Delele Tadesse Guadu, Biks Gashaw Andargie, Abebe Solomon Mekonnen, Kebede Zemene Tigabu
Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Departments of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Int J Gen Med. 2021 Mar 23;14:993-1001. doi: 10.2147/IJGM.S300178. eCollection 2021.
Although Ethiopia has developed many strategies to promote health facility delivery, more than half of the women gave birth at home contributing to high maternal and neonatal mortality. Therefore, this study aimed to identify the determinants of health facility delivery in Northwest Ethiopia.
A community-based unmatched case-control study was conducted in selected districts in Northwest Ethiopia. The sample included 885 infant mothers (295 cases and 590 controls) from April 6-16, 2019. Data were collected using a pretested interviewer-administered structured questionnaire. A multivariable logistic regression model was used to identify predictors, and STATA 14 statistical software was used to analyze the data.
The mean maternal age was 26.4 years (SD±6.7) for cases and 28.1 years (SD±6.8) for controls. The overall good newborn care qualities were 95.8% (206) for cases and 40.8% (262) for controls. Attending a formal education (AOR=2.1 (95% CI: 1.5, 2.9)), having first pregnancy from 18 to 25 (AOR=1.5 (95% CI: 1.1, 2.1)), living within 1 km distance from the nearest health center (AOR=2.5 (95% CI: 1.5, 4.0)), having ANC visits (AOR=3.9 (95% CI: 2.4, 6.5)), having a mobile (AOR=1.7 (95% CI: 1.3, 2.4)) were the determinants of health facility delivery.
Maternal education, not having pregnancy at early age, accessing health facilities to the nearby residents, attending antenatal care, and having a mobile were the determinants of health facility delivery. Therefore, strengthening education and health-seeking behavior of the mothers using a locally contextualized strategy is essential. Reaching mothers who are still far from health facility also deserves needs due attention.
尽管埃塞俄比亚已制定了许多促进在医疗机构分娩的策略，但仍有超过一半的妇女在家中分娩，这导致了较高的孕产妇和新生儿死亡率。因此，本研究旨在确定埃塞俄比亚西北部医疗机构分娩的决定因素。
在埃塞俄比亚西北部选定的地区进行了一项基于社区的非匹配病例对照研究。样本包括2019年4月6日至16日的885名婴儿母亲（295例病例和590名对照）。数据通过预先测试的访谈员管理的结构化问卷收集。使用多变量逻辑回归模型确定预测因素，并使用STATA 14统计软件分析数据。
病例组产妇的平均年龄为26.4岁（标准差±6.7），对照组为28.1岁（标准差±6.8）。病例组新生儿护理总体质量良好的比例为95.8%（206例），对照组为40.8%（262例）。接受正规教育（比值比=2.1（95%置信区间：1.5，2.9））、首次怀孕年龄在18至25岁之间（比值比=1.5（95%置信区间：1.1，2.1））、居住在距离最近的健康中心1公里范围内（比值比=2.5（95%置信区间：1.5，4.0））、进行产前检查（比值比=3.9（95%置信区间：2.4，6.5））、拥有手机（比值比=1.7（95%置信区间：1.3，2.4））是医疗机构分娩的决定因素。
孕产妇教育、非早育、附近居民可及的医疗机构、接受产前护理以及拥有手机是医疗机构分娩的决定因素。因此，采用因地制宜的策略加强母亲的教育和就医行为至关重要。关注那些距离医疗机构仍然较远的母亲也同样重要。
