埃塞俄比亚育龄妇女对产科瘘的认识及其相关因素：一项基于埃塞俄比亚人口与健康调查数据的多水平分析：一项横断面研究。
Awareness of obstetric fistula and its associated factors among reproductive-age women in Ethiopia: a multilevel analysis of Ethiopian Demographic and Health Survey data: a cross-sectional study.
机构信息
Department of Health Education and Behavioral Sciences, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia.
Human Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
出版信息
BMJ Open. 2021 Dec 8;11(12):e053221. doi: 10.1136/bmjopen-2021-053221.
OBJECTIVE
This study aimed to determine the magnitude and associated factors of obstetric fistula (OF) awareness among reproductive-age women in Ethiopia.
METHODS
This community-based cross-sectional study was conducted among 15 683 reproductive-aged women in Ethiopia. Following the presentation of a case vignette, women's OF awareness was measured by asking if they had ever heard of OF. A multilevel multivariable logistic regression analysis was employed. A 95% CI and p<0.05 were used to declare statistical significance.
RESULT
The magnitude of women's awareness of OF was 38% (95% CI 0.37 to 0.39). Individual level variables including being in the age group of 20-25 (adjusted OR, AOR 1.17; 95% CI 1.02 to 1.35), 26-30 (AOR 1.50; 95% CI 1.27 to 1.76) and >30 (AOR 1.76; 95% CI 1.50 to 2.07), being Muslim (AOR 0.83; 95% CI 0.73 to 0.94), having primary (AOR 1.70; 95% CI 1.53 to 1.89), secondary (AOR 3.43; 95% CI 2.95 to 3.99) and tertiary education (AOR 5.88; 95% CI 4.66 to 7.42), history of pregnancy termination (AOR 1.31; 95% CI 1.13 to 1.51), media exposure (AOR 1.33; 95% CI 1.2 to 1.49), internet use (AOR 2.25; 95% CI 1.84 to 2.75), medium (AOR 1.17; 95% CI 1.02 to 1.34) and rich house hold wealth (AOR 1.50; 95% CI 1.31 to 1.72) and community level factors including high community media exposure (AOR 1.30; 95% CI 1.05 to 1.61), high community antenatal care rate (AOR 1.66; 95% CI 1.37 to 2.02) and low health facility distance problem (AOR 1.49; 95% CI 1.23 to 1.81) were significantly associated with women's awareness of OF.
CONCLUSIONS AND RECOMMENDATIONS
The magnitude of women's awareness of OF was very low in Ethiopia. Awareness of OF was influenced by sociodemographic, economic, obstetric and community-related factors. Thus, tailored public health education is required at the national level to enhance women's awareness of OF.
目的
本研究旨在确定埃塞俄比亚育龄妇女中产科瘘（OF）意识的程度及其相关因素。
方法
这是一项在埃塞俄比亚进行的基于社区的横断面研究，共纳入 15683 名育龄妇女。在呈现病例后，通过询问她们是否听说过 OF 来衡量妇女对 OF 的意识。采用多水平多变量逻辑回归分析。使用 95%CI 和 p<0.05 来表示统计学意义。
结果
妇女对 OF 的认识程度为 38%（95%CI 0.37 至 0.39）。个体水平变量包括 20-25 岁（调整后的 OR，AOR 1.17；95%CI 1.02 至 1.35）、26-30 岁（AOR 1.50；95%CI 1.27 至 1.76）和>30 岁（AOR 1.76；95%CI 1.50 至 2.07）、穆斯林（AOR 0.83；95%CI 0.73 至 0.94）、初级（AOR 1.70；95%CI 1.53 至 1.89）、中级（AOR 3.43；95%CI 2.95 至 3.99）和高等教育（AOR 5.88；95%CI 4.66 至 7.42）、妊娠终止史（AOR 1.31；95%CI 1.13 至 1.51）、媒体接触（AOR 1.33；95%CI 1.2 至 1.49）、互联网使用（AOR 2.25；95%CI 1.84 至 2.75）、中等（AOR 1.17；95%CI 1.02 至 1.34）和富裕家庭财富（AOR 1.50；95%CI 1.31 至 1.72）以及社区水平因素，包括高社区媒体接触（AOR 1.30；95%CI 1.05 至 1.61）、高社区产前护理率（AOR 1.66；95%CI 1.37 至 2.02）和低卫生设施距离问题（AOR 1.49；95%CI 1.23 至 1.81）与妇女对 OF 的认识显著相关。
结论和建议
埃塞俄比亚妇女对 OF 的认识程度非常低。OF 的认识受到社会人口、经济、产科和社区相关因素的影响。因此，需要在国家一级开展有针对性的公共卫生教育，以提高妇女对 OF 的认识。
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