加纳女性是否达到了世卫组织推荐的孕产妇医疗保健（MCH）利用率？来自全国性调查的证据。
Are Ghanaian women meeting the WHO recommended maternal healthcare (MCH) utilisation? Evidence from a national survey.
机构信息
School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.
出版信息
BMC Pregnancy Childbirth. 2021 Feb 23;21(1):161. doi: 10.1186/s12884-021-03643-6.
BACKGROUND
To achieve the Sustainable Development Goal target 3.1, the World Health Organisation recommends that all pregnant women receive antenatal care (ANC) from skilled providers, utilise the services of a skilled birth attendant at birth and receive their first postnatal care (PNC) within the first 24 h after birth. In this paper, we examined the maternal characteristics that determine utilisation of skilled ANC, skilled birth attendance (SBA), and PNC within the first 24 h after delivery in Ghana.
METHODS
We used data from the 2014 Ghana Demographic and Health Survey. Women aged 15-49 with birth history not exceeding five before the survey were included in the study. A total of 2839 women were included. Binary logistic regression was employed at a 95% level of significance to determine the association between maternal factors and maternal healthcare (MCH) utilisation. Bivariate and multivariate regression was subsequently used to assess the drivers.
RESULTS
High proportion of women had ANC (93.2%) with skilled providers compared to the proportion that had SBA (76.9%) and PNC within the first 24 h after delivery (25.8%). Only 21.2% utilised all three components of MCH. Women who were covered by national health insurance scheme (NHIS) had a higher likelihood (AOR = 1.31, CI = 1.04 - 1.64) of utilising all three components of MCH as compared to those who were not covered by NHIS. Women with poorer wealth status (AOR = 0.72, CI = 0.53 - 0.97) and those living with partners (AOR = 0.65, CI = 0.49 - 0.86) were less likely to utilise all three MCH components compared to women with poorest wealth status and the married respectively.
CONCLUSION
The realisation that poorer women, those unsubscribed to NHIS and women living with partners have a lower likelihood of utilising the WHO recommended MCH strongly suggest that it is crucial for the Ministry of Health and the Ghana Health Service to take pragmatic steps to increase education about the importance of having ANC with a skilled provider, SBA, and benefits of having the first 24 h recommended PNC.
背景
为实现可持续发展目标 3.1，世界卫生组织建议所有孕妇都接受熟练提供者的产前护理（ANC），在分娩时利用熟练的接生员，并在分娩后 24 小时内接受第一次产后护理（PNC）。在本文中，我们研究了在加纳，决定在分娩后 24 小时内利用熟练的 ANC、熟练的接生员（SBA）和 PNC 的产妇特征。
方法
我们使用了 2014 年加纳人口与健康调查的数据。研究包括在调查前生育史不超过五次的 15-49 岁的妇女。共有 2839 名妇女被纳入研究。采用二元逻辑回归在 95%的置信水平下确定产妇因素与产妇保健（MCH）利用之间的关联。随后使用双变量和多变量回归来评估驱动因素。
结果
与 SBA（76.9%）和分娩后 24 小时内 PNC（25.8%）相比，接受熟练提供者 ANC（93.2%）的妇女比例较高。只有 21.2%的妇女利用了 MCH 的所有三个组成部分。与未参加国家健康保险计划（NHIS）的妇女相比，参加 NHIS 的妇女更有可能（AOR=1.31，CI=1.04-1.64）利用 MCH 的所有三个组成部分。与最贫穷的财富状况（AOR=0.72，CI=0.53-0.97）和与伴侣生活的妇女（AOR=0.65，CI=0.49-0.86）相比，那些财富状况较差和与伴侣生活的妇女不太可能利用 MCH 的所有三个组成部分。
结论
意识到较贫穷的妇女、未参加 NHIS 的妇女和与伴侣生活的妇女利用世卫组织建议的 MCH 的可能性较低，这强烈表明，卫生部和加纳卫生局必须采取切实步骤，加强教育，提高人们对 ANC 与熟练提供者、SBA 以及在分娩后 24 小时内进行推荐的 PNC 的重要性的认识。
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