卢旺达产后计划生育的预测因素：男性参与和医疗保健经验的影响。
Predictors of postpartum family planning in Rwanda: the influence of male involvement and healthcare experience.
机构信息
Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA.
Global Health Sciences, AIDS Research Institute and Cochrane HIV/AIDS Group, University of California San Francisco, San Francisco, CA, USA.
出版信息
BMC Womens Health. 2021 Mar 19;21(1):112. doi: 10.1186/s12905-021-01253-0.
BACKGROUND
Strengthened efforts in postpartum family planning (PPFP) is a key priority to accelerate progress in reproductive, maternal, newborn, and child health outcomes. This secondary data analysis explores factors associated with PPFP uptake in Rwanda. The purpose of this study was to explore variables that may influence PPFP use for postpartum women in Rwanda including health facility type, respectful maternity care, locus of control, and mental health status.
METHODS
This secondary analysis of data from a cluster randomized control trial used information abstracted from questionnaires administered to women (≥ 15 years of age) at two time points-one during pregnancy (baseline) and one after delivery of the baby (follow-up). The dependent variable, PPFP uptake, was evaluated against the independent variables: respectful care, locus of control, and mental health status. These data were abstracted from linked questionnaires completed from January 2017 to February 2019. The sample size provided 97% power to detect a change at a 95% significance level with a sample size of 640 at a 15% effect size. Chi-square testing was applied for the bivariate analyses. A logistic regression model using the generalized linear model function was performed; odds ratio and adjusted (by age group and education group) odds ratio with 95% confidence interval were reported.
RESULTS
Of the 646 respondents, although 92% reported not wanting another pregnancy within the next year, 72% used PPFP. Antenatal care wait time (p = < 0.01; Adj OR (Adj 95% CI) 21-40 min: 2.35 (1.46,3.79); 41-60 min: 1.50 (0.84,2.69); 61-450 min: 5.42 (2.86,10.75) and reporting joint healthcare decision-making between the woman and her partner (male) (p = 0.04; Adj OR (Adj 95% CI) husband/partner: 0.59 (0.35,0.97); mother and partner jointly: 1.06 (0.66,1.72) were associated with PPFP uptake.
CONCLUSIONS
These results illustrate that partner (male) involvement and improved quality of maternal health services may improve PPFP utilization in Rwanda.
背景
加强产后计划生育（PPFP）的力度是加速生殖、孕产妇、新生儿和儿童健康结果的关键优先事项。本二次数据分析探讨了与卢旺达 PPFP 采用相关的因素。本研究的目的是探讨可能影响卢旺达产后妇女使用 PPFP 的变量，包括医疗机构类型、尊重产妇护理、控制源和心理健康状况。
方法
这是对一项集群随机对照试验数据的二次分析，使用了从 2017 年 1 月至 2019 年 2 月期间两次向妇女（≥15 岁）管理的问卷中提取的信息。因变量是 PPFP 采用，与尊重护理、控制源和心理健康状况等独立变量进行了评估。这些数据是从完成的链接问卷中提取的，这些问卷是在 2017 年 1 月至 2019 年 2 月期间完成的。样本量提供了 97%的功效，以在 95%的显着性水平上检测到 15%效应量的变化，样本量为 640。卡方检验用于进行双变量分析。使用广义线性模型函数进行逻辑回归模型;报告了优势比和调整（按年龄组和教育组）优势比及其 95%置信区间。
结果
在 646 名受访者中，尽管 92%的人报告在未来一年内不希望再次怀孕，但仍有 72%的人使用了 PPFP。产前护理等待时间（p<0.01;调整后的优势比（调整后的 95%置信区间）21-40 分钟：2.35（1.46,3.79）;41-60 分钟：1.50（0.84,2.69）;61-450 分钟：5.42（2.86,10.75）和报告妇女与其伴侣（男性）之间共同做出医疗保健决策（p=0.04;调整后的优势比（调整后的 95%置信区间）丈夫/伴侣：0.59（0.35,0.97）;母亲和伴侣共同：1.06（0.66,1.72）与 PPFP 采用相关。
结论
这些结果表明，伴侣（男性）参与和改善孕产妇保健服务质量可能会提高卢旺达的 PPFP 利用率。
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