Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Australia; School of Health and Social Development, Deakin University, Melbourne, Australia.
School of Health and Social Development, Deakin University, Melbourne, Australia.
Women Birth. 2021 May;34(3):257-265. doi: 10.1016/j.wombi.2020.04.001. Epub 2020 Apr 28.
An effective continuum of care for pregnancy and childbirth connects women and girls with essential reproductive and maternity care services. This study aimed to estimate the continuum of care utilisation rate of women who lived in remote and isolated regions of Pakistan and explored factors that influence women's utilisation of reproductive and maternity care services.
A mixed-methods study was conducted in five rural villages of Sindh, Pakistan. A cross-sectional survey with 669 women who gave birth between July 2010 and September 2014 investigated women's maternity-care service utilisation during pregnancy, childbirth, and in the postpartum period. In-depth interviews with 15 women explored their maternity-care experiences with health providers.
Only 6.4% of 669 women participants reported to have completed the continuum of care for their last pregnancy. Skilled birth attendants, including health professionals, were used by 56.1% for antenatal care, 40.8% for both antenatal and childbirth, 22.3% for antenatal, childbirth and postnatal, and only 6.4% reported using all pregnancy-related and postpartum services. Limited knowledge about affordable health services, poor health literacy, and access to health services was associated with women's fragmented utilisation of maternity care. A lack of respectful maternity-care was also identified as a major barrier to women's utilisation of primary health care facilities, especially for childbirth.
The existing primary health structure in Pakistan provides a good foundation to deliver continuity of care services; however, health services utilisation for reproductive and maternity care remains suboptimal in women who live in geographically remote regions of Pakistan.
有效的妊娠和分娩连续护理将妇女和女童与基本的生殖和孕产妇保健服务联系起来。本研究旨在估计生活在巴基斯坦偏远和孤立地区的妇女的连续护理利用率，并探讨影响妇女利用生殖和孕产妇保健服务的因素。
在巴基斯坦信德省的五个农村村庄进行了一项混合方法研究。一项横断面调查，涉及 2010 年 7 月至 2014 年 9 月期间分娩的 669 名妇女，调查了妇女在怀孕期间、分娩期间和产后期间的孕产妇保健服务利用情况。对 15 名妇女进行的深入访谈探讨了她们与卫生提供者的孕产妇保健经验。
在 669 名参与的妇女中，只有 6.4%的人报告说在上一次怀孕中完成了连续护理。熟练的接生员，包括卫生专业人员，在产前护理中被 56.1%的人使用，在产前和分娩中被 40.8%的人使用，在产前、分娩和产后中被 22.3%的人使用，只有 6.4%的人报告使用了所有与妊娠相关的和产后服务。对负担得起的卫生服务的知识有限、健康素养低以及获得卫生服务的机会有限，与妇女零碎地利用孕产妇保健有关。缺乏尊重产妇保健的情况也被确定为妇女利用初级保健设施的一个主要障碍，尤其是在分娩方面。
巴基斯坦现有的初级卫生结构为提供连续护理服务奠定了良好的基础；然而，在巴基斯坦地理位置偏远的地区生活的妇女中，生殖和孕产妇保健服务的利用仍然不理想。
