School of Midwifery, College of Health Sciences, Woldia University, Woldia, Ethiopia.
Department of Social Medicine, Ohio University Heritage, College of Osteopathic Medicine, Dublin, OH, USA.
BMC Public Health. 2019 Nov 7;19(1):1472. doi: 10.1186/s12889-019-7854-2.
Globally, the magnitude of maternal mortality is the major public health problem. Nearly all (99%) of maternal deaths occur in low- and middle-income countries. Of which 66% occur in sub-Saharan Africa. Institutional delivery under the hygienic environment with the necessary skills and equipment promotes to identify and treat complications, infections, and the death of the mother and baby. In Ethiopia, the utilization of maternal health services is very low. For instance, 62% of women had antenatal care utilization during pregnancy while only 26% of women utilize institutions for delivery in 2016. Therefore, this study examined the association between antenatal care follow up and intestinal delivery among a nationally representative woman in Ethiopia.
A cross-sectional study design was used to examine 7575 women from the 2016 Ethiopia Demographic and Health Survey. Both descriptive and inferential statistics were utilized. Variables in the bivariate logistic regression with p-value < 0.2 were entered into the multivariable logistic regression. Odds ratios and corresponding 95% confidence intervals (CI) were reported. In the multivariable analysis, variables with p-value < 0.05 were considered as statistically significant.
The prevalence of institutional delivery service utilization for last childbirth was 11.3%. In comparison with women with no antenatal care visits, the multivariable odds ratio (95% confidence interval) of institutional delivery among those who attend one to three and four or more antenatal care visit were 2.49 (1.66, 3.74) and 3.90 (2.60, 5.84), respectively. Other factors significantly associated with institutional delivery include urban residence 2.25 (1.44, 3.51), complete primary education 3.22 (2.09, 4.98), complete secondary or higher education 1.59 (1.16, 2.17), poorer household wealth index 2.57 (1.57, 4.20), middle household wealth index 1.63 (1.05, 2.52), and richer household wealth index 1.56(1.03, 2.58).
Antenatal care follow-up was significantly associated with institutional delivery service utilization. As the number of antenatal care visits increased the odds of facility delivery increased. Thus, improved access and utilization of antenatal care can be an effective strategy to increase institutional deliveries and optimal maternal and child health outcomes.
全球范围内，孕产妇死亡的严重程度是主要的公共卫生问题。几乎所有（99%）的孕产妇死亡都发生在中低收入国家。其中，66%发生在撒哈拉以南非洲。在卫生环境下，有必要的技能和设备进行分娩，可以促进识别和治疗产妇、婴儿的并发症、感染和死亡。在埃塞俄比亚，孕产妇保健服务的利用率非常低。例如，2016 年，62%的妇女在怀孕期间接受了产前护理，而只有 26%的妇女在机构分娩。因此，本研究旨在检查埃塞俄比亚全国代表性妇女的产前护理随访与肠道分娩之间的关联。
采用横断面研究设计，对 2016 年埃塞俄比亚人口与健康调查中的 7575 名妇女进行了检查。采用描述性和推论性统计。将在双变量逻辑回归中 p 值<0.2 的变量纳入多变量逻辑回归。报告比值比和相应的 95%置信区间（CI）。在多变量分析中，p 值<0.05 的变量被认为具有统计学意义。
最后一次分娩的机构分娩服务利用率为 11.3%。与没有产前护理就诊的妇女相比，接受一到三次和四次或更多次产前护理就诊的妇女的机构分娩的多变量优势比（95%置信区间）分别为 2.49（1.66，3.74）和 3.90（2.60，5.84）。与机构分娩显著相关的其他因素包括城市居住者 2.25（1.44，3.51）、完全小学教育 3.22（2.09，4.98）、完全中学或更高教育 1.59（1.16，2.17）、较贫困的家庭财富指数 2.57（1.57，4.20）、中等家庭财富指数 1.63（1.05，2.52）和较富裕的家庭财富指数 1.56（1.03，2.58）。
产前护理随访与机构分娩服务的使用显著相关。随着产前护理就诊次数的增加，设施分娩的几率也随之增加。因此，改善产前护理的可及性和利用率可以是增加机构分娩和最佳母婴健康结果的有效策略。
