埃塞俄比亚亚的斯亚贝巴市公共卫生机构中孕妇首次产前检查的时间及其相关因素
Timing of First Antenatal Care Visit and its Associated Factors among Pregnant Women Attending Public Health Facilities in Addis Ababa, Ethiopia.
作者信息
Gulema Hanna, Berhane Yemane
机构信息
Department of Public Health Science, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
Department of Research and Evaluation, Addis Continental Institute of Public Health, Addis Ababa, Ethiopia.
出版信息
Ethiop J Health Sci. 2017 Mar;27(2):139-146. doi: 10.4314/ejhs.v27i2.6.
BACKGROUND
Early initiation of antenatal care visits is an essential component of services to improving maternal and new born health. The Ethiopian Demographic and Health Survey conducted in 2011 indicated that only 11% of pregnant women start antenatal care in the first trimester. However, detailed study to identify factors associated with late initiation of care has not been conducted in Addis Ababa where access to health services is almost universal. The aim of this study was to assess the level of late first antenatal care visit and the associated factors.
METHODS
Facility based cross sectional study was conducted in public health centers in Addis Ababa. The health centers with experience of at least more than two years were selected randomly, one form each sub-city. The study subjects were pregnant women visiting the facilities for the first time during the index pregnancy. The study health centers were selected randomly from each sub-city, and the study women were recruited consecutively until the required sample size was achieved. Data were collected using pre-tested questionnaire. Logistic regression analysis was done to identify factors associated with late ANC initiation.
RESULT
A total of 979 women participated in the study; 411(42.0%; 95% CI of 38.9%, 45.1%) of them came for their first ANC visit late, after 16 weeks of gestation. Wrongly perceived ANC initiation schedule was the strongest predictor of late initiation. After controlling for basic demographic and obstetric factors, the odds of starting the first antenatal care visit late was higher for women who did not know the antennal care initiation schedule correctly compared to women who knew the schedule correctly (AOR6.6; 95% CI 3.03, 14.03).
CONCLUSION
Over 40% of pregnant women do not initiate ANC visit in the first trimester largely due to lack of correct knowledge of the recommended ANC schedule.
背景
尽早开始产前检查是改善孕产妇和新生儿健康服务的重要组成部分。2011年进行的埃塞俄比亚人口与健康调查显示，只有11%的孕妇在孕早期开始产前检查。然而，在亚的斯亚贝巴尚未开展详细研究以确定与延迟开始产前检查相关的因素，该市几乎人人都能获得医疗服务。本研究的目的是评估首次产前检查延迟的程度及其相关因素。
方法
在亚的斯亚贝巴的公共卫生中心开展基于机构的横断面研究。随机选择至少有两年经验的卫生中心，每个次城市选一个。研究对象为在本次妊娠期间首次到这些机构就诊的孕妇。从每个次城市随机选择研究卫生中心，连续招募研究对象，直至达到所需样本量。使用经过预测试的问卷收集数据。进行逻辑回归分析以确定与延迟开始产前检查相关的因素。
结果
共有979名妇女参与研究；其中411名（42.0%；95%可信区间为38.9%，45.1%）在妊娠16周后才首次进行产前检查。对产前检查开始时间的错误认知是延迟开始的最强预测因素。在控制了基本人口统计学和产科因素后，与正确知晓产前检查开始时间的妇女相比，不知道正确产前检查开始时间的妇女延迟首次产前检查的几率更高（调整后比值比为6.6；95%可信区间为3.03，14.03）。
结论
超过40%的孕妇在孕早期未开始产前检查，主要原因是对推荐的产前检查时间表缺乏正确认识。
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