区主导的大众媒体在改善中低收入国家孕产妇健康结局方面可发挥重要作用。因此,我们建议在资源有限的环境中利用当地主导的大众媒体来传播公共卫生信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5482/4730729/18c6acac7be6/12884_2016_816_Fig1_HTML.jpg

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