The Australian Centre for Public and Population Health Research, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
BMC Public Health. 2020 Feb 3;20(1):164. doi: 10.1186/s12889-020-8258-z.
Skilled birth attendance (SBA) is a key strategy for averting maternal mortality ratio (MMR). The lifetime risk of maternal death is high in countries with low SBA. With the presence of a skilled birth attendant, the possibility of death owing to intrapartum-related complications or stillbirth can be reduced by 20%.
Using data from the most recent Demographic and Health Surveys, we investigated the prevalence of skilled birth attendance, variations, and associated factors. The sample was drawn from women aged 15-49 who were surveyed in these countries as part of the Demographic and Health Survey (DHS) program. With multivariate logistic regression, we explored the socio-demographic factors that predict women's likelihood of seeking skilled birth attendance or otherwise.
Less than half of the women in Niger, Sierra Leone, and Mali obtained skilled birth attendance, with the worst case occurring in Niger (32.6%). Women in rural areas have less likelihood of obtaining skilled birth attendance (OR 0.21; 95% CI 0.16-0.28), as compared to women in urban locations. Highly educated women (OR 2.50; 95% CI 0.72-8.69), those who had subscribed to health insurance (OR 1.39; 95% CI 0.88-2.20), those who obtain four or more antenatal care visits (OR 1.63; 95% CI 1.43-1.86), and women who watch television at least once a week (OR 2.33; 95% CI 1.88-2.88) are more probable to seek SBA.
Interventions to increase SBA rates in these countries need to be reassessed to focus on the rural-urban disparity in healthcare, female education, and ANC attendance.
熟练接生（SBA）是避免母婴死亡率（MMR）的关键策略。在熟练接生率低的国家，产妇终生死亡风险很高。如果有熟练的接生员，因分娩期相关并发症或死产而死亡的可能性可降低 20%。
我们使用最近的人口与健康调查数据，调查了熟练接生的流行率、变化及其相关因素。样本来自这些国家 15-49 岁的女性，她们是人口与健康调查（DHS）项目的调查对象。我们采用多变量逻辑回归，探讨了预测妇女寻求熟练接生的可能性或其他因素的社会人口因素。
尼日尔、塞拉利昂和马里的不到一半妇女获得了熟练接生，尼日尔的情况最差（32.6%）。与城市地区的妇女相比，农村地区的妇女获得熟练接生的可能性较小（OR 0.21；95%CI 0.16-0.28）。受过高等教育的妇女（OR 2.50；95%CI 0.72-8.69）、参加过医疗保险的妇女（OR 1.39；95%CI 0.88-2.20）、接受过四次或更多次产前护理的妇女（OR 1.63；95%CI 1.43-1.86）和每周至少看一次电视的妇女（OR 2.33；95%CI 1.88-2.88）更有可能寻求 SBA。
需要重新评估这些国家提高 SBA 率的干预措施，重点关注城乡医疗保健、女性教育和 ANC 参与的差距。
