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影响产妇使用产前护理和熟练接生服务的因素:来自 2018 年几内亚人口与健康调查数据的证据。

Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data.

机构信息

School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia.

Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.

出版信息

BMC Pregnancy Childbirth. 2021 Jan 3;21(1):2. doi: 10.1186/s12884-020-03489-4.

Abstract

BACKGROUND

Globally, maternal health remains a major priority. Most of maternal deaths globally occur in sub-Saharan Africa, with most of these deaths linked to lack of access to antenatal care and skilled assistance during delivery. This study assessed the determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea.

METHODS

Data for this study were obtained from the 2018 Guinea Demographic and Health Survey (GDHS). Data of 4,917 childbearing women were considered as our analytical sample. The outcome variables for the study were utilization of antenatal care and skilled birth attendance. Analysis was carried out using chi-square tests and multivariable logistic regression.

RESULTS

The results showed that women aged 15-24 (AOR=1.29, CI=1.03-1.62), women who had secondary/higher level of education (AOR=1.70, CI=1.33-2.19), and those whose partners had secondary/higher level of education (AOR=1.46, CI=1.22-1.75), women in the richest wealth quintile (AOR=5.09, CI=3.70-7.00), those with planned pregnancies (AOR=1.50, CI=1.23-1.81), Muslim women (AOR=1.65, CI=1.38-2.12), those who take healthcare decisions alone (AOR=1.53, CI=1.24-1.89), and those who listened to radio less than once a week (AOR= 1.30, CI=1.10-1.53) had higher odds of antenatal care uptake. Also, women with secondary/higher level of education (AOR=1.83, CI=1.25-2.68), those whose partners had secondary/higher level of education (AOR=1.40, CI=1.11-1.76), those in the richest wealth quintile (AOR=10.79, CI=6.64-17.51), those with planned pregnancies (AOR=1.25, CI=1.03-1.52), Christian women (AOR=4.13, CI=3.17-5.39), those living in urban areas (AOR=3.00, CI=2.29-3.94), women with one birth (AOR= 1.58, CI=1.20-2.06), those who take healthcare decisions alone (AOR=1.87, CI=1.46-2.39), those who read newspaper at least once a week (AOR= 1.19, CI=1.01-1.40), those who watched television at least once week (AOR=1.69, CI=1.30-2.19), and those in female-headed households (AOR=1.52, CI=1.20-1.92) were more likely to utilize the services of skilled birth attendants.

CONCLUSION

The study proved that various socio-economic and contextual factors influence antenatal care and skilled birth attendance in Guinea. These findings suggest the need to design community-based interventions (e.g., miniature local ANC clinics, early screening services) that prioritize women's education and vocational training, media accessibility, especially among the poor, and those residing in rural settings. Such interventions should not ignore the influence of other socio-cultural norms that hinder the utilization of antenatal care and skilled birth attendance services in Guinea.

摘要

背景

全球范围内,产妇健康仍然是一个主要的优先事项。全球大多数产妇死亡发生在撒哈拉以南非洲地区,其中大多数死亡与缺乏产前护理和分娩时的熟练助产服务有关。本研究评估了在几内亚,生育妇女利用产前护理和熟练助产服务的决定因素。

方法

本研究的数据来自 2018 年几内亚人口与健康调查(GDHS)。我们的分析样本包括 4917 名生育妇女的数据。研究的结果变量是利用产前护理和熟练助产服务。分析使用了卡方检验和多变量逻辑回归。

结果

结果表明,15-24 岁的妇女(AOR=1.29,CI=1.03-1.62)、具有中等/高等教育程度的妇女(AOR=1.70,CI=1.33-2.19)、其伴侣具有中等/高等教育程度的妇女(AOR=1.46,CI=1.22-1.75)、最富裕的五分之一财富阶层的妇女(AOR=5.09,CI=3.70-7.00)、有计划怀孕的妇女(AOR=1.50,CI=1.23-1.81)、穆斯林妇女(AOR=1.65,CI=1.38-2.12)、独自做出医疗保健决策的妇女(AOR=1.53,CI=1.24-1.89)、每周收听广播少于一次的妇女(AOR=1.30,CI=1.10-1.53),她们利用产前护理的可能性更高。此外,具有中等/高等教育程度的妇女(AOR=1.83,CI=1.25-2.68)、其伴侣具有中等/高等教育程度的妇女(AOR=1.40,CI=1.11-1.76)、最富裕的五分之一财富阶层的妇女(AOR=10.79,CI=6.64-17.51)、有计划怀孕的妇女(AOR=1.25,CI=1.03-1.52)、基督教妇女(AOR=4.13,CI=3.17-5.39)、居住在城市地区的妇女(AOR=3.00,CI=2.29-3.94)、有一次分娩的妇女(AOR=1.58,CI=1.20-2.06)、独自做出医疗保健决策的妇女(AOR=1.87,CI=1.46-2.39)、每周至少阅读一次报纸的妇女(AOR=1.19,CI=1.01-1.40)、每周至少观看一次电视的妇女(AOR=1.69,CI=1.30-2.19)、以及女性当家作主的家庭(AOR=1.52,CI=1.20-1.92),她们更有可能利用熟练的助产服务。

结论

研究证明,各种社会经济和背景因素影响几内亚的产前护理和熟练助产服务。这些发现表明,需要设计以社区为基础的干预措施(例如,微型当地 ANC 诊所、早期筛查服务),优先考虑妇女的教育和职业培训、媒体可及性,特别是在贫困地区和农村地区。这些干预措施不应忽视其他社会文化规范的影响,这些规范阻碍了几内亚利用产前护理和熟练助产服务。

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