Venyuy Mbinkar Adeline, Cumber Samuel Nambile, Nkfusai Claude Ngwayu, Bede Fala, Ijang Yunga Patience, Wepngong Emerson, Bama Solange Ngo, Tsoka-Gwegweni Joyce Mahlako, Tebeu Pierre Marie
Department of Public Health, School of Health Sciences, Catholic University of Central Africa, Box 1110, Yaoundé, Cameroon.
Cameroon Baptist Convention Health Services (CBCHS), Yaoundé, Cameroon.
Pan Afr Med J. 2020 Apr 10;35:112. doi: 10.11604/pamj.2020.35.112.18712. eCollection 2020.
To improve maternal health, barriers that limit access to quality maternal health services must be identified and addressed at all levels of the health system. The World Health Organisation (WHO) cites distance to health facility and inadequate health institutions as factors that prevent women from receiving or seeking care during pregnancy and childbirth. Specifically, we intended to determine factors associated with late start of late Antenatal Care (ANC) among pregnant women in the Saint Elizabeth General Hospital Shisong (SEGHS), Cameroon.
This was a cross sectional study carried out from the 24 October to 24 November 2016. A total of 602 pregnant women were recruited from ANC units of SEGHS and its satellite institutions. The outcome variable was gestational age at start of ANC (estimated by counting from last menstrual period to day of first ANC consultation) while the independent variables were individual, community and institutional factors. Data was analyzed using Epi info version 7. Chi square test was used to appreciate the influence of different variables on risk of late ANC initiation (> 14 weeks of pregnancy). The level of significance was set out at (p: < 0.05).
Out of the 602 pregnant women included in our study, 75% initiated ANC late (after 14 weeks of pregnancy). Factors associated with late ANC start were; age (p = 0.001), level of education (p = 0.002), marital status (p = 0.016), religion (p = 0.034), parity (p = 0.001), having a source of income (p=0.001), cost of services (p = 0.010), distance to health facility (p = 0.021) and dissatisfaction with previous ANC services (p = 0.014).
Cameroon is one of the countries with a high maternal mortality ratio. WHO estimated it to be 529 per 100000 live births in 2017. Prompt and adequate ANC services can improve on maternal and child outcomes of pregnancy. The results of this study suggest tackling issues related to cost of ANC services and improving geographical (distance) barrier to accessing ANC services (in addition to addressing other identified measures) may lead to an increase in pregnant women starting ANC early and thus potentially improve pregnancy outcomes.
为改善孕产妇健康状况，必须在卫生系统的各个层面识别并解决限制获得优质孕产妇保健服务的障碍。世界卫生组织（WHO）指出，距离医疗机构较远以及卫生机构不足是阻碍妇女在孕期和分娩期间接受或寻求护理的因素。具体而言，我们旨在确定喀麦隆圣伊丽莎白综合医院希松分院（SEGHS）中孕妇晚期开始接受晚期产前保健（ANC）的相关因素。
这是一项于2016年10月24日至11月24日开展的横断面研究。从SEGHS及其附属机构的产前保健科室共招募了602名孕妇。结果变量为开始接受产前保健时的孕周（通过计算从末次月经首日至首次产前保健咨询日来估算），而自变量为个人、社区和机构因素。使用Epi info 7软件进行数据分析。采用卡方检验来评估不同变量对晚期开始接受产前保健（妊娠>14周）风险的影响。显著性水平设定为（p：<0.05）。
在我们研究纳入的602名孕妇中，75%的孕妇晚期开始接受产前保健（妊娠14周后）。与晚期开始接受产前保健相关的因素有：年龄（p = 0.001）、教育程度（p = 0.002）、婚姻状况（p = 0.016）、宗教信仰（p = 0.034）、产次（p = 0.001）、有收入来源（p = 0.001）、服务费用（p = 0.010）、距医疗机构的距离（p = 0.021）以及对先前产前保健服务的不满（p = 0.014）。
喀麦隆是孕产妇死亡率较高的国家之一。WHO估计2017年该国每10万例活产中有529例孕产妇死亡。及时且充分的产前保健服务可改善妊娠的母婴结局。本研究结果表明，解决与产前保健服务费用相关的问题以及改善获得产前保健服务的地理（距离）障碍（除解决其他已确定的措施外）可能会使更多孕妇尽早开始接受产前保健，从而有可能改善妊娠结局。
