Tigray Health Research Institute, Mekelle, Ethiopia.
Department of Midwifery, College of Health Sciences, Mekelle University, Mekelle, Ethiopia.
Reprod Health. 2019 Nov 8;16(1):162. doi: 10.1186/s12978-019-0818-2.
INTRODUCTION: Above half of mothers in Ethiopia give birth at home. Home based care within the first week after birth as a complementary strategy to facility-based postnatal care service is critical to increase the survival of both mothers and newborns. However, evidence on utilization of postnatal care and location of service among mothers who delivered at home in Ethiopia is insufficiently documented. Therefore, this study assessed the magnitude and determinants for place of postnatal care service utilization among mothers who delivered at home in Ethiopia. METHODS: We used the 2016 Ethiopian Demographic and Health Survey, and extracted data from 4491 mothers who delivered at home during 5 years preceding the survey. A multinomial logistic regression model was applied to examine the determinants of both facility and home -based postnatal care service utilization. Likelihood ratio test was used to see the model fitness and p-value of < 0.05 was used to determine statistical significance at 95% confidence interval. RESULTS: From the total 4491 mothers who delivered at home, only 130(2.9%) and 236(5.3%) of them utilized postnatal service at home and at a health facility respectively. Being from an urban region (AOR = 0.378, 95%CI: 0.193-0.740), ever using the calendar method to delay pregnancy (AOR = 0.528, 95%CI: 0.337-0.826), receiving four and above antenatal care visits (AOR = 0.245, 95%CI: 0.145-0.413) and having a bank account (AOR = 0.479, 95%CI: 0.243-0.943) were the factors associated with utilizing home- based postnatal care. Similarly being a follower of the orthodox religion (AOR = 1.698, 95%CI: 1.137-2.536), being in the rich wealth index (AOR = 0.608, 95%CI: 0.424-0.873), ever using the calendar method to delay pregnancy (AOR = 0.694, 95%CI: 0.499-0.966), wantedness of the pregnancy (AOR = 0.264, 95%CI: 0.352-0.953), receiving four and above antenatal care visits (AOR = 0.264, 95%CI: 0.184-0.380) and listening to radio at least once a week (AOR = 0.652, 95%CI: 0.432-0.984) were the determinants of facility-based postnatal care utilization. CONCLUSION: The coverage of postnatal care service utilization among mothers who delivered at home was very low. Living in urban region, following the Orthodox religion, having higher wealth index, having a bank account, ever using calendar method to delay pregnancy, wantedness of the pregnancy, receiving four and above antenatal care visit and listening to radio at least weakly were associated with postnatal care service utilization. Therefore, targeted measures to improve socio-economic status, strengthen the continuum of care, and increase health literacy communication are critically important to increase postnatal care service utilization among women who deliver at home in Ethiopia.
介绍:在埃塞俄比亚,超过一半的母亲在家中分娩。在产后第一周内提供以家庭为基础的护理,作为机构内产后护理服务的补充策略,对于提高母婴的生存率至关重要。然而,关于在埃塞俄比亚在家分娩的母亲使用产后护理服务的情况和服务地点的证据不足。因此,本研究评估了在埃塞俄比亚在家分娩的母亲中使用产后护理服务的程度和决定因素。
方法:我们使用了 2016 年埃塞俄比亚人口和健康调查的数据,并从调查前 5 年内在家分娩的 4491 名母亲中提取了数据。应用多变量逻辑回归模型来研究利用机构和家庭为基础的产后护理服务的决定因素。使用似然比检验来评估模型拟合度,p 值<0.05 表示在 95%置信区间内具有统计学意义。
结果:在总共 4491 名在家分娩的母亲中,只有 130 名(2.9%)和 236 名(5.3%)分别在家中和医疗机构接受了产后护理服务。来自城市地区(AOR=0.378,95%CI:0.193-0.740)、曾经使用日历法避孕(AOR=0.528,95%CI:0.337-0.826)、接受了四次或以上产前护理(AOR=0.245,95%CI:0.145-0.413)和拥有银行账户(AOR=0.479,95%CI:0.243-0.943)是与利用家庭为基础的产后护理相关的因素。同样,信奉东正教(AOR=1.698,95%CI:1.137-2.536)、属于富有财富指数(AOR=0.608,95%CI:0.424-0.873)、曾经使用日历法避孕(AOR=0.694,95%CI:0.499-0.966)、希望怀孕(AOR=0.264,95%CI:0.352-0.953)、接受了四次或以上产前护理(AOR=0.264,95%CI:0.184-0.380)和每周至少听一次广播(AOR=0.652,95%CI:0.432-0.984)是利用机构内产后护理服务的决定因素。
结论:在家分娩的母亲中产后护理服务的利用率非常低。生活在城市地区、信奉东正教、拥有较高的财富指数、拥有银行账户、曾经使用日历法避孕、希望怀孕、接受了四次或以上产前护理和每周至少听一次广播与产后护理服务的利用有关。因此,为了提高在家分娩的母亲的产后护理服务利用率,需要采取有针对性的措施来改善社会经济地位、加强连续护理,并加强健康知识传播。
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