马拉维曼戈切区产妇利用产后护理服务的决定因素：基于社区的横断面研究。

Determinants of postnatal care service utilization among mothers of Mangochi district, Malawi: a community-based cross-sectional study.

机构信息

Community Health Department, Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi.

School of Statistics and Planning, Department of Population Studies, Makerere University, Post Office Box 7062, Kampala, Uganda.

出版信息

BMC Pregnancy Childbirth. 2021 Aug 30;21(1):591. doi: 10.1186/s12884-021-04061-4.

DOI:10.1186/s12884-021-04061-4

PMID:34461844

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8406845/

Abstract

BACKGROUND

Postnatal care (PNC) service is a neglected yet an essential service that can reduce maternal, neonatal and infant morbidity and mortality rates in low and middle-income countries. In Malawi, maternal and infant mortality rates remain high despite numerous efforts by the government and its partners to improve maternal health service coverage across the country. This study examined the determinants of PNC utilization among mothers in Mangochi District, Malawi.

METHODS

A community based cross-sectional study was conducted among 600 mothers who gave birth in the past 2 years preceding January 1-31; 2016. A multistage sampling technique was employed to select respondents from nine randomly selected villages in Mangochi district. A transcribed semi-structured questionnaire was pre-tested, modified and used to collect data on socio-demographic characteristics and maternal related factors. Data was coded in EpiData version 3.1 and analysed in Stata version 12. A multivariable logistic regression adjusted for confounding factors was used to identify predictors of PNC utilization using odds ratio with 95% confidence interval and p-value of 0.05.

RESULTS

The study revealed that the prevalence of PNC service utilization was 84.8%. Mother's and partner's secondary education level and above (AOR = 2.42, CI: 1.97-6.04; AOR = 1.45, CI: 1.25-2.49), partner's occupation in civil service and business (AOR = 3.17, CI: 1.25, 8.01; AOR =3.39, CI:1.40-8.18), household income of at least MK50, 000 (AOR = 14.41, CI: 5.90-35.16), joint decision making (AOR = 2.27, CI: 1.13, 4.57), knowledge of the available PNC services (AOR = 4.06, CI: 2.22-7.41), knowledge of at least one postpartum danger sign (AOR = 4.00, CI: 2.09, 7.50), health facility delivery of last pregnancy (AOR = 6.88, CI: 3.35, 14.14) positively associated with PNC service utilization.

CONCLUSION

The rate of PNC service utilization among mothers was 85%. The uptake of PNC services among mothers was mainly influenced by mother and partner education level, occupation status of the partner, household income, decision making power, knowledge of available PNC services, knowledge of at least one postpartum danger signs, and place of delivery. Therefore, PNC awareness campaigns, training and economic empowerment programs targeting mothers who delivered at home with primary education background and low economic status are needed.

摘要

背景

产后护理（PNC）服务是一项被忽视但至关重要的服务，可以降低中低收入国家产妇、新生儿和婴儿的发病率和死亡率。尽管马拉维政府及其合作伙伴为提高全国产妇保健服务覆盖率做出了诸多努力，但产妇和婴儿的死亡率仍然很高。本研究调查了马拉维曼戈乔区产妇利用 PNC 的决定因素。

方法

在 2016 年 1 月 1 日至 31 日之前的过去 2 年中分娩的 600 名母亲中进行了一项基于社区的横断面研究。采用多阶段抽样技术从曼戈乔区随机选择的 9 个村庄中选择受访者。使用转录的半结构式问卷进行预测试、修改，并用于收集社会人口特征和产妇相关因素的数据。数据在 EpiData 版本 3.1 中进行编码，并在 Stata 版本 12 中进行分析。使用调整混杂因素的多变量逻辑回归，使用比值比和 95%置信区间和 p 值 0.05 确定 PNC 利用的预测因素。

结果

研究表明，PNC 服务利用率的流行率为 84.8%。母亲和伴侣的中学及以上学历（AOR=2.42，CI：1.97-6.04；AOR=1.45，CI：1.25-2.49），伴侣的公务员和商业职业（AOR=3.17，CI：1.25，8.01；AOR=3.39，CI：1.40-8.18），家庭收入至少 50,000 克瓦查（AOR=14.41，CI：5.90-35.16），共同决策（AOR=2.27，CI：1.13,4.57），对可用的 PNC 服务的了解（AOR=4.06，CI：2.22-7.41），对至少一种产后危险迹象的了解（AOR=4.00，CI：2.09,7.50），上次妊娠在医疗机构分娩（AOR=6.88，CI：3.35,14.14）与 PNC 服务的利用呈正相关。

结论

母亲的 PNC 服务利用率为 85%。母亲对 PNC 服务的利用主要受母亲和伴侣教育程度、伴侣职业状况、家庭收入、决策权、对可用 PNC 服务的了解、对至少一种产后危险信号的了解以及分娩地点的影响。因此，需要针对在家分娩且具有小学教育背景和较低经济地位的母亲开展 PNC 宣传活动、培训和经济赋权计划。