Shahabuddin Asm, De Brouwere Vincent, Adhikari Ramesh, Delamou Alexandre, Bardají Azucena, Delvaux Therese
Department of Public Health, Instituut voor Tropische Geneeskunde, Antwerp, Belgium
Department of Earth and Life Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
BMJ Open. 2017 Apr 13;7(4):e012446. doi: 10.1136/bmjopen-2016-012446.
To identify the determinants of institutional delivery among young married women in Nepal.
Nepal Demographic and Health Survey (NDHS) data sets 2011 were analysed. Bivariate and multivariate logistic regression analyses were performed using a subset of 1662 ever-married young women (aged 15-24 years).
Place of delivery.
The rate of institutional delivery among young married women was 46%, which is higher than the national average (35%) among all women of reproductive age. Young women who had more than four antenatal care (ANC) visits were three times more likely to deliver in a health institution compared with women who had no antenatal care visit (OR: 3.05; 95% CI: 2.40 to 3.87). The probability of delivering in an institution was 69% higher among young urban women than among young women who lived in rural areas. Young women who had secondary or above secondary level education were 1.63 times more likely to choose institutional delivery than young women who had no formal education (OR: 1.626; 95% CI: 1.171 to 2.258). Lower use of a health institution for delivery was also observed among poor young women. Results showed that wealthy young women were 2.12 times more likely to deliver their child in an institution compared with poor young women (OR: 2.107; 95% CI: 1.53 to 2.898). Other factors such as the age of the young woman, religion, ethnicity, and ecological zone were also associated with institutional delivery.
Maternal health programs should be designed to encourage young women to receive adequate ANC (at least four visits). Moreover, health programs should target poor, less educated, rural, young women who live in mountain regions, are of Janajati ethnicity and have at least one child as such women are less likely to choose institutional delivery in Nepal.
确定尼泊尔年轻已婚妇女中机构分娩的决定因素。
分析了2011年尼泊尔人口与健康调查（NDHS）数据集。对1662名曾婚年轻女性（年龄在15 - 24岁之间）的子集进行了双变量和多变量逻辑回归分析。
分娩地点。
年轻已婚妇女的机构分娩率为46%，高于所有育龄妇女的全国平均水平（35%）。接受过四次以上产前检查（ANC）的年轻女性在医疗机构分娩的可能性是未接受产前检查女性的三倍（比值比：3.05；95%置信区间：2.40至3.87）。城市年轻女性在机构分娩的概率比农村年轻女性高69%。接受过中等或中等以上教育的年轻女性选择机构分娩的可能性是未接受正规教育年轻女性的1.63倍（比值比：1.626；95%置信区间：1.171至2.258）。贫困年轻女性在医疗机构分娩的使用率也较低。结果显示，富裕年轻女性在机构分娩的可能性是贫困年轻女性的2.12倍（比值比：2.107；95%置信区间：1.53至2.898）。年轻女性的年龄、宗教、种族和生态区域等其他因素也与机构分娩有关。
孕产妇健康项目应旨在鼓励年轻女性接受充分的产前检查（至少四次）。此外，健康项目应针对贫困、受教育程度较低、农村、居住在山区、属于贾纳贾蒂族且至少有一个孩子的年轻女性，因为这类女性在尼泊尔选择机构分娩的可能性较小。
