Terefe Abiyot Negash, Gelaw Assaye Belay
Jimma University, College of Natural Sciences, Jimma, Ethiopia.
Mizan-Tepi University, College of Natural and Computational Science, Teppi, Ethiopia.
Health Serv Res Manag Epidemiol. 2019 Jul 30;6:2333392819866620. doi: 10.1177/2333392819866620. eCollection 2019 Jan-Dec.
Antenatal care (ANC) is a preventive obstetric health-care program aimed at optimizing maternal fetal outcome through regular monitoring of pregnancy. Even if World Health Organization recommends a minimum of 4 ANC visits for normal pregnancy, existing evidence from developing countries including Ethiopia indicates there are few women who utilize it due to different reasons. The purpose of this article is to identify determinants significantly influencing the ANC visit utilization of child-bearing mothers in the Kaffa, Sheka, and Bench-Maji zones of Southern Nation Nationalities and Peoples Region, Ethiopia.
A total of 1715 child-bearing mothers were selected. Several count models such as Poisson, negative binomial, zero-inflated Poisson, zero-inflated negative binomial, hurdle Poisson, and hurdle negative binomial regression models were fitted to select the model which best fits the data. The parameters were estimated by maximum likelihood. Measures of goodness of fit were based on the Rootogram.
The data were found zeros (8.1%); the variance (3.794), which is less than its mean (3.91). Hurdle Poisson regression model was found to be better fitted with the data given. Variables are selected by backward selection method, through the analysis, zones, residence, age at first pregnancy, source of information, knowledge during danger sin, willingness, time of visit, and satisfaction, which were major predictors of ANC service utilization. The estimated odds that the number of ANC visits those child-bearing mothers made (mothers who lived in urban) are 3.52 times more likely than mothers who lived in rural keeping others variables constant and the like.
Based on our findings, a lot of effort needs to be made by health offices to create awareness, maternal health-care programs should be expanded and intensified in rural areas, improve women's knowledge and awareness about the risk factor of late visit, the necessary investigations and follow-up throughout the antenatal period to promote regular attendance for ANC, and fulfill the client's satisfaction.
产前保健（ANC）是一项预防性产科保健计划，旨在通过定期监测孕期来优化母婴结局。尽管世界卫生组织建议正常妊娠至少进行4次产前检查，但包括埃塞俄比亚在内的发展中国家的现有证据表明，由于各种原因，很少有女性利用这一服务。本文旨在确定显著影响埃塞俄比亚南方民族和人民地区卡法、谢卡和本奇-马吉地区育龄母亲产前检查利用情况的决定因素。
共选取了1715名育龄母亲。拟合了几种计数模型，如泊松模型、负二项模型、零膨胀泊松模型、零膨胀负二项模型、障碍泊松模型和障碍负二项回归模型，以选择最适合数据的模型。通过最大似然估计参数。拟合优度的度量基于残差图。
发现数据中存在零值（8.1%）；方差（3.794）小于均值（3.91）。发现障碍泊松回归模型与给定数据拟合得更好。通过向后选择法选择变量，经分析，地区、居住地、初孕年龄、信息来源、危险信号时的知识、意愿、就诊时间和满意度是产前保健服务利用的主要预测因素。在其他变量不变的情况下，那些进行产前检查的育龄母亲（居住在城市的母亲）进行产前检查的次数比居住在农村的母亲多3.52倍。
根据我们的研究结果，卫生部门需要做出很多努力来提高认识，农村地区应扩大和加强孕产妇保健项目，提高妇女对延迟就诊风险因素的认识，在整个孕期进行必要的检查和随访，以促进定期进行产前检查，并满足客户的满意度。
