在埃塞俄比亚西北部达巴特健康与人口监测系统站点，频繁的产前检查增加了机构分娩率。
Frequent Antenatal Care Visits Increase Institutional Delivery at Dabat Health and Demographic Surveillance System Site, Northwest Ethiopia.
作者信息
Fekadu Abel, Yitayal Mezgebu, Alemayehu Geta Asrade, Abebe Solomon Mekonnen, Ayele Tadesse Awoke, Tariku Amare, Andargie Gashaw, Teshome Destaw Fetene, Gelaye Kassahun Alemu
机构信息
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Ethiopia.
Department of Health Service Management and Health Economics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Ethiopia.
出版信息
J Pregnancy. 2019 Jan 27;2019:1690986. doi: 10.1155/2019/1690986. eCollection 2019.
BACKGROUND
Early diagnosis of pregnancy, professional follow-up, and skilled delivery service are the main interventions that reduce maternal morbidity and mortality. Generating local based evidence could support targeted and effective intervention placed by a government. Therefore, determining the prevalence of skilled institutional delivery and its associated factors is of supreme importance.
METHODS
A community based cross-sectional study was conducted among pregnant women at Dabat Health and Demographic Surveillance System (DHDSS) site from 2014 to 2015. A total of 1290 pregnant women were included in the study. Data were extracted from what was collected as part of the ongoing DHDSS. Variables were extracted from the Household Registration System (HRS2 version 2.1) database and exported to STATA version 14.1 for analysis. Binary logistic regression was used to identify the factors associated with skilled institutional delivery. Statistical test was considered significant at P value < 0.05.
RESULTS
The proportion of skilled institutional delivery was 31.0% (95% CI: 28.5, 33.6). Frequent Antenatal care (ANC) visits (Adjusted Odds Ratio (AOR): 2.94; 95% CI: 1.75, 4.94)), living in urban setting (AOR: 9.54; 95% CI: 5.99, 15.17), and ability to read and write (AOR: 1.81; 95% CI: 1.18, 2.75) were factors associated with increased delivery in the health institutions. On the other hand, giving more number of births (AOR: 0.39; 95% CI: 0.22, 0.66) decreased health institution delivery by 61%.
CONCLUSION
Higher rate of skilled institutional delivery has been observed at the surveillance site as compared with the previous national estimates. Giving less number of births, frequent ANC visits, being in urban residence, and ability to read and write increased the likelihood of health institution delivery. Strengthening interventions that could influence the identified factors could improve mothers' choice to skilled institutional delivery.
背景
早期妊娠诊断、专业随访和熟练的分娩服务是降低孕产妇发病率和死亡率的主要干预措施。生成基于当地的证据可以支持政府实施有针对性且有效的干预措施。因此，确定熟练机构分娩的患病率及其相关因素至关重要。
方法
2014年至2015年期间，在达巴特健康与人口监测系统（DHDSS）站点对孕妇进行了一项基于社区的横断面研究。共有1290名孕妇纳入研究。数据从作为正在进行的DHDSS一部分收集的资料中提取。变量从家庭登记系统（HRS2版本2.1）数据库中提取，并导出到STATA 14.1版本进行分析。采用二元逻辑回归来确定与熟练机构分娩相关的因素。当P值<0.05时，统计检验被认为具有显著性。
结果
熟练机构分娩的比例为31.0%（95%置信区间：28.5，33.6）。频繁的产前检查（ANC）就诊（调整后的优势比（AOR）：2.94；95%置信区间：1.75，4.94）、居住在城市地区（AOR：9.54；95%置信区间：5.99，15.17）以及读写能力（AOR：1.81；95%置信区间：1.18，2.75）是与在医疗机构分娩增加相关的因素。另一方面，生育次数较多（AOR：0.39；95%置信区间：0.22，0.66）使医疗机构分娩减少了61%。
结论
与之前的全国估计相比，在监测站点观察到熟练机构分娩的比例更高。生育次数较少、频繁进行产前检查、居住在城市以及具备读写能力会增加在医疗机构分娩的可能性。加强能够影响已确定因素的干预措施可以提高母亲选择熟练机构分娩的几率。
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