UVRI-IAVI HIV Vaccine Program, Entebbe, Uganda.
Ghent University International Centre for Reproductive Health, Ghent, Belgium.
BMC Health Serv Res. 2020 Sep 29;20(1):901. doi: 10.1186/s12913-020-05739-9.
Uganda has one of the highest maternal deaths at a ratio of 336 per 100,000 live births. As Uganda strives to achieve sustainable development goals, appropriate antenatal care is key to reduction of maternal mortality. We explored women's reported receipt of seven of the Uganda guidelines components of antenatal care, and associated factors in hard to reach Lake Victoria island fishing communities of Kalangala district.
A cross sectional survey among 486 consenting women aged 15-49 years, who were pregnant at any time in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January-May 2018. Interviewer administered questionnaires, were used to collect data on socio-demographics and receipt of seven of the Uganda guidelines components of antenatal care. Regression modeling was used to determine factors associated with receipt of all seven components.
Over three fifths (65.0%) had at least one ANC visit during current or most recent pregnancy. Fewer than a quarter of women who reported attending care at least four times received all seven ANC components [(23.6%), P < 0.05]. Women who reported receipt of ANC from the mainland were twice as likely to have received all seven components as those who received care from islands (aOR = 1.8; 95% CI:0.9-3.7). Receipt of care from a doctor was associated with thrice likelihood of receiving all components relative to ANC by a midwife or nurse (aOR = 3.2; 95% CI:1.1-9.1).
We observed that the delivery of antenatal care components per Ugandan guidelines is poor in these communities. Cost effective endeavors to improve components of antenatal care received by women are urgently needed. Task shifting some components of ANC to community health workers may improve care in these island communities.
PACTR201903906459874 (Retrospectively registered).
乌干达的孕产妇死亡率居世界前列，每十万例活产中就有 336 例死亡。随着乌干达努力实现可持续发展目标，适当的产前护理是降低孕产妇死亡率的关键。本研究旨在探讨在难以到达的维多利亚湖北部卡兰加拉区岛屿渔业社区中，妇女接受乌干达产前护理指南七个组成部分的情况以及相关因素。
2018 年 1 月至 5 月，在乌干达卡兰加拉区的 6 个岛屿渔业社区中，对 486 名 15-49 岁之间在过去 6 个月的任何时候怀孕的同意参与本研究的妇女进行了横断面调查。采用访谈员管理的问卷收集社会人口统计学资料和乌干达产前护理指南七个组成部分的接受情况。采用回归模型确定与接受所有七个组成部分相关的因素。
超过五分之三（65.0%）的妇女在当前或最近一次妊娠期间至少接受过一次产前护理。不到四分之一的报告至少接受过四次护理的妇女接受了所有七个 ANC 组成部分[（23.6%），P<0.05]。报告从大陆接受 ANC 的妇女接受所有七个组成部分的可能性是从岛屿接受护理的妇女的两倍（aOR=1.8；95%CI：0.9-3.7）。与由助产士或护士提供 ANC 相比，由医生提供 ANC 与接受所有七个组成部分的可能性相关三倍（aOR=3.2；95%CI：1.1-9.1）。
我们观察到，这些社区的产前护理服务按照乌干达指南提供的服务较差。迫切需要采取具有成本效益的措施来改善妇女获得的产前护理服务。将 ANC 的某些组成部分转移给社区卫生工作者可能会改善这些岛屿社区的护理。
PACTR201903906459874（回顾性注册）。
