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影响南非北开普省约翰·陶洛·盖特塞韦(JTG)地区青少年产前护理利用情况的因素:强调应对健康的社会决定因素的必要性。

Factors that Influence Teenage Antenatal Care Utilization in John Taolo Gaetsewe (JTG) District of Northern Cape Province, South Africa: Underscoring the Need for Tackling Social Determinants of Health.

作者信息

Worku Eshetu Bekele, Woldesenbet Selamawit Alemu

机构信息

Northern Cape Department of Health, Kimberley 8301, South Africa.

U.S. Centers for Disease Control and Prevention, Pretoria 0001, South Africa.

出版信息

Int J MCH AIDS. 2016;5(2):134-145.

Abstract

BACKGROUND AND OBJECTIVES

In resource-limited settings, the uptake of antenatal care visits among women, especially teenage pregnant women, is disturbingly low. Factors that influence the uptake of ANC services among teenage women is largely understudied and poorly understood in John Taolo Gaetsewe (JTG), a predominantly rural and poor district of South Africa. The aim of this study was to determine the factors that influence uptake of ANC services among teenage mothers in JTG district.

METHODS

A cross-sectional health facility-based study utilising mixed method was conducted in all public health facilities (n=44) at JTG district. Mother-infant pairs (n=383) who brought their infants for six-week first DPT immunisation during the study period were enrolled in the study. Structured questionnaires were used to collect data on demographic, socio-economic and uptake of ANC indicators.

RESULTS

Out of 272 respondent mothers, 18.68% were adolescent mothers (13-19 years). The logistic regression analysis shows that mother's age (OR=2.11; 95%CI = 1.04 - 4.27); distance to the nearest health facility (OR=3.38; 95%CI = 1.45-7.87); and client service satisfaction (OR=8.58; 95%CI =2.10-34.95 are significantly associated with poor uptake of ANC services.

CONCLUSION AND GLOBAL HEALTH IMPLICATIONS

There is a need to improve the quality of adolescent reproductive health services tailored to their health and developmental needs. Moreover, addressing the social determinants of health that affect individual's healthy life style and health seeking behavior is critical.

摘要

背景与目的

在资源有限的环境中,女性尤其是青少年孕妇的产前检查就诊率低得令人担忧。在南非一个以农村为主且贫困的约翰·陶洛·盖特塞韦(JTG)地区,对影响青少年女性接受产前护理服务的因素研究甚少且了解不足。本研究的目的是确定JTG地区影响青少年母亲接受产前护理服务的因素。

方法

在JTG地区的所有公共卫生机构(n = 44)中开展了一项基于卫生机构的横断面混合方法研究。在研究期间带婴儿前来进行六周龄首次百白破疫苗接种的母婴对(n = 383)纳入研究。使用结构化问卷收集有关人口统计学、社会经济状况和产前护理指标接受情况的数据。

结果

在272名受访母亲中,18.68%为青少年母亲(13 - 19岁)。逻辑回归分析表明,母亲年龄(比值比[OR]=2.11;95%置信区间[CI]=1.04 - 4.27);到最近卫生机构的距离(OR = 3.38;95%CI = 1.45 - 7.87);以及客户服务满意度(OR = 8.58;95%CI = 2.10 - 34.95)与产前护理服务接受率低显著相关。

结论及全球健康意义

有必要根据青少年的健康和发展需求,提高青少年生殖健康服务的质量。此外,解决影响个人健康生活方式和就医行为的健康社会决定因素至关重要。

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