老挝人民民主共和国农村村庄中妇女选择机构分娩的相关潜在因素：初步研究。
Potential factors associated with institutional childbirth among women in rural villages of Lao People's Democratic Republic: a preliminary study.
机构信息
Teikyo University Graduate School of Public Health, 2-11-1 Kaga, Itabashi, Tokyo, Japan.
Center for Birth Cohort Studies, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi, Japan.
出版信息
BMC Pregnancy Childbirth. 2020 Feb 10;20(1):89. doi: 10.1186/s12884-020-2776-7.
BACKGROUND
The provision of quality health services has been a global priority to reduce neonatal and maternal deaths. In Lao People's Democratic Republic (Lao PDR), the coverage of institutional childbirth stayed at a low level regardless of a sharp increase in the coverage of antenatal care (ANC) and fee exemption. The aim of the present study was to preliminary explore factors associated with increased institutional childbirth and the association between ANC attendance and maternal knowledge among women in rural villages of Lao PDR.
METHODS
A secondary data analysis was conducted using data collected through a pilot survey in Sekong province in Lao PDR. The study participants were women with children under 5 years of age in villages within 10 km (km) from health centers staffed with skilled birth attendants. Data were collected via a face-to-face interview using a semi-structured questionnaire and were analysed using logistic regression models to estimate odds ratios (ORs) and their 95% confidence intervals (CIs) for having institutional childbirth in relation to potential factors.
RESULTS
A total of 302 women, 203 (67.2%) of whom gave birth at a health facility. 277 (91.7%) attended ANC at least once. Sixty-nine women (22.9%) had received no formal education, 272 (90.1%) were of an ethnic minority, 174 (57.6%) were unwaged and 99 (32.8%) lived more than 6 km from the nearest health facility. 51 (16.6%) did not know about birth complications at interview. Institutional childbirth was negatively associated with a lack of maternal knowledge about birth complications (OR, 0.27; 95% Cl, 0.14-0.54) after adjusting for covariates. Although there were few women who did not received ANC, the results suggested ANC might not be associated with maternal knowledge about birth complications (OR, 1.87; 95% Cl, 0.43-8.12).
CONCLUSIONS
The present study suggests that maternal knowledge about birth complications is an important factor in increasing the institutional childbirth in rural villages of Lao PDR where majority of residents were ethnic minority. Improving quality of ANC and attitude among health care providers may be key to increasing health-seeking behavior. However, further research is needed to understand factors influencing choice of place of childbirth.
背景
提供优质的卫生服务一直是全球减少新生儿和产妇死亡的优先事项。在老挝人民民主共和国（老挝），尽管产前护理（ANC）的覆盖率急剧增加，并且免除了费用，但机构分娩的覆盖率仍保持在较低水平。本研究的目的是初步探讨与增加机构分娩相关的因素，以及 ANC 就诊与老挝农村村庄中产妇知识之间的关系。
方法
使用老挝色贡省试点调查收集的数据进行二次数据分析。研究参与者是在距离有熟练助产士的卫生中心 10 公里（km）范围内的村庄中 5 岁以下儿童的妇女。通过面对面访谈使用半结构化问卷收集数据，并使用逻辑回归模型分析数据，以估计与潜在因素相关的机构分娩的优势比（OR）及其 95%置信区间（CI）。
结果
共有 302 名妇女，其中 203 名（67.2%）在医疗机构分娩。277 名（91.7%）至少接受过一次 ANC。69 名妇女（22.9%）没有接受过正规教育，272 名（90.1%）是少数民族，174 名（57.6%）无薪，99 名（32.8%）居住在离最近卫生设施 6 公里以上的地方。51 名妇女（16.6%）在访谈时不知道分娩并发症。调整了协变量后，机构分娩与产妇对分娩并发症的知识缺乏呈负相关（OR，0.27；95%CI，0.14-0.54）。尽管很少有妇女没有接受 ANC，但结果表明 ANC 可能与产妇对分娩并发症的知识无关（OR，1.87；95%CI，0.43-8.12）。
结论
本研究表明，产妇对分娩并发症的知识是增加老挝农村村庄机构分娩的重要因素，这些村庄的大多数居民都是少数民族。提高 ANC 的质量和卫生保健提供者的态度可能是增加卫生服务需求行为的关键。但是，需要进一步研究来了解影响分娩地点选择的因素。
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