Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh; University of Strathclyde, Glasgow, UK.
Health Economics and Financing Research, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
Public Health. 2018 Apr;157:94-103. doi: 10.1016/j.puhe.2018.01.010. Epub 2018 Mar 20.
To identify the factors associated with adolescent maternal healthcare utilization in Bangladesh.
A secondary analysis was undertaken using the latest data set from the Bangladesh Demographic and Health Survey (2014). Data were collected from the cross-sectional survey carried out from June to mid November 2014. In total, 17,863 ever-married women aged 15-49 years were interviewed. According to the definition of the World Health Organization, 2029 of these women were adolescents and therefore eligible for inclusion in this study.
Both bivariate and multivariate logistic regression models were used to determine the factors influencing adolescent pregnancy, use of contraception, use of antenatal care services, facility-based delivery and presence of a skilled birth attendant at the last birth. The results are presented in terms of adjusted odds ratio (OR) with 95% confidence interval (CI), at a significance level of 5%.
Maternal age, education, knowledge of menstrual regulations i.e. any procedure which disrupts the intra uterine environment, awareness of community clinic, household size, socio-economic status and administrative division were found to have a significant effect on adolescent pregnancy in Bangladesh. Sexual knowledge has a significant positive role in the use of modern contraceptives. Adolescents of low socio-economic status are significantly more likely to deliver at home compared with adolescents in the richest quintile (OR 0.26, 95% CI 0.15-0.47; P < 0.001). The likelihood of delivering at a health facility was higher among adolescents who had knowledge about sexually transmitted infections (OR 1.84, 95% CI 1.28-2.65; P < 0.001) and menstrual regulations (OR 1.41, 95% CI 1.04-1.91; P < 0.05).
Adolescent maternal healthcare utilization was associated with a number of factors including low socio-economic status, limited reproductive knowledge (e.g. menstrual regulations, sexually transmitted infections) and geographical region. The study findings will serve to inform policy and would be beneficial for introducing need-based adolescent maternal health programmes by targeting a range of maternal health services and opportunities that contribute to better health and development for adolescent mothers in Bangladesh.
确定与孟加拉国青少年产妇保健利用相关的因素。
利用最新的孟加拉国人口与健康调查（2014 年）数据集进行二次分析。数据来自于 2014 年 6 月至 11 月中旬进行的横断面调查。共有 17863 名 15-49 岁的已婚妇女接受了采访。根据世界卫生组织的定义，其中 2029 名妇女为青少年，因此有资格纳入本研究。
使用双变量和多变量逻辑回归模型来确定影响青少年怀孕、避孕措施使用、产前保健服务使用、医疗机构分娩和上次分娩有熟练接生员的因素。结果以调整后的优势比（OR）及其 95%置信区间（CI）表示，在 5%的显著水平下。
产妇年龄、教育程度、对月经规律的了解（即任何扰乱子宫内环境的程序）、对社区诊所的认识、家庭规模、社会经济地位和行政区都对孟加拉国青少年怀孕有显著影响。性知识对现代避孕药具的使用有显著的积极作用。社会经济地位较低的青少年与最富裕五分位数的青少年相比，在家分娩的可能性显著更高（OR 0.26，95%CI 0.15-0.47；P<0.001）。对性传播感染（OR 1.84，95%CI 1.28-2.65；P<0.001）和月经规律（OR 1.41，95%CI 1.04-1.91；P<0.05）有了解的青少年在医疗机构分娩的可能性更高。
青少年产妇保健利用与包括社会经济地位低、生殖知识有限（如月经规律、性传播感染）和地理位置在内的多个因素有关。研究结果将为政策提供信息，并将有利于通过针对一系列产妇保健服务和机会，为孟加拉国的青少年母亲提供基于需求的青少年产妇保健方案，从而促进青少年母亲的健康和发展。
