Kebede Alemi Olika, Biratu Yonas Terfa, Kebede Ayantu Olika, Belina Sena Kitila
Population and Family Health Department, Jimma University Institute of Health Science, Jimma, Ethiopia.
School of Nursing and Midwifery, Jimma University Institute of Health Science, Jimma, Ethiopia.
Int J Womens Health. 2020 Nov 13;12:1047-1056. doi: 10.2147/IJWH.S275153. eCollection 2020.
Although young people have a right to sexual and reproductive health, they are facing inadequate access to information and services. The Ethiopian government has started implementing policies and strategies to eliminate inequalities in reproductive health service use. However, there are huge disparities in institutional delivery utilization between different age groups. Therefore, this study aimed to explore trends and factors associated with institutional childbirth among young women in Ethiopia.
Ethiopian demographic and health survey data (EDHS) from 2000 to 2016 surveys were used. Data on the most recent births to women aged 15-24 years that occurred in the 5 years preceding the survey period were extracted. All the four EDHS data were used to examine trends of institutional delivery, whereas determinants for institutional delivery were analyzed from a 2016 dataset by using multivariable logistic regression analysis.
Between 2000 and 2016, the proportion of institutional delivery among young women increased from 6% (95% CI=3.7-6.5%) to 40.1% (95% CI=30.6-44.3%). The odds of institutional delivery increased for young women who had attended secondary and above education (AOR=2.68; 95% CI=1.559-4.607), started ANC visits early (AOR=1.518; 95% CI=1.095-2.105) and received four or more ANC visits (AOR=1.87; 95% CI=1.370-2.561). However, the odds were lower among young women who had two (AOR=0.31; 95% CI=0.185-0.514), and three or more children (AOR=0.62; 95% CI=0.452-0.849).
There is an increase in trend of institutional delivery among young women during the 2000 to 2016 EDHS. Having higher educational levels, early ANC booking, and attending four or more ANC visits were positively associated with institutional delivery. Increased number of children is negatively associated with institutional delivery. Strengthening strategies for improving girls' education and addressing their socioeconomic and demographic vulnerabilities, and strengthening strategies being implemented for encouraging early and recommended ANC visits is crucial.
尽管年轻人有权享有性与生殖健康，但他们获取信息和服务的机会不足。埃塞俄比亚政府已开始实施政策和战略，以消除生殖健康服务利用方面的不平等现象。然而，不同年龄组在机构分娩利用率方面存在巨大差异。因此，本研究旨在探讨埃塞俄比亚年轻女性机构分娩的趋势及相关因素。
使用2000年至2016年埃塞俄比亚人口与健康调查（EDHS）的数据。提取调查期前5年中15至24岁女性最近一次分娩的数据。所有四次EDHS数据均用于研究机构分娩的趋势，而通过多变量逻辑回归分析从2016年的数据集中分析机构分娩的决定因素。
2000年至2016年期间，年轻女性的机构分娩比例从6%（95%置信区间=3.7-6.5%）增至40.1%（95%置信区间=30.6-44.3%）。接受过中等及以上教育的年轻女性（调整后比值比[AOR]=2.68；95%置信区间=1.559-4.607）、早期开始产前检查的年轻女性（AOR=1.518；95%置信区间=1.095-2.105）以及接受过四次及以上产前检查的年轻女性（AOR=1.87；95%置信区间=1.370-2.561），其机构分娩的几率增加。然而，有两个孩子（AOR=0.31；95%置信区间=0.185-0.514）以及有三个及以上孩子的年轻女性（AOR=0.62；95%置信区间=0.452-0.849），其机构分娩的几率较低。
在2000年至2016年的EDHS期间，年轻女性的机构分娩趋势有所增加。较高的教育水平、早期产前检查预约以及接受四次及以上产前检查与机构分娩呈正相关。孩子数量增加与机构分娩呈负相关。加强提高女孩教育水平的策略，解决她们的社会经济和人口脆弱性问题，以及加强为鼓励早期和建议的产前检查而实施的策略至关重要。
