Dixit Priyanka, Khan Junaid, Dwivedi Laxmi Kant, Gupta Amrita
Tata Institute of Social Sciences, Mumbai, Maharashtra, India.
International Institute for Population Sciences, Mumbai, Maharashtra, India.
PLoS One. 2017 Jul 25;12(7):e0181793. doi: 10.1371/journal.pone.0181793. eCollection 2017.
A number of studies have assessed the effectiveness of antenatal care (ANC) on uptake of institutional delivery care. However, none address the issue of association between the different components of ANC i.e. ANC component which is independent of health care delivery systems (timing and number of ANC visits), ANC components which depends on health care delivery systems (specific ANC procedures that women receive) with institutional delivery.
Data for the study has been taken from the DHS conducted in the six selected South and South-East Asian countries during 1998-2013. The two dimensions of ANC are the key predictors. The outcome variable is a binary variable, where zero '0' denotes a home delivery and one '1' denotes an institutional delivery. In addition to probit estimation biprobit estimation method has been used to correct for the possible endogeneity.
Analysis suggests that both the factors show a positive effect on institutional delivery but the level of associations are different. Probit estimation for each country suggests that the association is higher for the factor- which depends on health care delivery systems than the other factor. After correction of endogeneity through biprobit estimation we get the true associations for both the dimensions and it confirms that the ANC components which depends on health care delivery systems is more associated with the utilization of institutional delivery than the other factor.
The content of care may fulfill the women's need and expectations while visiting for ANC care. The study suggests that the quality of antenatal care must be improved which depends on health care delivery systems to motivates the women to utilize the institutional delivery.
多项研究评估了产前护理(ANC)对机构分娩护理利用率的有效性。然而,没有一项研究探讨ANC不同组成部分之间的关联问题,即独立于医疗保健提供系统的ANC组成部分(ANC就诊时间和次数)、依赖于医疗保健提供系统的ANC组成部分(妇女接受的特定ANC程序)与机构分娩之间的关联。
该研究数据取自1998年至2013年期间在六个选定的南亚和东南亚国家进行的 DHS。ANC的两个维度是关键预测因素。结果变量是一个二元变量,其中“0”表示在家分娩,“1”表示在机构分娩。除了Probit估计外,还使用了双Probit估计方法来校正可能的内生性。
分析表明,这两个因素对机构分娩都有积极影响,但关联程度不同。每个国家的Probit估计表明,依赖于医疗保健提供系统的因素的关联度高于另一个因素。通过双Probit估计校正内生性后,我们得到了两个维度的真实关联,证实了依赖于医疗保健提供系统的ANC组成部分比另一个因素与机构分娩的利用率更相关。
护理内容可能满足妇女在进行ANC护理时的需求和期望。该研究表明,必须提高依赖于医疗保健提供系统的产前护理质量,以促使妇女利用机构分娩。