2016年1月在埃塞俄比亚西北部德布雷马科斯镇进行的基于社区的横断面研究：上次怀孕时登记接受产前护理的妇女的家庭分娩情况及相关因素
Home delivery among antenatal care booked women in their last pregnancy and associated factors: community-based cross sectional study in Debremarkos town, North West Ethiopia, January 2016.
作者信息
Kasaye Habtamu Kebebe, Endale Zerfu Mulaw, Gudayu Temesgen Worku, Desta Melese Siyoum
机构信息
Midwifery Department, College of Medical and Health Sciences, Wollega University, P.O. Box 395, Nekemte, Ethiopia.
Midwifery Department, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia.
出版信息
BMC Pregnancy Childbirth. 2017 Jul 14;17(1):225. doi: 10.1186/s12884-017-1409-2.
BACKGROUND
In Ethiopia, nearly half of the mothers who were booked for antenatal care, who supposed to have institutional delivery, gave home delivery nationally. Home delivery accounts majority while few of childbirth were attended by the skilled provider in Amhara regional state. This study aimed to determine the proportion of home delivery and associated factors among antenatal care booked women who gave childbirth in the past 1 year in Debremarkos Town, Northwest Ethiopia.
METHODS
A community-based Cross sectional study was conducted from January 1st 25th 2016. Epi Info version 7 was used to determine a total sample size of 518 and simple random sampling procedure was employed. Data was collected through an interview by using pretested structured questionnaire. Data were entered into Epi Info version 7, cleaned and exported to SPSS version 21 for analysis. A p-value less than or equals to 0.05 at 95% Confidence Intervals of odds ratio were taken as significance level in the multivariable model.
RESULTS
A total of 127 (25.3%) women gave childbirth at home. Un-attending formal education (Adjusted Odds Ratio = 7.56, 95% CI: [3.28, 17.44]), absence of health facility within 30 min distance (AOR = 3.41, 95% CI: [1.42, 8.20]), not exposed to media (AOR = 4.46, 95% CI: [2.09, 9.49]), Unplanned pregnancy (AOR = 3.47, 95% CI [1.82, 6.61]), attending ANC at health post (AOR = 5.45, 95% CI: (1.21, 24.49) and health center (AOR = 2.74, 95% CI [1.29, 5.82]), perceived privacy during ANC (AOR = 3.69[1.25, 10.91]) and less than four times ANC visit (AOR = 5.04, 95% CI (2.30, 11.04]) were significantly associated with home delivery.
CONCLUSIONS
Home delivery in this study was found to be low. Educational level, media exposure, geographic access to a health facility, Unplanned pregnancy, an institution where ANC was booked, perceived privacy during ANC and number of ANC visit were found to be determinants of home delivery. Health institutions, health professionals, policy makers, community leaders and all concerned with the planning and implementation of maternity care in Ethiopia need to consider these associations in implementing services and providing care, for pregnant women.
背景
在埃塞俄比亚，全国范围内，近一半已登记接受产前护理且本应在医疗机构分娩的母亲选择了在家分娩。在家分娩占大多数，而在阿姆哈拉州，只有少数分娩由专业医护人员接生。本研究旨在确定埃塞俄比亚西北部德布雷马科斯镇在过去1年中已登记接受产前护理并分娩的妇女在家分娩的比例及相关因素。
方法
于2016年1月1日至25日开展了一项基于社区的横断面研究。使用Epi Info 7版本确定了518的总样本量，并采用简单随机抽样程序。通过使用预先测试的结构化问卷进行访谈来收集数据。数据录入Epi Info 7版本，进行清理后导出到SPSS 21版本进行分析。在多变量模型中，95%置信区间的比值比p值小于或等于0.05被视为显著水平。
结果
共有127名（25.3%）妇女在家分娩。未接受正规教育（调整后的比值比=7.56，95%置信区间：[3.28, 17.44]）、距离30分钟路程内没有医疗机构（调整后的比值比=3.41，95%置信区间：[1.42, 8.20]）、未接触媒体（调整后的比值比=4.46，95%置信区间：[2.09, 9.49]）、意外怀孕（调整后的比值比=3.47，95%置信区间[1.82, 6.61]）、在卫生站接受产前护理（调整后的比值比=5.45，95%置信区间：(1.21, 24.49)）和在健康中心接受产前护理（调整后的比值比=2.74，95%置信区间[1.29, 5.82]）、产前护理期间感觉隐私（调整后的比值比=3.69[1.25, 10.91]）以及产前护理就诊次数少于4次（调整后的比值比=5.04，95%置信区间(2.30, 11.04]）与在家分娩显著相关。
结论
本研究发现在家分娩的比例较低。教育水平、媒体接触、到医疗机构的地理可达性、意外怀孕、登记接受产前护理的机构、产前护理期间感觉的隐私以及产前护理就诊次数被发现是在家分娩的决定因素。埃塞俄比亚的卫生机构、卫生专业人员、政策制定者、社区领袖以及所有参与孕产妇护理规划和实施的人员在为孕妇提供服务和护理时需要考虑这些关联因素。
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