通过马拉维的产妇候产之家惠及弱势妇女。
Reaching vulnerable women through maternity waiting homes in Malawi.
作者信息
Singh Kavita, Speizer Ilene, Kim Eunsoo Timothy, Lemani Clara, Phoya Ann
机构信息
Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Int J Gynaecol Obstet. 2017 Jan;136(1):91-97. doi: 10.1002/ijgo.12013. Epub 2016 Oct 24.
OBJECTIVE
To determine whether two maternity waiting homes (MWHs) supported by the Safe Motherhood Initiative are reaching vulnerable women during the early phase of their implementation.
METHODS
A cross-sectional interview-based study was conducted among women who attended two centers in Malawi with attached MWHs (Area 25 Health Centre, Lilongwe; and Kasungu District Hospital, Kasungu). Between April and June 2015, exit interviews were conducted among MWH users and non-users.
RESULTS
Compared with non-users, MWH users at Area 25 were significantly more likely to report a prior spontaneous abortion (10/46 [21.7%] vs 5/95 [5.3%]; P=0.006) and to be in the lowest wealth quintile (4/87 [4.6%] vs 0/150; P=0.029). Although not significant, a greater percentage of MWH users at Kasungu District Hospital than non-users had a prior stillbirth (6/84 [7.1%] vs 0/77) or spontaneous abortion (3/84 [3.6%] vs 2/77 [2.6%]), and were in the lowest wealth quintile (15/175 [8.6%] vs 5/141 [3.5%]). MWH users at Kasungu lived further from the hospital than did non-MWH users, although the difference was not significant (mean 6.81±9.1 km vs 4.05±7.42 km; P=0.067).
CONCLUSION
MWHs offer a promising strategy to reduce maternal mortality in Malawi and other low-income countries.
目的
确定由安全孕产倡议支持的两个产妇候产之家（MWHs）在实施早期阶段是否能够惠及弱势妇女。
方法
在马拉维两个设有MWHs的中心（利隆圭的25区健康中心；卡松古的卡松古区医院）就诊的妇女中开展了一项基于访谈的横断面研究。2015年4月至6月期间，对MWHs使用者和非使用者进行了出院访谈。
结果
与非使用者相比，25区的MWHs使用者报告既往自然流产的可能性显著更高（10/46 [21.7%] 对5/95 [5.3%]；P=0.006），且处于最贫困财富五分位数的可能性也显著更高（4/87 [4.6%] 对0/150；P=0.029）。虽然差异不显著，但卡松古区医院的MWHs使用者中，有既往死产（6/84 [7.1%] 对0/77）或自然流产（3/84 [3.6%] 对2/77 [2.6%]）的比例高于非使用者，且处于最贫困财富五分位数的比例也更高（15/175 [8.6%] 对5/141 [3.5%]）。卡松古的MWHs使用者居住距离医院比非MWHs使用者更远，尽管差异不显著（平均6.81±9.1公里对4.05±7.42公里；P=0.067）。
结论
产妇候产之家为降低马拉维和其他低收入国家的孕产妇死亡率提供了一个有前景的策略。
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