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熟练孕产妇卫生服务利用的预测因素:以埃塞俄比亚农村妇女为例。

Predictors of skilled maternal health services utilizations: A case of rural women in Ethiopia.

机构信息

Department of Midwifery, Hawassa University Health Science College, Hawassa, Ethiopia.

Department of Sidama Region Health Department, Hawassa, Ethiopia.

出版信息

PLoS One. 2021 Feb 19;16(2):e0246237. doi: 10.1371/journal.pone.0246237. eCollection 2021.

Abstract

BACKGROUND

Maternal health services are affected by complex factors from one setting to another. Consequently, health planners should prioritize different interventions and design appropriate programs to enhance maternal health services utilization. Results of prior studies are conflicting. Furthermore, only few studies were done from antenatal to postnatal continuum of care in Ethiopia.

OBJECTIVES

This study aimed to assess prevalence and predictors of skilled maternal health services utilization at Dale-Wonsho health and demographic surveillance site of the Hawassa University, South Ethiopia, in 2019.

METHODS

A community based cross sectional study was conducted from January 1-30; 2019. A total of 682 women who gave birth in the last twelve months were selected by using a two stage sampling technique. Data were collected through face to face interview. Data were entered into Epidata version 3.1. Then, they were exported and analyzed by SPSS version 22. Bi-variable logistic regression analysis was done and variables with p-value less than 0.05 were considered as candidate for multivariable logistic regression analysis. Adjusted Odds Ratios (AOR) with 95% CI were computed, and p-value less than 0.01 was computed to determine the level of significance.

RESULT

Prevalence of antenatal care, institutional delivery and postnatal care utilizations were 69.1%, 52.1% and 32.7% respectively. Educated women (AOR = 4.72, 95%CI,2.82,7.9), household training (AOR = 8.52,95%CI = 5.5,13.1), middle wealth quantile(AOR = 0.8,95%CI,0.4-0.7), being richest wealth quantile (AOR = 0.16;95%CI = 0.06,0.41) and pregnancy plan (AOR = 3.65,95%CI,1.67-8.0) were factors positively associated with antenatal care utilization. Husband education (AOR = 4.96,95CI,3.08-8.0), and antenatal care (AOR = 5.9; 95%CI,3.87,9.1) were factors associated with institutional delivery. Maternal education (AOR = 2.5,95CI,1.4-4.4), information about postnatal care service utilization (AOR = 3.6,95CI,2.1,6.2) and women autonomy(AOR = 6.1,95CI,3.8,9.7) were positively associated with postnatal care service.

CONCLUSION

Prevalence of antenatal care, institutional delivery and postnatal care services were lower than the targeted plan. Policy makers should focus on capacity building of women both economically and academically. So, women should be more autonomous to utilize health services effectively. Moreover, awareness creation among women should be enhanced about maternal health service.

摘要

背景

产妇健康服务受到来自不同环境的复杂因素的影响。因此,卫生规划人员应优先考虑不同的干预措施,并设计适当的方案,以提高产妇健康服务的利用率。先前的研究结果相互矛盾。此外,在埃塞俄比亚,仅有少数研究是在产前到产后连续护理方面进行的。

目的

本研究旨在评估 2019 年在埃塞俄比亚 Hawassa 大学 Dale-Wonsho 健康和人口监测点,熟练产妇健康服务利用的流行率和预测因素。

方法

这是一项于 2019 年 1 月 1 日至 30 日进行的基于社区的横断面研究。采用两阶段抽样技术,共选取了过去 12 个月内分娩的 682 名妇女。通过面对面访谈收集数据。数据被输入到 EpiData 版本 3.1,然后导出并由 SPSS 版本 22 进行分析。进行了双变量逻辑回归分析,将 p 值小于 0.05 的变量视为多变量逻辑回归分析的候选变量。计算了调整后的优势比(AOR)和 95%置信区间(CI),并计算了 p 值小于 0.01 以确定显著性水平。

结果

产前护理、机构分娩和产后护理的利用率分别为 69.1%、52.1%和 32.7%。接受过教育的妇女(AOR=4.72,95%CI,2.82,7.9)、家庭培训(AOR=8.52,95%CI,5.5,13.1)、中等财富五分位数(AOR=0.8,95%CI,0.4-0.7)、最富有五分位数(AOR=0.16;95%CI=0.06,0.41)和计划妊娠(AOR=3.65,95%CI,1.67-8.0)是与产前护理利用率相关的积极因素。丈夫教育(AOR=4.96,95CI,3.08-8.0)和产前护理(AOR=5.9;95%CI,3.87,9.1)与机构分娩相关。产妇教育(AOR=2.5,95CI,1.4-4.4)、产后护理服务利用信息(AOR=3.6,95CI,2.1,6.2)和妇女自主权(AOR=6.1,95CI,3.8,9.7)与产后护理服务呈正相关。

结论

产前护理、机构分娩和产后护理服务的利用率均低于目标计划。政策制定者应注重妇女在经济和学术方面的能力建设。因此,妇女应更加自主,以便有效利用卫生服务。此外,应加强妇女对产妇保健服务的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06c1/7894870/10262d54168a/pone.0246237.g001.jpg

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