Sserwanja Quraish, Nabbuye Rehemah, Kawuki Joseph
Programmes Department, GOAL, Khartoum, Sudan.
Advocacy Department, Ice Breakers Uganda, Kampala, Uganda.
Int J Health Plann Manage. 2022 May;37(3):1736-1753. doi: 10.1002/hpm.3439. Epub 2022 Feb 17.
Women empowerment has been viewed as a good strategy in the reduction of global maternal morbidity and mortality. Most of the recent studies in Uganda have focussed on antenatal care (ANC) frequency and the associated factors with no focus on the effect of women empowerment. Our study aims at examining the prevalence of optimal access to ANC by considering the timing of initiation, type of ANC provider and ANC frequency and their association with women empowerment.
We used Uganda Demographic and Health Survey 2016 data of 9957 women aged 15-49 years. Multistage stratified sampling was used to select study participants and we conducted multivariable logistic regression to establish the association between women empowerment and access to ANC using Statistical package for the social sciences version 25.
Out of 9957 women, 2953 (29.7%: 95% CI: 28.5.0-30.2) had initiated ANC in first trimester, 6080 (61.1%: 95% CI: 60.4-62.3) had 4 or more ANC contacts, and 9880 (99.2%: 95% CI: 99.0-99.3) had received ANC from a skilled provider. Overall, 2399 (24.1%: 95% CI: 23.0-24.6) had optimal access to ANC. Economic empowerment and exposure to media were the only women empowerment indices that were positively associated with optimal access to ANC. Other factors that were significant include; region, wealth index, age, level of education and working status.
To ensure increased access to ANC, policy-makers and other stakeholders should prioritise the use of mass media in maternal health programs, equitable allocation of the limited financial resources with a focus on older, poor and uneducated women.
妇女赋权被视为降低全球孕产妇发病率和死亡率的一项良好策略。乌干达最近的大多数研究都集中在产前保健（ANC）的次数及其相关因素上，而没有关注妇女赋权的影响。我们的研究旨在通过考虑开始时间、ANC提供者类型和ANC次数及其与妇女赋权的关联，来研究获得最佳ANC服务的情况。
我们使用了2016年乌干达人口与健康调查中9957名15 - 49岁女性的数据。采用多阶段分层抽样来选择研究参与者，并使用社会科学统计软件包第25版进行多变量逻辑回归，以确定妇女赋权与获得ANC服务之间的关联。
在9957名女性中，2953名（29.7%：95%置信区间：28.5 - 30.2）在孕早期开始接受ANC，6080名（61.1%：95%置信区间：60.4 - 62.3）有4次或更多次ANC接触，9880名（99.2%：95%置信区间：99.0 - 99.3）从专业提供者处接受了ANC。总体而言，2399名（24.1%：95%置信区间：23.0 - 24.6）获得了最佳ANC服务。经济赋权和接触媒体是与获得最佳ANC服务呈正相关的仅有的妇女赋权指标。其他显著因素包括；地区、财富指数、年龄、教育水平和工作状况。
为确保增加获得ANC服务的机会，政策制定者和其他利益相关者应优先在孕产妇健康项目中使用大众媒体，公平分配有限的财政资源，重点关注年龄较大、贫困和未受过教育的妇女。
