Agho Kingsley E, Ezeh Osita K, Ogbo Felix A, Enoma Anthony I, Raynes-Greenow Camille
School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith NSW 2571, Australia.
Translational Health Research Institute, School of Medicine, Western Sydney University, Locked Bag 1797, Penrith NSW 2571, Australia.
Int Health. 2018 May 1;10(3):172-181. doi: 10.1093/inthealth/ihy011.
Antenatal care (ANC) is an essential intervention to improve maternal and child health. In Nigeria, no population-based studies have investigated predictors of poor receipt of components and uptake of ANC at the national level to inform targeted maternal health initiatives. This study aimed to examine factors associated with inadequate receipt of components and use of ANC in Nigeria.
The study used information on 20 405 singleton live-born infants of the mothers from the 2013 Nigeria Demographic and Health Survey. Multivariable logistic regression analyses that adjusted for cluster and survey weights were used to determine potential factors associated with inadequate receipt of components and use of ANC.
The prevalence of underutilization and inadequate components of ANC were 47.5% (95% CI: 45.2 to 49.9) and 92.6% (95% CI: 91.8 to 93.2), respectively. Common risk factors for underutilization and inadequate components of ANC in Nigeria included residence in rural areas, no maternal education, maternal unemployment, long distance to health facilities and less maternal exposure to the media. Other risk factors for underutilization of ANC were home births and low household wealth.
The study suggests that underutilization and inadequate receipt of the components of ANC were associated with amenable factors in Nigeria. Subsidized maternal services and well-guided health educational messages or financial support from the government will help to improve uptake of ANC services.
产前保健是改善母婴健康的一项重要干预措施。在尼日利亚，尚无基于全国人口的研究调查全国范围内产前保健各组成部分接受情况不佳及利用率低的预测因素，以指导针对性的孕产妇健康倡议。本研究旨在探讨尼日利亚产前保健各组成部分接受不足及利用情况的相关因素。
该研究采用了2013年尼日利亚人口与健康调查中母亲所生的20405名单胎活产婴儿的信息。采用多变量逻辑回归分析，并对聚类和调查权重进行了调整，以确定与产前保健各组成部分接受不足及利用情况相关的潜在因素。
产前保健利用不足和组成部分不充分的患病率分别为47.5%（95%置信区间：45.2至49.9）和92.6%（95%置信区间：91.8至93.2）。尼日利亚产前保健利用不足和组成部分不充分的常见风险因素包括居住在农村地区、母亲未受过教育、母亲失业、距离医疗机构远以及母亲接触媒体较少。产前保健利用不足的其他风险因素是在家分娩和家庭财富水平低。
该研究表明，在尼日利亚，产前保健利用不足和各组成部分接受不充分与可控因素有关。政府提供补贴的孕产妇服务以及精心指导的健康教育信息或财政支持将有助于提高产前保健服务的利用率。
