Department of Healthcare Management, Eulji University, Seongnam 13135, Korea.
Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen 9713 GZ, The Netherlands.
Int J Environ Res Public Health. 2019 Mar 15;16(6):932. doi: 10.3390/ijerph16060932.
Medical facility birth with skilled birth attendance is essential to reduce maternal mortality. The purpose of this study was to assess the demographic characteristics, socio-economic factors, and varied health information sources that may influence the uptake of birth services in Pakistan. We used pooled data from Maternal-Child Health Program Indicator Survey 2013 and 2014. Study population was 9719 women. Generalized linear model with log link and a Poisson distribution was used to identify factors associated with place of birth. 3403 (35%) women gave birth at home, and 6316 (65%) women gave birth at a medical facility. After controlling for all covariates, women's age, number of children, education, wealth, and mother and child health information source (doctors and nurses/midwives) were associated with facility births. Women were significantly less likely to give birth at a medical facility if they received maternal-child health information from low-level health workers or relatives/friends. The findings suggest that interventions should target disadvantaged and vulnerable groups of women after considering rural-urban differences. Training non-health professionals may help improve facility birth. Further research is needed to examine the effect of individual information sources on facility birth, both in urban and rural areas in Pakistan.
医疗设施分娩和熟练的接生人员对于降低产妇死亡率至关重要。本研究旨在评估人口统计学特征、社会经济因素以及不同的健康信息来源，这些因素可能会影响巴基斯坦的分娩服务的采用。我们使用了 2013 年和 2014 年母婴健康计划指标调查的汇总数据。研究对象为 9719 名妇女。使用带有对数链接和泊松分布的广义线性模型来确定与分娩地点相关的因素。3403 名（35%）妇女在家中分娩，6316 名（65%）妇女在医疗设施中分娩。在控制所有协变量后，妇女的年龄、子女数量、教育程度、财富以及母婴健康信息来源（医生和护士/助产士）与在医疗设施分娩有关。如果妇女从低级别卫生工作者或亲戚/朋友那里获得母婴健康信息，她们在医疗设施分娩的可能性显著降低。研究结果表明，在考虑城乡差异的情况下，应该针对弱势和脆弱的妇女群体实施干预措施。培训非卫生专业人员可能有助于提高在医疗设施分娩的比例。需要进一步研究以检验个体信息来源对巴基斯坦城乡地区在医疗设施分娩的影响。
