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埃塞俄比亚南部登巴萨农村地区产妇产后护理利用不足的决定因素:基于社区的非匹配病例对照研究。

Determinants of postnatal care non-utilization among women in Demba Gofa rural district, southern Ethiopia: a community-based unmatched case-control study.

机构信息

Sawla General Hospital, Gofa zone, Southern Nation Nationalities and Peoples' Region, Ethiopia.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, P. O. Box: 196, Gondar, Ethiopia.

出版信息

BMC Pregnancy Childbirth. 2020 Sep 18;20(1):546. doi: 10.1186/s12884-020-03244-9.

Abstract

BACKGROUND

Maternal and neonatal mortality remain a significant problem across much of the developing world, especially in sub-Saharan Africa countries. In Ethiopia, most maternal and neonatal deaths occur during the postpartum period; this is a critical time for monitoring the health of women and newborns, but the most neglected period for care. In rural communities of Ethiopia, the utilization of postnatal care service is very low and evidence on which factors contribute to the non-utilization of postnatal care (PNC) is insufficient. Consequently, this study was designed to identify the determinants of postnatal service non-utilization among women who gave birth in Demba Gofa rural district, Southern Ethiopia.

METHODS

A community-based unmatched case-control study was conducted among 186 cases (postnatal care non-utilizers) and 186 controls (postnatal care utilizers) in Demba Gofa rural district from March 1 to April 10, 2019. A previously tested interviewer-administered structured questionnaire was used for data collection. Binary logistic regression analysis was performed. In the final multivariable logistic regression analysis model, a p-value of less than 0.05 and an Adjusted Odd Ratio (AOR) with a 95% confidence interval (CI) was used to determine variables for postnatal care non-utilization.

RESULTS

In this study, women who delivered recently were incorporated within 186 cases and 186 controls. Not knowing the availability of PNC services (AOR: 4.33, 95% CI: 1.71-10.99), having a home delivery (AOR: 7.06, 95% CI: 3.71-13.44), ANC non-attendance (AOR: 6.14, 95% CI: 3.01-12.50), unable to make an independent decision (AOR: 9.31, 95% CI: 3.29-26.35), and not participating in the Women's Development Army (WDA) (AOR: 5.09, 95% CI: 2.73-9.53) comprised the determinants which were assessed for non-utilization of postnatal care services.

CONCLUSIONS

Encouraging institutional delivery along with integrated health education about postnatal care and postnatal danger signs, empowering women to execute independent decisions, accessing PNC services and strengthening participation in the Model Families will likely improve postnatal care service utilization in the district of Ethiopia.

摘要

背景

孕产妇和新生儿死亡率仍然是发展中国家,尤其是撒哈拉以南非洲国家面临的一个重大问题。在埃塞俄比亚,大多数孕产妇和新生儿死亡发生在产后期间;这是监测妇女和新生儿健康的关键时期,但却是最被忽视的护理时期。在埃塞俄比亚农村社区,利用产后护理服务的比例非常低,对于导致不利用产后护理的因素的证据也不足。因此,本研究旨在确定在 Demba Gofa 农村地区分娩的妇女不利用产后护理服务的决定因素。

方法

这是一项在 Demba Gofa 农村地区进行的基于社区的病例对照研究,共纳入了 186 名病例(未利用产后护理服务)和 186 名对照(利用产后护理服务),研究时间为 2019 年 3 月 1 日至 4 月 10 日。采用经过预先测试的访谈式结构化问卷进行数据收集。采用二元逻辑回归分析。在最终的多变量逻辑回归分析模型中,使用 P 值小于 0.05 和调整后的比值比(AOR)及其 95%置信区间(CI)来确定产后护理服务不利用的变量。

结果

在本研究中,最近分娩的妇女被纳入了 186 名病例和 186 名对照。不知道产后护理服务的可用性(AOR:4.33,95%CI:1.71-10.99)、家庭分娩(AOR:7.06,95%CI:3.71-13.44)、未参加 ANC(AOR:6.14,95%CI:3.01-12.50)、无法做出独立决定(AOR:9.31,95%CI:3.29-26.35)以及未参加妇女发展军(WDA)(AOR:5.09,95%CI:2.73-9.53)是评估产后护理服务不利用的决定因素。

结论

鼓励机构分娩,并综合开展关于产后护理和产后危险信号的健康教育,赋予妇女独立决策的能力,提供产后护理服务,并加强参与模范家庭,这可能会提高该地区的产后护理服务利用率。

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