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孟加拉国洪灾对母婴保健服务利用的影响。

Impact of Recurrent Floods on the Utilization of Maternal and Newborn Healthcare in Bangladesh.

机构信息

Department of Statistics, Jagannath University, Dhaka, 1100, Bangladesh.

Centre for Research on the Epidemiology of Disasters (CRED), Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium.

出版信息

Matern Child Health J. 2020 Jun;24(6):748-758. doi: 10.1007/s10995-020-02917-3.

Abstract

OBJECTIVE

Floods are one of the most common types of disasters in Bangladesh and lead to direct and indirect impacts on health. The aim of the study was to assess the impact of floods on Maternal and Newborn Healthcare (MNH) utilization in Bangladesh between the years 2011 and 2014.

METHODS

We used variables from the Bangladesh Demographic and Health Survey 2014 data and georeferenced data of floods between 2011 and 2014 from the Emergency Events Database. Multivariate logistic regression was used to determine whether the flood-affected exposures were significant in predicting differences in MNH utilization.

RESULTS

The odds for the received antenatal care by skilled providers, institutional deliveries, deliveries by c-section, and postnatal care of the babies were significantly lower (Unadjusted OR = 0.81, 0.88, 0.83, and 0.82 respectively; P < 0.05) in the flood-affected area than the non-affected area. Additionally, the odds of postnatal checkup of women was statistically significant (P < 0.001) and less likely to be received in flood-affected area (OR = 0.76). The odds of all indicators were significantly lower (OR < 1) for the women living in the twice and four times flooded areas compared to the once flooded areas.

CONCLUSIONS FOR PRACTICE

The study shows that floods can have a negative impact on MNH utilization. In addition, repeated floods have a worse impact on MNH utilization than incidental floods. Extra effort should be put on ensuring access to MNH of women in flood-affected areas.

摘要

目的

洪水是孟加拉国最常见的灾害类型之一,对健康造成直接和间接影响。本研究旨在评估 2011 年至 2014 年间洪水对孟加拉国母婴保健利用的影响。

方法

我们使用了 2014 年孟加拉国人口与健康调查中的变量以及 2011 年至 2014 年期间紧急事件数据库中洪水的地理参考数据。采用多变量逻辑回归来确定洪水暴露是否对母婴保健利用的差异有显著预测作用。

结果

在接受熟练提供者的产前护理、机构分娩、剖腹产分娩和婴儿的产后护理方面,受灾地区的几率明显较低(未经调整的 OR 分别为 0.81、0.88、0.83 和 0.82;P<0.05)。此外,妇女进行产后检查的几率具有统计学意义(P<0.001),且在受灾地区不太可能进行(OR=0.76)。与仅受一次洪水影响的地区相比,两次和四次受洪水影响的地区的所有指标的几率均明显较低(OR<1)。

结论

本研究表明,洪水可能对母婴保健利用产生负面影响。此外,反复发生的洪水对母婴保健利用的影响比偶然发生的洪水更为严重。应特别努力确保受灾地区妇女获得母婴保健服务。

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