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贝宁12至23个月儿童的孕产妇保健利用情况和全程免疫覆盖率:一项基于人群数据的横断面研究

Maternal healthcare utilization and full immunization coverage among 12-23 months children in Benin: a cross sectional study using population-based data.

作者信息

Budu Eugene, Seidu Abdul-Aziz, Agbaglo Ebenezer, Armah-Ansah Ebenezer Kwesi, Dickson Kwamena Sekyi, Hormenu Thomas, Hagan John Elvis, Adu Collins, Ahinkorah Bright Opoku

机构信息

Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana.

College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.

出版信息

Arch Public Health. 2021 Mar 16;79(1):34. doi: 10.1186/s13690-021-00554-y.

Abstract

BACKGROUND

Maternal and child health are important issues for global health policy, and the past three decades have seen a significant progress in maternal and child healthcare worldwide. Immunization is a critical, efficient, and cost-effective public health intervention for newborns. However, studies on these health-promoting indicators in low-income and middle-income countries, especially in sub-Sahara Africa are sparse. We investigated the association between maternal healthcare utilization and complete vaccination in the Republic of Benin.

METHODS

We analysed data from the 2018 Benin Demographic and Health Survey (BDHS). Specifically, the children's recode file was used for the study. The outcome variable used was complete vaccination. Number of antenatal care visits, assistance during delivery, and postnatal check-up visits were the key explanatory variables. Bivariate and multilevel logistic regression analyses were carried out. The results were presented as unadjusted odds ratios (uOR) and adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CIs) signifying their level of precision. Statistical significance was declared at p < 0.05.

RESULTS

The prevalence of full immunization coverage in Benin was 85.4%. The likelihood of full immunization was lower among children whose mothers had no antenatal care visits, compared to those whose mothers had 1-3 visits [aOR = 0.11, 95% CI: 0.08-0.15], those who got assistance from Traditional Birth Attendants/other during delivery, compared to those who had assistance from Skilled Birth Attendants/health professionals [aOR = 0.55, 95% CI: 0.40-0.77], and mothers who had no postnatal care check-up visit, compared to those who had postnatal care check-up < 24 h after delivery [aOR = 0.49, 95% CI: 0.36-0.67]. With the covariates, religion, partner's level of education, parity, wealth quintile, and place of residence also showed significant associations with full immunization.

CONCLUSION

The study has demonstrated strong association between full immunization and antenatal care, skilled attendance at birth, and postnatal care check-up visit. We found that full immunization decreases among women with no antenatal care visits, those who receive assistance from Traditional Birth Attendants during delivery, and those who do not go for postnatal care visits. To help achieve full immunization, it is prudent that the government of Benin collaborates with international organisations such as WHO and UNICEF to provide education to pregnant women on the importance of immunization after delivery. Such education can be embedded in the antenatal care, delivery and postnatal care services offered to pregnant women during pregnancy, delivery, and after delivery.

摘要

背景

妇幼健康是全球卫生政策的重要议题,在过去三十年里,全球妇幼保健取得了显著进展。免疫接种是针对新生儿的一项关键、高效且具有成本效益的公共卫生干预措施。然而,关于低收入和中等收入国家,尤其是撒哈拉以南非洲地区这些促进健康指标的研究却很匮乏。我们调查了贝宁共和国孕产妇保健利用情况与全程疫苗接种之间的关联。

方法

我们分析了2018年贝宁人口与健康调查(BDHS)的数据。具体而言,使用儿童重新编码文件进行研究。所使用的结果变量是全程疫苗接种。产前检查次数、分娩时的协助以及产后检查次数是关键解释变量。进行了双变量和多水平逻辑回归分析。结果以未调整比值比(uOR)和调整比值比(aOR)呈现,其相应的95%置信区间(CIs)表明其精确程度。当p < 0.05时宣布具有统计学意义。

结果

贝宁的全程免疫覆盖率为85.4%。与母亲进行过1 - 3次产前检查的儿童相比,母亲未进行产前检查的儿童全程免疫的可能性较低[aOR = 0.11,95% CI:0.08 - 0.15];与由熟练助产士/卫生专业人员提供协助的儿童相比,在分娩时由传统助产士/其他人提供协助的儿童全程免疫的可能性较低[aOR = 0.55,95% CI:0.40 - 0.77];与产后<24小时进行产后检查的母亲相比,未进行产后检查的母亲所生儿童全程免疫的可能性较低[aOR = 0.49,95% CI:0.36 - 0.67]。在考虑协变量时,宗教、伴侣的教育水平、胎次、财富五分位数和居住地点也与全程免疫存在显著关联。

结论

该研究表明全程免疫与产前检查、熟练接生和产后检查之间存在密切关联。我们发现,未进行产前检查的妇女、分娩时接受传统助产士协助的妇女以及未进行产后检查的妇女所生儿童的全程免疫率较低。为帮助实现全程免疫,贝宁政府与世界卫生组织和联合国儿童基金会等国际组织合作,向孕妇宣传产后免疫接种的重要性是明智之举。此类教育可融入孕期、分娩期及产后为孕妇提供的产前保健、分娩和产后保健服务中。

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