Kumbeni Maxwell Tii, Apanga Paschal Awingura, Chanase Mary-Ann Wepiamo, Alem John Ndebugri, Mireku-Gyimah Nana
Ghana Health Service, Nabdam District Health Directorate, Nangodi, Ghana.
School of Community Health Sciences, University of Nevada, Reno, USA.
BMC Health Serv Res. 2021 Jun 30;21(1):621. doi: 10.1186/s12913-021-06665-0.
Early essential newborn care is one of the important interventions developed by the World Health Organization to reduce morbidities and mortalities in neonates. This study investigated the role of the public and private sector health facilities on factors associated with early essential newborn care practices following institutional delivery in Ghana.
We used data from the 2017/2018 multiple indicator cluster survey for our analysis. A total of 2749 mothers aged 15-49 years were included in the study. Logistic regression analysis was used to assess the factors associated with early essential newborn care in both public and private health sectors.
The prevalence of good early essential newborn care in the public sector health facilities was 26.4 % (95 % CI: 23.55, 29.30) whiles that of the private sector health facilities was 19.9 % (95 % CI: 13.55, 26.30). Mothers who had a Caesarean section in the public sector health facilities had 67 % lower odds of early essential newborn care compared to mothers who had a vaginal delivery [adjusted prevalence odds ratios (aPOR) = 0.33, 95 % CI: 0.20, 0.53]. Mothers without a health insurance in the public sector health facilities had 26 % lower odds of early essential newborn care compared to mothers with a health insurance (aPOR = 0.74, 95 % CI: 0.56, 0.97). However, these associations were not observed in the private sector health facilities.
The findings suggest that the prevalence of good early essential newborn care in the public sector health facilities was higher than that reported in the private sector health facilities. Child health programs on early essential newborn care needs to be prioritized in the private healthcare sector. The Government of Ghana may also need to increase the coverage of the national health insurance scheme for women in reproductive age.
早期基本新生儿护理是世界卫生组织制定的旨在降低新生儿发病率和死亡率的重要干预措施之一。本研究调查了加纳公立和私立卫生设施在机构分娩后与早期基本新生儿护理实践相关因素方面所起的作用。
我们使用2017/2018年多指标类集调查的数据进行分析。共有2749名年龄在15至49岁之间的母亲纳入本研究。采用逻辑回归分析评估公立和私立卫生部门中与早期基本新生儿护理相关的因素。
公立卫生设施中早期基本新生儿护理良好的患病率为26.4%(95%置信区间:23.55,29.30),而私立卫生设施的患病率为19.9%(95%置信区间:13.55,26.30)。在公立卫生设施中接受剖宫产的母亲进行早期基本新生儿护理的几率比经阴道分娩的母亲低67%[调整后的患病率比值比(aPOR)=0.33,95%置信区间:0.20,0.53]。在公立卫生设施中没有医疗保险的母亲进行早期基本新生儿护理的几率比有医疗保险的母亲低26%(aPOR=0.74,95%置信区间:0.56,0.97)。然而,在私立卫生设施中未观察到这些关联。
研究结果表明,公立卫生设施中早期基本新生儿护理良好的患病率高于私立卫生设施报告的患病率。私立医疗部门需要优先开展关于早期基本新生儿护理的儿童健康项目。加纳政府可能还需要提高国家医疗保险计划对育龄妇女的覆盖范围。