Department of Population Studies, School of Statistics and Planning, College of Business and Management Sciences, Makerere University, Kampala, Uganda.
Department of Criminology and Sociology, Faculty of Arts, Cultures and Education, University of Hull, Hull, United Kingdom.
PLoS One. 2022 Apr 7;17(4):e0266657. doi: 10.1371/journal.pone.0266657. eCollection 2022.
Uganda has a high maternal mortality rate combined with poor use of health facilities at childbirth among youth. Improved use of maternal health services by the youth would help reduce maternal deaths in the country. Predictors of use of health facilities at childbirth among unmarried compared to married youth aged 15-24 years in Uganda between 2006 and 2016 are examined.
Binary logistic regression was conducted on the pooled data of the 2006, 2011 and 2016 Uganda Demographic and Health Surveys among youth who had given birth within five years before each survey. This analysis was among a sample of 764 unmarried, compared to 5,176 married youth aged 15-24 years.
Overall, unmarried youth were more likely to have a childbirth within the health facilities (79.3%) compared to married youth (67.6%). Higher odds of use of health facilities at childbirth were observed among youth with at least secondary education (OR = 2.915, 95%CI = 1.747-4.865 for unmarried vs OR = 1.633, 95%CI = 1.348-1.979 for married) and frequent antenatal care of at least four visits (OR = 1.758, 95%CI = 1.153-2.681 for unmarried vs OR = 1.792, 95%CI = 1.573-2.042 for married). Results further showed that youth with parity two or more, those that resided in rural areas and those who were engaged in agriculture had reduced odds of the use of health facilities at childbirth. In addition, among married youth, the odds of using health facilities at childbirth were higher among those with at least middle wealth index, and those with frequent access to the newspapers (OR = 1.699, 95%CI = 1.162-2.486), radio (OR = 1.290, 95%CI = 1.091-1.525) and television (OR = 1.568, 95%CI = 1.149-2.138) compared to those with no access to each of the media, yet these were not significant among unmarried youth.
Frequent use of antenatal care and higher education attainment were associated with increased chances of use of health facilities while higher parity, rural residence and being employed in the agriculture sector were negatively associated with use of health facilities at childbirth among both unmarried and married youth. To enhance use of health facilities among youth, there is a need to encourage frequent antenatal care use, especially for higher parity births and for rural residents, and design policies that will improve access to mass media, youth's education level and their economic status.
乌干达的孕产妇死亡率很高，年轻人在分娩时也很少使用医疗设施。提高年轻人对产妇保健服务的利用，有助于减少该国的孕产妇死亡人数。本研究旨在探讨 2006 年至 2016 年间，15-24 岁未婚与已婚青年在分娩时使用医疗设施的差异及其影响因素。
对 2006 年、2011 年和 2016 年乌干达人口与健康调查中，5 年内分娩过的未婚和已婚青年的汇总数据进行二元逻辑回归分析。本研究分析的未婚青年样本为 764 人，已婚青年为 5176 人。
总体而言，未婚青年在医疗设施中分娩的比例（79.3%）高于已婚青年（67.6%）。与未婚青年相比，已婚青年中至少接受过中等教育（OR=2.915，95%CI=1.747-4.865）和至少接受过四次产前检查（OR=1.758，95%CI=1.153-2.681）的人更有可能在医疗设施中分娩。此外，生育两个或更多子女、居住在农村地区和从事农业工作的青年在分娩时使用医疗设施的可能性较小。此外，在已婚青年中，至少拥有中等财富指数、经常接触报纸（OR=1.699，95%CI=1.162-2.486）、广播（OR=1.290，95%CI=1.091-1.525）和电视（OR=1.568，95%CI=1.149-2.138）的人，其在医疗设施中分娩的可能性更高，而那些没有接触过任何一种媒体的人则较低，但这些关联在未婚青年中并不显著。
频繁使用产前护理和接受更高水平的教育与增加使用医疗设施的机会有关，而更高的生育次数、农村居住和从事农业工作与未婚和已婚青年在分娩时使用医疗设施的机会减少有关。为了提高青年对医疗设施的利用，需要鼓励他们经常接受产前护理，特别是对于生育次数较高和居住在农村地区的青年，并制定改善大众媒体、青年教育水平和经济地位的政策。
