Asseffa Netsanet Abera, Bukola Fawole, Ayodele Arowojolu
College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia.
Department of Obstetrics and Gynaecology, College of Medicine, Pan-African University, University of Ibadan, Ibadan, Nigeria.
BMC Pregnancy Childbirth. 2016 Nov 16;16(1):355. doi: 10.1186/s12884-016-1151-1.
Maternal mortality remains a major global public health concern despite many international efforts. Facility-based childbirth increases access to appropriate skilled attendance and emergency obstetric care services as the vast majority of obstetric complications occur during delivery. The purpose of the study was to determine the proportion of facility delivery and assess factors influencing utilization of health facility for childbirth.
A cross-sectional study was conducted in two rural districts of Hadiya zone, southern Ethiopia. Participants who delivered within three years of the survey were selected by stratified random sampling. Trained interviewers administered a pre-tested semi-structured questionnaire. We employed bivariate analysis and logistic regression to identify determinants of facility-based delivery.
Data from 751 participants showed that 26.9% of deliveries were attended in health facilities. In bivariate analysis, maternal age, education, husband's level of education, possession of radio, antenatal care, place of recent ANC attended, planned pregnancy, wealth quintile, parity, birth preparedness and complication readiness, being a model family and distance from the nearest health facility were associated with facility delivery. On multiple logistic regression, age, educational status, antenatal care, distance from the nearest health facility, wealth quintile, being a model family, planned pregnancy and place of recent ANC attended were the determinants of facility-based childbirth.
Efforts to improve institutional deliveries in the region must strengthen initiatives that promote female education, opportunities for wealth creation, female empowerment and increased uptake of family planning among others. Service related barriers and cultural influences on the use of health facility for childbirth require further evaluation.
尽管国际上做出了诸多努力，但孕产妇死亡率仍是全球主要的公共卫生问题。由于绝大多数产科并发症发生在分娩期间，在医疗机构分娩可增加获得适当的专业护理和紧急产科护理服务的机会。本研究的目的是确定医疗机构分娩的比例，并评估影响利用医疗机构进行分娩的因素。
在埃塞俄比亚南部哈迪亚地区的两个农村地区进行了一项横断面研究。通过分层随机抽样选取在调查前三年内分娩的参与者。经过培训的访谈员使用预先测试的半结构化问卷进行调查。我们采用双变量分析和逻辑回归来确定医疗机构分娩的决定因素。
751名参与者的数据显示，26.9%的分娩在医疗机构进行。在双变量分析中，产妇年龄、教育程度、丈夫的教育程度、拥有收音机、产前护理、最近一次产前检查的地点、计划怀孕、财富五分位数、胎次、分娩准备和并发症准备情况、模范家庭以及与最近医疗机构的距离与医疗机构分娩有关。在多因素逻辑回归分析中，年龄、教育状况、产前护理、与最近医疗机构的距离、财富五分位数、模范家庭、计划怀孕以及最近一次产前检查的地点是医疗机构分娩的决定因素。
该地区为提高机构分娩率所做的努力必须加强促进女性教育、创造财富机会、女性赋权以及增加计划生育采用率等举措。与服务相关的障碍以及文化对利用医疗机构分娩的影响需要进一步评估。
