Sánchez-Gómez Amaya, Cevallos William, Grijalva Mario J, Silva-Ayçaguer Luis C, Tamayo Susana, Jacobson Jerry O, Costales Jaime A, Jiménez-Garcia Rodrigo, Hernández-Barrera Valentín, Serruya Suzanne, Riera Celia
Organización Panamericana de la Salud, Quito, Ecuador.
Centro de Biomedicina, Carrera de Medicina, Universidad Central del Ecuador, Quito, Ecuador.
Rev Panam Salud Publica. 2016 Nov;40(5):341-346.
Prenatal care is a pillar of public health, enabling access to interventions including prevention of mother-to-child transmission of HIV and congenital syphilis. This paper describes social factors related to use of prenatal care in Ecuador.
In 2011 and 2012, participant clinical history and interview information was analyzed from a national probability sample of 5 998 women presenting for delivery or miscarriage services in 15 healthcare facilities in Ecuador, to estimate prevalence of HIV, syphilis, and Chagas disease, and prenatal care coverage.
The study found that 94.1% of women had attended at least one prenatal visit, but that attendance at no less than four visits was 73.1%. Furthermore, lower educational level, greater number of pregnancies, occupation in the agriculture or livestock sector, and membership in ethnic indigenous, Afro-Ecuadorian, or other minority groups were factors associated with lack of use (no prenatal visits) or insufficient use of prenatal care (fewer than four visits or first visit at >20 weeks gestation) in Ecuador.
These results point to persistence of marked inequalities in access to and use of prenatal health services attributable to socioeconomic factors and to the need to strengthen strategies to address them, to reach the goal of universal prenatal care coverage.
产前保健是公共卫生的支柱，能提供包括预防母婴传播艾滋病毒和先天性梅毒在内的干预措施。本文描述了厄瓜多尔与产前保健利用相关的社会因素。
2011年和2012年，对厄瓜多尔15家医疗机构中5998名前来分娩或流产的妇女的全国概率样本的参与者临床病史和访谈信息进行了分析，以估计艾滋病毒、梅毒和恰加斯病的患病率以及产前保健覆盖率。
研究发现，94.1%的妇女至少进行了一次产前检查，但进行不少于四次检查的比例为73.1%。此外，教育水平较低、怀孕次数较多、从事农业或畜牧业、属于土著、非裔厄瓜多尔人或其他少数群体是厄瓜多尔缺乏产前保健利用（未进行产前检查）或产前保健利用不足（少于四次检查或妊娠>20周时首次检查）的相关因素。
这些结果表明，由于社会经济因素，在获得和利用产前保健服务方面存在明显不平等现象，且有必要加强应对这些问题的策略，以实现普遍产前保健覆盖的目标。
