意图使用机构分娩服务及其预测因素在孕妇中， 埃塞俄比亚西北部：使用计划行为理论。
Intention to use institutional delivery service and its predictors among pregnant women, North West Ethiopia: Using theory of planned behavior.
机构信息
Amhara Regional State Health Bureau, Bahir Dar, Ethiopia.
Department of Health Education and Behavioral Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia.
出版信息
PLoS One. 2021 May 7;16(5):e0248697. doi: 10.1371/journal.pone.0248697. eCollection 2021.
BACKGROUND
Improving institutional delivery service is the most crucial strategies to reduce maternal and neonatal mortalities. In developing countries, only 50% of pregnant women deliver in health facilities and in Ethiopia only 48% of pregnant women deliver in health facilities. Maternal mortality remains the highest in Ethiopia. This study assessed intention to use institutional delivery service and its predictors among pregnant women using theory of planned behavior.
METHODS
Community-based cross-sectional study was conducted among 645 Yilmana Densa District Pregnant women using multi-stage followed by cluster sampling technique. Data were entered into Epi Data version 4.6.0.2 and analyzed with STATA version 14. Binary logistic regression analysis was done to identify independent predictors of intention at 95% confidence level and P < 0.05 was used to determine statistically significant predictors.
RESULTS
Intention of pregnant women to use institutional delivery service was 74.3% (CI; 70.71%, 77.6%). In the multivariable logistic regression; those who had 1-3 and 4 &above antenatal care 2.85(1.41, 5.75) and 3.14(1.16, 8.45) respectively, those who had past experience of institutional delivery (AOR = 3.39, 95%CI: 1.72, 6.71), parity of 1-3 and 4 & above % (AOR = 0.37, 0.19, 0.71) and (AOR = 0.25, 95%CI: 0.12, 0.55) respectively, rural residence (AOR = 0.51, 95%CI: 0.27, 0.96), favorable attitude (AOR = 2.93, 95%CI: 1.56, 5.50), favorable perceived behavioral control (AOR = 2.60, 95%CI: 1.44, 4.69) were factors significantly associated with intention to use institutional delivery service.
CONCLUSION AND RECOMMENDATION
Majority of the pregnant women were intended to deliver in the institution. Good Knowledge on institutional delivery, antenatal care visit, past experience of institutional delivery, rural residence, parity, attitude and perceived behavioral control were identified factors significantly associated with intention to use institutional delivery service. So, strengthening awareness creation and behavioral change communication programs are required at all levels of health system to raise intention of residents towards institutional delivery.
背景
提高机构分娩服务是降低孕产妇和新生儿死亡率的最关键策略。在发展中国家，只有 50%的孕妇在医疗机构分娩，而在埃塞俄比亚，只有 48%的孕妇在医疗机构分娩。孕产妇死亡率仍然是埃塞俄比亚最高的。本研究使用计划行为理论评估了孕妇使用机构分娩服务的意愿及其预测因素。
方法
采用多阶段、随后采用聚类抽样技术，在 Yilmana Densa 区的 645 名孕妇中进行了基于社区的横断面研究。数据输入 EpiData 版本 4.6.0.2，并使用 STATA 版本 14 进行分析。采用二项逻辑回归分析确定意向的独立预测因素，置信水平为 95%，P<0.05 用于确定有统计学意义的预测因素。
结果
孕妇使用机构分娩服务的意愿为 74.3%（CI；70.71%，77.6%）。在多变量逻辑回归中；那些接受了 1-3 次和 4 次以上产前护理的孕妇，其意愿分别为 2.85（1.41，5.75）和 3.14（1.16，8.45），那些有过机构分娩经历的孕妇（AOR=3.39，95%CI：1.72，6.71），1-3 次和 4 次以上的产次（AOR=0.37，0.19，0.71）和（AOR=0.25，95%CI：0.12，0.55），农村居民（AOR=0.51，95%CI：0.27，0.96），有利态度（AOR=2.93，95%CI：1.56，5.50），有利的感知行为控制（AOR=2.60，95%CI：1.44，4.69）与使用机构分娩服务的意愿显著相关。
结论和建议
大多数孕妇都打算在机构分娩。良好的机构分娩知识、产前护理、机构分娩经历、农村居民、产次、态度和感知行为控制是与使用机构分娩服务意愿显著相关的因素。因此，需要在各级卫生系统加强意识创造和行为改变沟通计划，以提高居民对机构分娩的意愿。
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