Akter Shahinoor, Rich Jane Louise, Davies Kate, Inder Kerry Jill
School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.
Priority Research Centre for Generational Health and Ageing, University of Newcastle, Callaghan, New South Wales, Australia.
PLoS One. 2020 Dec 29;15(12):e0244640. doi: 10.1371/journal.pone.0244640. eCollection 2020.
Prevalence of accessing antenatal care (ANC) services among Indigenous women in the Chittagong Hill Tracts (CHT) is unknown. This study aims to estimate the prevalence of accessing ANC services by Indigenous women in the CHT and identify factors associated with knowledge of, and attendance at, ANC services.
Using a cross-sectional design three Indigenous groups in Khagrachari district, CHT, Bangladesh were surveyed between September 2017 and February 2018. Indigenous women within 36 months of delivery were asked about attending ANC services and the number who attended was used to estimate prevalence. Socio-demographic and obstetric characteristics were used to determine factors associated with knowledge and attendance using multivariable logistic regression techniques adjusted for clustering by village; results are presented as odds ratios (OR), adjusted OR, and 95% confidence intervals (CI).
Of 494 indigenous women who met the inclusion criteria in two upazilas, 438 participated (89% response rate) in the study, 75% were aged 16-29 years. Sixty-nine percent were aware of ANC services and the prevalence of attending ANC services was 53% (n = 232, 95%CI 0.48-0.58). Half (52%; n = 121) attended private facilities. Independent factors associated with knowledge about ANC were age ≥30 years (OR 2.2, 95%CI 1.1-4.6), monthly household income greater than 20,000 Bangladeshi Taka (OR 3.4, 95%CI 1.4-8.6); knowledge of pregnancy-related complications (OR 3.6, 95%CI 1.6-8.1), knowledge about nearest health facilities (OR 4.3, 95%CI 2.1-8.8); and attending secondary school or above (OR 4.8, 95%CI 2.1-11). Independent factors associated with attending ANC services were having prior knowledge of ANC benefits (OR 7.7, 95%CI 3.6-16), Indigenous women residing in Khagrachhari Sadar subdistrict (OR 6.5, 95%CI 1.7-25); and monthly household income of 20,000 Bangladeshi Taka or above (OR 2.8, 95%CI 1.1-7.4).
Approximately half of Indigenous women from Chittagong Hill Tracts Bangladesh attended ANC services at least once. Better awareness and education may improve ANC attendance for Indigenous women. Cultural factors influencing attendance need to be explored.
吉大港山区（CHT）原住民妇女获得产前护理（ANC）服务的比例尚不清楚。本研究旨在估计吉大港山区原住民妇女获得ANC服务的比例，并确定与ANC服务知识及就诊相关的因素。
采用横断面设计，于2017年9月至2018年2月期间对孟加拉国吉大港山区卡格拉乔里县的三个原住民群体进行了调查。询问了分娩36个月内的原住民妇女是否参加过ANC服务，并以参加人数来估计比例。利用社会人口学和产科特征，采用多变量逻辑回归技术确定与知识和就诊相关的因素，并对村庄聚类进行了调整；结果以比值比（OR）、调整后的OR和95%置信区间（CI）表示。
在两个乡符合纳入标准的494名原住民妇女中，438名（应答率89%）参与了研究，75%的年龄在16 - 29岁之间。69%的人知晓ANC服务，参加ANC服务的比例为53%（n = 232，95%CI 0.48 - 0.58）。一半（52%；n = 121）的人在私立机构就诊。与ANC知识相关的独立因素包括年龄≥30岁（OR 2.2，95%CI 1.1 - 4.6）、家庭月收入超过20000孟加拉塔卡（OR 3.4，95%CI 1.4 - 8.6）；对妊娠相关并发症的了解（OR 3.6，95%CI 1.6 - 8.1）、对最近医疗机构的了解（OR 4.3，95%CI 2.1 - 8.8）；以及上过中学或以上（OR 4.8，95%CI 2.1 - 11）。与参加ANC服务相关的独立因素包括事先了解ANC的益处（OR 7.7，95%CI 3.6 - 16）、居住在卡格拉乔里县萨达尔分区的原住民妇女（OR 6.5，95%CI 1.7 - 25）；以及家庭月收入20000孟加拉塔卡或以上（OR 2.8，95%CI 1.1 - 7.4）。
孟加拉国吉大港山区约一半的原住民妇女至少参加过一次ANC服务。提高认识和教育水平可能会增加原住民妇女的ANC就诊率。需要探索影响就诊率的文化因素。
