Makerere University, College of Health Sciences, School of Public Health, Kampala, Uganda.
Centre of Excellence for Maternal and Newborn Health, Makerere University College of Health Sciences School of Public Health, Kampala, Uganda.
PLoS One. 2019 Apr 18;14(4):e0214995. doi: 10.1371/journal.pone.0214995. eCollection 2019.
Delivery in health facilities is a proxy for skilled birth attendance, which is an important intervention to reduce maternal and neonatal mortality. We investigated the determinants of facility based deliveries among women in urban slums of Kampala city, Uganda.
A cross sectional study using quantitative methods was used. A total of 420 mothers who had delivered in the past one year preceding the survey, were randomly selected and interviewed using a pre-tested interviewer administered questionnaire. Univariate and multivariable logistic regression analysis was done to determine independent predictors of facility based deliveries.
Ninety-five percent of respondents attended at least one antenatal care visit and 66.1%delivered in a health facility. Independent predictors of health facility births included exposure to media concerning facility delivery (OR = 2.5, 95% CI = 1.6-3.9), ANC attendance less than 4 times (OR = 0.6, 95% CI = 0.3-0.9) and timing of first ANC visit in the 2 and 3rd trimesters of pregnancy (OR = 0.5 95% CI = 0.3-0.8).
Despite good physical access, a third of mothers did not deliver in health facilities. Increasing health facility births among the slum dwellers can be improved through interventions geared at increased awareness, starting ANC in early stages of pregnancy and attending at least 4 ANC visits.
在医疗机构分娩是熟练接生的代表,这是减少孕产妇和新生儿死亡的重要干预措施。我们调查了乌干达坎帕拉市市区贫民窟妇女在医疗机构分娩的决定因素。
使用定量方法进行了一项横断面研究。总共随机选择了 420 名在调查前一年分娩的母亲,并使用经过预测试的访谈员管理问卷对其进行访谈。进行单变量和多变量逻辑回归分析,以确定医疗机构分娩的独立预测因素。
95%的受访者至少接受过一次产前护理就诊,66.1%在医疗机构分娩。医疗机构分娩的独立预测因素包括接触有关医疗机构分娩的媒体(OR=2.5,95%CI=1.6-3.9)、产前护理就诊次数少于 4 次(OR=0.6,95%CI=0.3-0.9)和第一次产前护理就诊时间在妊娠 2 至 3 个月(OR=0.5,95%CI=0.3-0.8)。
尽管物理通道良好,但仍有三分之一的母亲未在医疗机构分娩。通过增加意识、在妊娠早期开始进行 ANC 并至少进行 4 次 ANC 就诊等干预措施,可以提高贫民窟居民的医疗机构分娩率。