Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS One. 2019 Mar 25;14(3):e0214375. doi: 10.1371/journal.pone.0214375. eCollection 2019.
Maternity care services provide critical interventions aimed at improving maternal and newborn health. In this study, we examined determinants of antenatal care (ANC) content in Syria, together with changes over time.
We analysed two national surveys conducted by the Central Bureau of Statistics in Damascus (PAPFAM 2001 and MICS 2006). Findings of this initial analysis led to a qualitative study on adequacy of antenatal care content in two Syrian governorates, Aleppo and Latakia in 2010, which in turn informed further quantitative analysis. The perspectives and practices of doctors, women, midwives and health officials were explored using in-depth interviews. A framework approach was used to analyse the data.
The quantitative analysis demonstrated that women's education level, the type of health facility they attended and whether they had experienced health complications were important determinants of adequacy of ANC content received. The qualitative study revealed that additional factors related to supply side and demand side factors (e.g. organization of health services, doctors' selective prescription of ANC tests and women's selective uptake of those tests), influenced the quality of ANC and explained some regional differences between Aleppo and Latakia.
The percentage of women who received adequate ANC content was probably higher in Latakia than in Aleppo because women in Latakia were more educated, and because services were more available, accessible, and acceptable to them.
孕产妇保健服务提供了重要的干预措施，旨在改善母婴健康。本研究旨在探讨叙利亚产前保健（ANC）内容的决定因素及其随时间的变化。
我们分析了由大马士革中央统计局进行的两项全国性调查（PAPFAM 2001 年和 MICS 2006 年）。这项初步分析的结果导致了 2010 年在叙利亚两个省份阿勒颇和拉塔基亚进行的关于产前保健内容充足性的定性研究，这反过来又为进一步的定量分析提供了信息。使用深入访谈探讨了医生、妇女、助产士和卫生官员的观点和做法。采用框架方法对数据进行分析。
定量分析表明，妇女的教育水平、她们就诊的卫生机构类型以及是否经历过健康并发症是接受 ANC 内容充足性的重要决定因素。定性研究表明，与供应方和需求方因素（例如卫生服务的组织、医生对 ANC 检查的选择性处方以及妇女对这些检查的选择性接受）有关的其他因素影响了 ANC 的质量，并解释了阿勒颇和拉塔基亚之间的一些地区差异。
拉塔基亚接受足够 ANC 内容的妇女比例可能高于阿勒颇，因为拉塔基亚的妇女受教育程度更高，而且服务对她们来说更加可用、可及和可接受。
