International Institute for Population Sciences, Deonar, Mumbai, India.
J Biosoc Sci. 2021 Sep;53(5):643-662. doi: 10.1017/S0021932020000450. Epub 2020 Aug 24.
Continuum of care throughout pregnancy, delivery and post-delivery has proved to be a critical health intervention for improving the health of mothers and their newborn children. Using data from the fourth wave of the National Family Health Survey (NFHS-4) conducted in 2015-16, this study examined the correlates of utilization of maternal health care services and child immunization following the continuum of care approach in India. The study also assessed whether the continuity in utilizing maternal health care services affects the immunization of children. A total of 33,422 survey women aged 15-49 were included in the analysis of maternal health care indicators, and 8246 children aged 12-23 months for the analysis of child immunization. The results indicated that about 19% of the women had completed the maternal health continuum, i.e. received full antenatal care, had an institutional delivery and received postnatal care. Women with a higher level of education and of higher economic status were more likely to have complete continuum of care. Continuity of maternal health care was found to be associated with an increase in the immunization level of children. It was observed that 76% of the children whose mothers had complete continuum of care were fully immunized. Furthermore, the results from propensity score matching revealed that if mothers received continuum of care, the chance of their child being fully immunized increased by 17 percentage points. The results suggest that promotion of the continuum of maternal health care approach could help reduce not only the burden of maternal deaths in India, but also that of child deaths by increasing the immunization level of children.
从怀孕、分娩到产后的连续护理已被证明是改善母婴健康的重要干预措施。本研究利用 2015-2016 年第四次全国家庭健康调查（NFHS-4）的数据，按照连续护理方法考察了印度利用产妇保健服务和儿童免疫的相关因素。本研究还评估了连续利用产妇保健服务是否会影响儿童的免疫接种。共有 33422 名 15-49 岁的调查妇女被纳入产妇保健指标分析，8246 名 12-23 个月大的儿童被纳入儿童免疫分析。结果表明，约 19%的妇女完成了产妇保健连续护理，即接受了全面的产前护理、在机构分娩并接受了产后护理。受教育程度较高和经济地位较高的妇女更有可能完成连续护理。产妇保健的连续性与儿童免疫水平的提高有关。结果显示，在完成连续护理的母亲所生的儿童中，有 76%的儿童完全接受了免疫接种。此外，倾向评分匹配的结果表明，如果母亲接受连续护理，其子女完全免疫接种的机会增加了 17 个百分点。结果表明，促进产妇保健连续护理方法的推广不仅有助于降低印度产妇死亡人数的负担，还有助于通过提高儿童免疫接种率来降低儿童死亡人数。
