Global Environmental Health LAB, Brooklyn, NY 11026, USA.
Department of International Relation, Yadanabon University, Mandalay, 05063, Myanmar.
Int J Environ Res Public Health. 2020 Feb 25;17(5):1464. doi: 10.3390/ijerph17051464.
The study objective was to examine barriers and facilitators of maternal health services utilization in Myanmar with the highest maternal mortality ratio in Southeast Asia. Data for 258 mothers with children under five were extracted from a community health survey administered between 2016 and 2017 in Mandalay, the largest city in central Myanmar, and analyzed for associations between determinants of maternal health care choices and related outcomes. The study showed that late antenatal care was underutilized (41.7%), and antenatal care attendance was significantly associated with geographical setting, household income, education, and access to transportation ( ≤ 0.05). Less than one-third of women gave birth at home and 18.5% of them did so without the assistance of traditional birth attendants. Household education level was a significant predictor for home delivery ( < 0.01). Utilization of postnatal care services was irregular (47.9%-70.9%) and strongly associated with women's places of delivery ( < 0.01). Efforts geared towards improving maternal health outcomes should focus on supporting traditional birth attendants in their role of facilitating high-quality care and helping women reach traditional health facilities, as well as on maternal health literacy based on culturally appropriate communication.
本研究旨在探讨在东南亚孕产妇死亡率最高的缅甸，影响孕产妇卫生服务利用的障碍和促进因素。研究数据来源于 2016 年至 2017 年在缅甸中部最大城市曼德勒进行的一项社区卫生调查，该调查共纳入了 258 名 5 岁以下儿童的母亲。对母亲卫生保健选择及其相关结果的决定因素之间的关联进行了分析。研究结果表明，晚期产前保健的利用率较低（41.7%），而产前保健的利用情况与地理位置、家庭收入、教育程度和交通可达性显著相关（ ≤ 0.05）。不到三分之一的妇女在家分娩，其中 18.5%的妇女分娩时没有传统助产士的帮助。家庭教育水平是决定在家分娩的重要因素（ < 0.01）。产后护理服务的利用情况不规则（47.9%-70.9%），与妇女分娩地点密切相关（ < 0.01）。改善孕产妇健康结果的工作应侧重于支持传统助产士在促进高质量护理方面的作用，并帮助妇女获得传统卫生设施，同时还应提高基于文化适宜的沟通的孕产妇健康素养。
