Mugo Ngatho S, Agho Kingsley E, Zwi Anthony B, Dibley Michael J
Sydney School of Public Health, The University of Sydney, Sydney, Australia;
School of Science and Health, Western Sydney University, Penrith, Australia.
Glob Health Action. 2016 Jul 28;9:29693. doi: 10.3402/gha.v9.29693. eCollection 2016.
In South Sudan, birth deliveries attended by unskilled birth attendants put the mothers and their newborns at increased risk of perinatal morbidity and mortality. The aim of this study was to identify factors associated with delivery by unskilled birth attendants or by unassisted delivery.
We examined data for 2,767 (weighted total) women aged 15-49 years who delivered at home 2 years prior to the South Sudan Household Health Survey 2010. Multinomial logistic regression analyses were used to identify factors associated with delivery by unskilled birth attendants or by unassisted delivery.
The prevalence of delivery by unskilled birth attendants was 19% [95% confidence interval (CI) 17.0, 20.5], by skilled birth attendants (SBAs) was 45% (95% CI 42.4, 47.0), and by unassisted delivery was 36% (95% CI 34.2, 38.6). After adjusting for potential confounders, the following factors were associated with the increased odds for unassisted delivery or delivery by an unskilled birth attendant: mothers with no schooling, who did not attend antenatal care (ANC) during pregnancy, who had lower quality of ANC services, from poor households, or who had no prior knowledge about obstetric danger signs.
We found that non-utilization of maternal health care services, such as ANC, was significantly associated with unattended birth delivery or delivery by unskilled health providers. The increased uptake of SBAs at delivery will require easier access to ANC services, health promotion on the importance and benefits of SBAs for delivery, targeting both mothers and their families, and the training and deployment of more SBAs across the country.
在南苏丹,由无技能接生员接生会使母亲及其新生儿面临围产期发病和死亡风险增加的情况。本研究的目的是确定与无技能接生员接生或无人协助分娩相关的因素。
我们检查了2010年南苏丹家庭健康调查前两年在家分娩的2767名(加权总数)15 - 49岁妇女的数据。采用多项逻辑回归分析来确定与无技能接生员接生或无人协助分娩相关的因素。
无技能接生员接生的比例为19%[95%置信区间(CI)17.0, 20.5],有技能接生员(SBA)接生的比例为45%(95% CI 42.4, 47.0),无人协助分娩的比例为36%(95% CI 34.2, 38.6)。在对潜在混杂因素进行调整后,以下因素与无人协助分娩或无技能接生员接生的几率增加相关:未受过教育的母亲、孕期未接受产前护理(ANC)的母亲、接受的ANC服务质量较低的母亲、来自贫困家庭的母亲或对产科危险信号没有预先了解的母亲。
我们发现,不利用孕产妇保健服务,如ANC,与无人接生或由无技能卫生服务提供者接生显著相关。要提高分娩时SBA的使用率,就需要更方便地获得ANC服务,针对母亲及其家庭开展关于SBA对分娩的重要性和益处的健康促进活动,以及在全国培训和部署更多的SBA。