Rutaremwa Gideon, Kabagenyi Allen
United Nations Economic Commission for Africa (ECA), Social Development Policy Division, P.O.Box 3001, Addis Ababa, Ethiopia.
Center for Population and Applied Statistics (CPAS) and Department of Population Studies, Makerere University, Kampala, Uganda.
BMC Health Serv Res. 2016 Sep 20;16:494. doi: 10.1186/s12913-016-1761-3.
While the rationale for integration of HIV and sexual and reproductive health (HIV and SRH) services is strong, there is paucity of information on which population groups most utilize these services. Such studies would inform policy and programs on integration of services. The overall objective of this assessment is to provide information to researchers, planners and policy makers on the best practices for integrated services in order to maximize feasibility of scaling up. Specifically, this research paper identifies demographic and socioeconomic factors that are most related to utilization of integrated services in Uganda.
This manuscript uses data from a sample of 9,691 women interviewed during the Uganda AIDS Indicator Survey (UAIS) of 2011. The selection criteria of the study respondents for this paper included women of reproductive age 15 - 49 years. The dependent variable is whether the respondent utilized integrated HIV and SRH services during pregnancy and delivery of the last child, while independent variables include; region of residence, age-group of woman, marital status, rural-urban residence, wealth indicator and educational level attainment. In the main analysis, a binary logistic regression model was fitted to the data.
Log-odds of utilizing integrated services were significantly higher among those women with a primary education (OR = 1.2, 95 % CI = 1.0-1.4, p < 0.05) compared to those with no education. Women from the Central part of Uganda were more likely to utilize integrated HIV and SRH services (OR = 1.3, 95 % CI = 1.0-1.7, p < 0.05), further the log-odds of utilizing integrated HIV and SRH services were significantly higher among women residing in Northern region (OR = 1.6, 95 % CI = 1.2-2.2, p < 0.01). The odds of utilization of integrated HIV and SRH services were higher for currently married women (OR = 6.6, 95 % CI = 5.5-8.0, p < 0.01) and the formerly married (OR = 3.4, 95 % CI = 2.7-4.2, p < 0.01), compared to the never married group. The odds of utilizing integrated HIV and SRH services were higher for younger women of ages less than 35 years compared to older women aged 40 - 49 years.
Utilization of integrated HIV and SRH services in Uganda is influenced greatly by demographic and socioeconomic characteristics. This study contributes to the current debate as it shows the on how best ways to improve HIV and SRH service delivery to the people.
虽然整合艾滋病毒与性健康和生殖健康（艾滋病毒与性健康和生殖健康）服务的理由很充分，但关于哪些人群最常使用这些服务的信息却很少。此类研究将为服务整合的政策和项目提供参考。本次评估的总体目标是向研究人员、规划者和政策制定者提供有关综合服务最佳做法的信息，以最大限度地提高扩大规模的可行性。具体而言，本研究论文确定了乌干达与综合服务利用最相关的人口和社会经济因素。
本论文使用了2011年乌干达艾滋病指标调查（UAIS）期间对9691名女性进行访谈的数据样本。本论文研究受访者的选择标准包括15 - 49岁的育龄妇女。因变量是受访者在最后一个孩子怀孕和分娩期间是否使用了综合艾滋病毒与性健康和生殖健康服务，而自变量包括；居住地区、女性年龄组、婚姻状况、城乡居住情况、财富指标和教育程度。在主要分析中，对数据拟合了二元逻辑回归模型。
与未受过教育的女性相比，受过小学教育的女性使用综合服务的对数几率显著更高（OR = 1.2，95%CI = 1.0 - 1.4，p < 0.05）。来自乌干达中部的女性更有可能使用综合艾滋病毒与性健康和生殖健康服务（OR = 1.3，95%CI = 1.0 - 1.7，p < 0.05），此外，居住在北部地区的女性使用综合艾滋病毒与性健康和生殖健康服务的对数几率显著更高（OR = 1.6，95%CI = 1.2 - 2.2，p < 0.01）。与从未结婚的女性群体相比，目前已婚女性（OR = 6.6，95%CI = 5.5 - 8.0，p < 0.01）和曾经结婚的女性（OR = 3.4，95%CI = 2.7 - 4.2，p < 0.01）使用综合艾滋病毒与性健康和生殖健康服务的几率更高。与40 - 49岁的老年女性相比，年龄小于35岁的年轻女性使用综合艾滋病毒与性健康和生殖健康服务的几率更高。
乌干达综合艾滋病毒与性健康和生殖健康服务的利用受到人口和社会经济特征的极大影响。本研究为当前的辩论做出了贡献，因为它展示了如何以最佳方式改善向民众提供艾滋病毒与性健康和生殖健康服务的情况。
