School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
African Mental Health Research Initiative (AMARI) post-doctoral fellow, Addis Ababa University, Addis Ababa, Ethiopia.
BMC Pregnancy Childbirth. 2019 Feb 11;19(1):64. doi: 10.1186/s12884-019-2216-8.
Antenatal care provides the best opportunity to promote maternal and child health services use. But many Ethiopian mothers deliver at home and fail to attend postnatal care. Therefore, this study was done to identify factors associated with health facility delivery among mothers who attended four or more antenatal care visits. The study was also intended to identify factors associated with postnatal care service use among mothers who delivered at home after four or more antenatal care visits.
This study used the 2016 Ethiopian Demographic and Health Survey data. Two thousand four hundred fifteen women who attended four or more antenatal care visits were included to identify factors associated with health facility delivery after four or more antenatal care visits. Among them, 1055 mothers delivered at home. These women were included to identify factors associated with postnatal care service use. Stata 15.1 was used to analyze the data. Multivariable logistic regression model was fitted to identify associations between the outcome and predictor variables.
Among women who had four or more antenatal care visits, 56% delivered at health facility. Mothers with secondary or higher level of education (AOR = 2.9; 95% CI = 1.6-5.3), urban residents (AOR = 3.4; 95% CI = 1.9-6.1), women with highest wealth quintile (AOR = 2.7; 95% CI = 1.5-4.8), and working women (AOR = 1.6; 95% CI = 1.2-2.3) had higher odds of delivering at health facilities. High birth order (AOR = 0.5; 95% CI = 0.3-0.7) was negatively associated with a lower likelihood of health facility delivery. Among women who delivered at home, only 8% received postnatal care within 42 days after delivery. Only the content of care received during antenatal care visits (AOR = 1.40; 95% CI = 1.1-1.8) was significantly associated with postnatal care attendance.
Women with lower socio-economic status had lower odds of giving birth at health facility even after attending antenatal care. The more antenatal care components a mother received, the higher her probability of delivering at health facility. Similarly, postnatal care attendance was higher among women who had received more antenatal care components.
产前护理提供了促进母婴健康服务利用的最佳机会。但是，许多埃塞俄比亚母亲在家分娩，未能接受产后护理。因此，本研究旨在确定与接受过四次或更多次产前护理的母亲中在医疗机构分娩相关的因素。该研究还旨在确定与接受过四次或更多次产前护理后在家中分娩的母亲中使用产后护理服务相关的因素。
本研究使用了 2016 年埃塞俄比亚人口与健康调查数据。纳入了 2415 名接受过四次或更多次产前护理的妇女，以确定与接受过四次或更多次产前护理后的医疗机构分娩相关的因素。其中，有 1055 名母亲在家中分娩。将这些妇女纳入，以确定与产后护理服务使用相关的因素。使用 Stata 15.1 分析数据。多变量逻辑回归模型用于确定结局与预测变量之间的关联。
在接受过四次或更多次产前护理的妇女中，有 56%在家中分娩。接受过中等或高等教育的母亲（AOR=2.9；95%CI=1.6-5.3）、城市居民（AOR=3.4；95%CI=1.9-6.1）、处于最高财富五分位数的妇女（AOR=2.7；95%CI=1.5-4.8）和职业妇女（AOR=1.6；95%CI=1.2-2.3），更有可能在医疗机构分娩。高出生顺序（AOR=0.5；95%CI=0.3-0.7）与较低的医疗机构分娩可能性呈负相关。在家中分娩的妇女中，只有 8%在分娩后 42 天内接受产后护理。只有在产前护理期间接受的护理内容（AOR=1.40；95%CI=1.1-1.8）与接受产后护理有显著关联。
社会经济地位较低的妇女即使接受了产前护理，在医疗机构分娩的可能性也较低。母亲接受的产前护理内容越多，在医疗机构分娩的可能性就越高。同样，接受过更多产前护理内容的妇女接受产后护理的比例也更高。
