产妇利用卫生服务对尼泊尔母亲尽早开始母乳喂养的影响。
The effect of maternal health service utilization in early initiation of breastfeeding among Nepalese mothers.
机构信息
New ERA, Kalopul, Rudramati Marga, Kathmandu, 44600 Nepal.
出版信息
Int Breastfeed J. 2019 Jul 31;14:33. doi: 10.1186/s13006-019-0228-7. eCollection 2019.
BACKGROUND
The World Health Organization (WHO) recommends early initiation of breastfeeding and exclusive breastfeeding for six months. Understanding the association of maternal health services and early initiation of breastfeeding might be useful on prioritizing the health services to promote early breastfeeding practices. The purpose of this study was to examine the association between utilization of maternal health services and early initiation of breastfeeding among Nepalese mothers.
METHODS
Nationally representative data from the 2016 Nepal Demographic Health Survey (NDHS) was used to determine the association between early initiation of breastfeeding and variables related to maternal health services utilization. Association was measured by using Chi-square test followed by calculation of adjusted odds ratio (AOR) and 95% confidence intervals (CI) using multivariable logistic regression analysis.
RESULTS
Out of 1,978 children, 55% were breastfed within an hour of birth. Early initiation of breastfeeding was associated among mothers who delivered at the health facilities (AOR 2.22; 95% CI 1.36, 3.60). Mothers who had a vaginal birth (AOR 6.70; 95% CI 4.30, 10.42) were significantly more likely to breastfeed within an hour of birth compared to mothers who had caesarean delivery. The odds of initiating early breastfeeding were higher among mothers from Province 5 (AOR 1.59; CI 1.02, 2.48), Province 6 (AOR 2.58; 95% CI 1.41,4.69) and Province 7 (AOR 2.30; CI 1.36, 3.87).
CONCLUSIONS
Health facility delivery and a vaginal delivery were strongly associated with early initiation of breastfeeding. It is vital to intensify maternal health service up to the community to aware pregnant women to utilize maternal health services to improve breastfeeding practices. Skilled Birth Attendant (SBA) training should include comprehensive breastfeeding counselling package to motivate mothers to initiate early breastfeeding especially for mothers having caesarean delivery.
背景
世界卫生组织（WHO）建议母乳喂养应尽早开始，并持续六个月纯母乳喂养。了解产妇保健服务与母乳喂养开始时间之间的关联，有助于确定优先提供卫生服务的重点，以促进早期母乳喂养实践。本研究旨在探讨尼泊尔产妇利用产妇保健服务与母乳喂养开始时间之间的关联。
方法
使用 2016 年尼泊尔人口与健康调查（NDHS）的全国代表性数据，确定母乳喂养开始时间与与产妇保健服务利用相关的变量之间的关联。采用卡方检验进行关联测量，然后使用多变量逻辑回归分析计算调整后的比值比（AOR）和 95%置信区间（CI）。
结果
在 1978 名儿童中，有 55%的儿童在出生后 1 小时内进行母乳喂养。在在保健机构分娩的母亲中，母乳喂养开始时间较早（AOR 2.22；95%CI 1.36，3.60）。与剖宫产分娩的母亲相比，阴道分娩的母亲（AOR 6.70；95%CI 4.30，10.42）更有可能在出生后 1 小时内进行母乳喂养。来自第五省（AOR 1.59；CI 1.02，2.48）、第六省（AOR 2.58；95%CI 1.41，4.69）和第七省（AOR 2.30；CI 1.36，3.87）的母亲开始早期母乳喂养的可能性更高。
结论
在保健机构分娩和阴道分娩与母乳喂养开始时间密切相关。至关重要的是，要将产妇保健服务扩展到社区，让孕妇了解并利用产妇保健服务，以改善母乳喂养实践。熟练接生员（SBA）培训应包括全面的母乳喂养咨询方案，以激励母亲尽早开始母乳喂养，特别是对接受剖宫产分娩的母亲。
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