Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith NSW 2751, Australia.
School of Science and Health, Western Sydney University, Penrith, NSW 2751, Australia.
Int J Environ Res Public Health. 2020 Dec 29;18(1):193. doi: 10.3390/ijerph18010193.
Most maternal deaths in the world occur during the postpartum period, especially within the first two days following delivery. This makes postnatal care (PNC) critical to improving the chances of maternal and child survival. Over the past 20 years, the proportion of women receiving antenatal care (ANC) in Ethiopia has increased while the proportion of those receiving PNC has remained low. This study aimed to understand the trends, determinants and urban-rural variations of PNC service utilisation.
This study draws on the Ethiopian Demographic and Health Survey (EDHS) data for the years 2000 (n = 4552), 2005 (n = 4467), 2011 (n = 4445) and 2016 (n = 4275) to estimate the trends and determinants of PNC service utilisation. Multivariate logistic regression models with adjustment for clustering and sampling weights were used to investigate the association between the independent factors, the study factors and PNC service utilisation.
Over the twenty-year period of the EDHS, the proportion of Ethiopian women who received PNC services increased from 5.6% (95% CI: 4.6-6.9%) in 2000 to 18.5% (95% CI: 16.4-20.7%) in 2016. Similarly, women who received PNC services in urban areas increased from 15.2% (95% CI: 23.6-30.7%) in 2000 to 47% (95% CI: 60.4-67.3%) in 2016. Women who were in the wealthy quintile, had ANC visits, delivered in a health facility, and delivered by caesarean section were most likely to have PNC. The present study also showed that whilst birth spacing was a significant factor among urban women, wealth index, ANC visits, and perception of health facility distance were significant factors among rural women.
The study suggests low levels of utilisation of PNC among Ethiopian women from rural districts. Geographically targeted interventions with a focus on low-socioeconomic rural women, and those with no previous contacts with the health system during pregnancy, are needed to improve PNC in Ethiopia.
世界上大多数产妇死亡发生在产后期间，尤其是分娩后头两天。这使得产后护理（PNC）对于提高母婴生存机会至关重要。在过去的 20 年中，埃塞俄比亚接受产前护理（ANC）的妇女比例有所增加，而接受 PNC 的妇女比例仍然很低。本研究旨在了解 PNC 服务利用的趋势、决定因素和城乡差异。
本研究利用埃塞俄比亚人口与健康调查（EDHS）2000 年（n=4552）、2005 年（n=4467）、2011 年（n=4445）和 2016 年（n=4275）的数据，估算 PNC 服务利用的趋势和决定因素。采用多变量逻辑回归模型，调整聚类和抽样权重，调查独立因素、研究因素与 PNC 服务利用之间的关系。
在 EDHS 的二十年期间，接受 PNC 服务的埃塞俄比亚妇女比例从 2000 年的 5.6%（95%CI：4.6-6.9%）增加到 2016 年的 18.5%（95%CI：16.4-20.7%）。同样，在城市地区接受 PNC 服务的妇女比例从 2000 年的 15.2%（95%CI：23.6-30.7%）增加到 2016 年的 47%（95%CI：60.4-67.3%）。处于富裕五分位、有 ANC 就诊、在医疗机构分娩和剖宫产分娩的妇女最有可能接受 PNC。本研究还表明，出生间隔是城市妇女的一个重要因素，而在农村妇女中，财富指数、ANC 就诊和对医疗机构距离的看法是重要因素。
研究表明，埃塞俄比亚农村地区妇女的 PNC 利用率较低。需要针对地理位置，重点关注社会经济地位较低的农村妇女，以及那些在怀孕期间与卫生系统没有任何先前接触的妇女，以改善埃塞俄比亚的 PNC。
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