J Assoc Nurses AIDS Care. 2019 Sep-Oct;30(5):548-555. doi: 10.1097/JNC.0000000000000050.
As maternal child health (MCH) programs expand in the setting of HIV, health systems are challenged to reach those most vulnerable and at the greatest need. Cross-sectional surveys of MCH clinics and recent mothers in the Siaya Health Demographic Surveillance System were conducted to assess correlates of accessing antenatal care and facility delivery. Of 376 recent mothers, 93.4% accessed antenatal care and 41.2% accessed facility delivery. Per-kilometer distance between maternal residence and the nearest facility offering delivery services was associated with 7% decreased probability of uptake of facility delivery. Compared with a reference of less than 1 km between home and clinic, a distance of more than 3 km to the nearest facility was associated with 25% decreased probability of uptake of facility delivery. Distance to care was a factor in accessing facility delivery services. Decentralization or transportation considerations may be useful to optimize MCH and HIV service impact in high-prevalence regions.
随着母婴健康（MCH）项目在艾滋病毒环境下的扩展，卫生系统面临着向最脆弱和最有需要的人群提供服务的挑战。对 Siaya 健康人口监测系统中的 MCH 诊所和近期产妇进行了横断面调查，以评估获得产前护理和设施分娩的相关因素。在 376 名近期产妇中，93.4%接受了产前护理，41.2%接受了设施分娩。产妇居住地与提供分娩服务的最近设施之间每公里的距离与设施分娩接受率降低 7%相关。与家庭和诊所之间的距离小于 1 公里的参考值相比，最近设施的距离超过 3 公里与设施分娩接受率降低 25%相关。距离是获得设施分娩服务的一个因素。权力下放或交通考虑因素可能有助于优化高流行地区的母婴健康和艾滋病毒服务影响。
