产前护理利用的空间分布及相关因素分析——来自埃塞俄比亚人口健康调查的证据

Spatial distribution of antenatal care utilization and associated factors in Ethiopia: evidence from Ethiopian demographic health surveys.

机构信息

College of Medicine and Health Sciences Institute of Public Health, Department of Health Informatics, University of Gondar, Gondar, Ethiopia.

College of Medicine and Health Sciences, Institute of Public Health, Department of Health Informatics, Department of Epidemiology and Biostatistics, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Pregnancy Childbirth. 2018 Jun 18;18(1):242. doi: 10.1186/s12884-018-1874-2.

BACKGROUND

Antenatal care (ANC) is one of the components of care to be provided to pregnant women. In Ethiopia, characterizing the spatial distribution of antenatal care utilization is essential to prioritize risk areas where ANC is needed and facilitate interventions. Therefore, this spatial analysis was performed to assess the spatial distribution of ANC utilization between 2000 and 2011 and to identify factors associated with ANC utilization in Ethiopia.

METHODS

A total of 23,179 women who had a live birth in the five years preceding the surveys were included in the study. The spatial data were created in ArcGIS10.1 for each study clusters. The Bernoulli model was used by applying Kulldorff methods using the SaTScan™ software to analyze the purely spatial clusters of ANC utilization. Multiple logistic regression analysis was used to identify predictors affecting ANC utilization.

RESULTS

ANC utilization had spatial variations across the country. Spatial scan statistics identified 49 high performing clusters (LLR = 111.92, P < 0.001) in 2000, 51 (LLR = 114.49, P < 0.001) in 2005 and, 86 (LLR = 121.53, P < 0.001) in 2011. ANC utilization was higher among mothers; with richest wealth quintiles, lowest number of birth order, who are living in urban areas, younger and educated.

CONCLUSION

These results provide further insight into differences in ANC utilization in the country and highlight high and modest performing clusters. This could enable efficient and timely spatial targeting to improve ANC service up take in Ethiopia.

背景

产前护理（ANC）是为孕妇提供的护理内容之一。在埃塞俄比亚，对产前护理利用情况的空间分布进行特征描述对于确定需要 ANC 的高风险地区以及促进干预措施至关重要。因此，进行了这项空间分析，以评估 2000 年至 2011 年期间产前护理利用的空间分布，并确定与埃塞俄比亚产前护理利用相关的因素。

方法

本研究共纳入了在调查前五年内有活产的 23179 名妇女。在 ArcGIS10.1 中为每个研究集群创建了空间数据。使用 Kulldorff 方法，通过 SaTScan™软件应用 Bernoulli 模型来分析 ANC 利用的纯粹空间集群。使用多因素逻辑回归分析来确定影响 ANC 利用的预测因素。

结果

ANC 利用在全国范围内存在空间差异。空间扫描统计数据在 2000 年确定了 49 个表现良好的集群（LLR=111.92，P<0.001），2005 年确定了 51 个（LLR=114.49，P<0.001），2011 年确定了 86 个（LLR=121.53，P<0.001）。最富有的五个财富阶层、出生顺序最低、居住在城市地区、年龄较小和受过教育的母亲更倾向于利用 ANC。