巴基斯坦信德省产前护理使用的相关因素：基于人群的研究。
Factors associated with the use of antenatal care in Sindh province, Pakistan: A population-based study.
机构信息
Department of Healthcare Management, Eulji University, Seongnam, Korea.
Global Health Unit, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands.
出版信息
PLoS One. 2019 Apr 3;14(4):e0213987. doi: 10.1371/journal.pone.0213987. eCollection 2019.
BACKGROUND
Antenatal care (ANC) is critical to decrease maternal and neonatal mortality. However, little is known about the utilization of ANC services in Pakistan. This study assessed the utilization of ANC in Sindh province, Pakistan, and identified the factors that affect its use.
METHODS
We analysed a subset of data from Maternal and Child Health (MCH) Program Indicator Surveys conducted in Sindh province, Pakistan in 2013 and 2014. Respondents included 10,200 women who had given birth in the past two years. The outcome measure was making at least four ANC visits. Logistic regression models were used to identify demographic, socioeconomic, characteristics of ANC, and informational factors associated with ANC use.
RESULTS
Most women (83.5%) received one or more ANC, mostly by doctors (95%), but only 57.3% of them made the recommended four or more visits, and just 53.7% received their initial ANC care during the first trimester. Making four or more ANC visits was associated with: fewer household occupants (odds ratio [OR] = 0.98; 95% confidence interval [CI] = [0.97, 0.99]), large city residence (OR = 1.92; 95% CI = [1.57, 2.35]), higher women's education (OR = 1.70; 95% CI = [1.33, 2.15]), greater household wealth (OR = 5.66; 95% CI = [4.22, 7.60]), and receiving MCH information from lady health worker (OR = 1.17; 95% CI = [1.00, 1.37]), mother-in-law (OR = 1.17; 95% CI = [1.01, 1.36]), other relatives/friends (OR = 1.19; 95% CI = [1.03, 1.38]), or nurse/midwife (OR = 1.31; 95% CI = [1.06, 1.61]).
CONCLUSIONS
This study demonstrates that both socioeconomic factors and health information sources are associated with women's use of ANC. Therefore, programs should target socially disadvantaged and vulnerable groups, particularly rural, less educated, and poor women, to improve utilization of ANC. In addition, strategies to increase exposure to MCH information sources should be a priority in Sindh, Pakistan.
背景
产前护理（ANC）对于降低母婴死亡率至关重要。然而，目前对于巴基斯坦利用 ANC 服务的情况知之甚少。本研究评估了巴基斯坦信德省 ANC 的利用情况，并确定了影响其利用的因素。
方法
我们分析了 2013 年和 2014 年在巴基斯坦信德省进行的母婴健康（MCH）计划指标调查的一个子数据集。受访者包括过去两年内分娩的 10200 名妇女。结局指标是至少进行 4 次 ANC 检查。使用逻辑回归模型确定与 ANC 利用相关的人口统计学、社会经济学、ANC 特征和信息因素。
结果
大多数妇女（83.5%）接受了一次或多次 ANC，主要是由医生提供（95%），但只有 57.3%的人进行了推荐的 4 次或更多次检查，只有 53.7%的人在孕早期接受了首次 ANC 护理。进行 4 次或更多次 ANC 检查与以下因素相关：家庭居住人数较少（比值比[OR] = 0.98；95%置信区间[CI] = [0.97，0.99]）、居住在大城市（OR = 1.92；95% CI = [1.57，2.35]）、女性受教育程度较高（OR = 1.70；95% CI = [1.33，2.15]）、家庭财富较高（OR = 5.66；95% CI = [4.22，7.60]）以及从妇女健康工作者（OR = 1.17；95% CI = [1.00，1.37]）、婆婆（OR = 1.17；95% CI = [1.01，1.36]）、其他亲戚/朋友（OR = 1.19；95% CI = [1.03，1.38]）或护士/助产士（OR = 1.31；95% CI = [1.06，1.61]）获得 MCH 信息。
结论
本研究表明，社会经济因素和健康信息来源都与妇女使用 ANC 有关。因此，应针对社会劣势和弱势群体，特别是农村、教育程度较低和贫困妇女，开展提高 ANC 利用率的项目。此外，在巴基斯坦信德省，增加接触母婴健康信息来源的策略应是优先事项。
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