Taylor Yhenneko J, Laditka Sarah B, Laditka James N, Huber Larissa R Brunner, Racine Elizabeth F
Dickson Advanced Analytics, Carolinas HealthCare System, 720 E. Morehead St., Suite 202, Charlotte, NC, 28202, USA.
Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
Matern Child Health J. 2016 Nov;20(11):2402-2410. doi: 10.1007/s10995-016-2068-z.
Objective To examine associations of household wealth and individual literacy with prenatal care in West Africa. Methods Data on women with recent births in Benin, Burkina Faso, Ghana, Guinea, Liberia, Mali, Nigeria, Niger, Senegal and Sierra Leone were obtained from 2006 to 2010 Demographic and Health Surveys (n = 58,512). Separate logistic regressions estimated associations of literacy and wealth quintiles with prenatal care, controlling for age, parity, marital status, rural/urban residence, religion, multiple births, pregnancy wantedness, and the woman's involvement in decision-making at home. Any prenatal care was defined by ≥1 prenatal care visit. Adequate prenatal care was defined as at least four prenatal care visits beginning in the first trimester, at least one with a skilled provider. Results Seventy-eight percent of women had any prenatal care; 23 % had adequate care. Women who were not literate had lower odds of having any prenatal care (odds ratio, OR 0.29; 95 % confidence interval, CI 0.26-0.33) and lower odds of adequate care (OR 0.73, CI 0.68-0.78). Women in the poorest wealth quintile were substantially less likely to have any prenatal care than women in the wealthiest quintile (OR 0.24, CI 0.11-0.18), and less likely to have adequate care (OR 0.31, CI 0.27-0.35). Conclusions for Practice A substantial percentage of women in West Africa have no prenatal care. Few have adequate care. Illiteracy and poverty are important risk factors for having little or no prenatal care. Increasing education for girls, promoting culturally appropriate messages about prenatal care, and building trust in providers may increase prenatal care.
目的 研究西非地区家庭财富和个人识字水平与产前保健之间的关联。方法 从2006年至2010年的人口与健康调查中获取贝宁、布基纳法索、加纳、几内亚、利比里亚、马里、尼日利亚、尼日尔、塞内加尔和塞拉利昂近期生育妇女的数据（n = 58,512）。通过单独的逻辑回归分析识字水平和财富五分位数与产前保健之间的关联，并对年龄、胎次、婚姻状况、城乡居住情况、宗教信仰、多胎妊娠、妊娠意愿以及妇女在家庭决策中的参与度进行控制。任何产前保健定义为至少进行过1次产前检查。充分产前保健定义为从孕早期开始至少进行4次产前检查，且至少有1次是由专业医护人员进行。结果 78%的妇女接受过任何产前保健；23%接受过充分保健。不识字的妇女接受任何产前保健的几率较低（优势比，OR 0.29；95%置信区间，CI 0.26 - 0.33），接受充分保健的几率也较低（OR 0.73，CI 0.68 - 0.78）。最贫困财富五分位数组的妇女接受任何产前保健的可能性显著低于最富裕五分位数组的妇女（OR 0.24，CI 0.11 - 0.18），接受充分保健的可能性也较低（OR 0.31，CI 0.27 - 0.35）。实践结论 西非地区相当大比例的妇女没有接受产前保健。很少有人接受充分保健。文盲和贫困是接受很少或没有产前保健的重要风险因素。提高女童教育水平、传播关于产前保健的文化适宜信息以及增强对医护人员的信任可能会增加产前保健。
