Adde Kenneth Setorwu, Dickson Kwamena Sekyi, Amu Hubert
Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
PLoS One. 2020 Dec 31;15(12):e0244875. doi: 10.1371/journal.pone.0244875. eCollection 2020.
Maternal mortality is an issue of global public health concern with over 300,000 women dying globally each year. In sub-Saharan Africa (SSA), these deaths mainly occur around childbirth and the first 24hours after delivery. The place of delivery is, therefore, important in reducing maternal deaths and accelerating progress towards attaining the 2030 sustainable development goals (SDGs) related to maternal health. In this study, we examined the prevalence and determinants of the place of delivery among reproductive age women in SSA.
This was a cross-sectional study among women in their reproductive age using data from the most recent demographic and health surveys of 28 SSA countries. Frequency, percentage, chi-square, and logistic regression were used in analysing the data. All analyses were done using STATA.
The overall prevalence of health facility delivery was 66%. This ranged from 23% in Chad to 94% in Gabon. More than half of the countries recorded a less than 70% prevalence of health facility delivery. The adjusted odds of health facility delivery were lowest in Chad. The probability of giving birth at a health facility also declined with increasing age but increased with the level of education and wealth status. Women from rural areas had a lower likelihood (AOR = 0.59, 95%CI = 0.57-0.61) of delivering at a health facility compared with urban women.
Our findings point to the inability of many SSA countries to meet the SDG targets concerning reductions in maternal mortality and improving the health of reproductive age women. The findings thus justify the need for peer learning among SSA countries for the adaption and integration into local contexts, of interventions that have proven to be successful in improving health facility delivery among reproductive age women.
孕产妇死亡率是一个全球公共卫生关注的问题,全球每年有超过30万妇女死亡。在撒哈拉以南非洲地区(SSA),这些死亡主要发生在分娩期间及分娩后的头24小时内。因此,分娩地点对于降低孕产妇死亡率以及加速实现与孕产妇健康相关的2030年可持续发展目标(SDGs)至关重要。在本研究中,我们调查了SSA地区育龄妇女的分娩地点患病率及其决定因素。
这是一项针对育龄妇女的横断面研究,使用了28个SSA国家最新人口与健康调查的数据。采用频率、百分比、卡方检验和逻辑回归对数据进行分析。所有分析均使用STATA软件完成。
医疗机构分娩的总体患病率为66%。这一比例在乍得为23%,在加蓬为94%。超过半数的国家医疗机构分娩患病率低于70%。在乍得,医疗机构分娩的校正比值最低。在医疗机构分娩的概率也随着年龄的增长而下降,但随着教育水平和财富状况的提高而增加。与城市妇女相比,农村地区妇女在医疗机构分娩的可能性较低(调整后比值比[AOR]=0.59,95%置信区间[CI]=0.57 - 0.61)。
我们的研究结果表明,许多SSA国家无法实现与降低孕产妇死亡率和改善育龄妇女健康相关的可持续发展目标。因此,这些研究结果证明了SSA国家之间进行同行学习的必要性,以便将已被证明在改善育龄妇女医疗机构分娩方面成功的干预措施适应当地情况并加以整合。