Hunie Asratie Melaku, Belay Daniel Gashaneh
Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Front Glob Womens Health. 2022 May 25;3:869552. doi: 10.3389/fgwh.2022.869552. eCollection 2022.
Improving the coverage of completion of the maternity continuum of care is the priority area of sub-Saharan African countries to achieve the sustainable development goal. Despite this, information is scant about the pooled prevalence of completion of the maternity continuum of care and its determinants in sub-Saharan African countries. Therefore, this study aimed to assess the pooled prevalence of completion of the maternity continuum of care and its determinants among women in sub-Saharan African countries.
The study was conducted based on Demographic and Health Survey (DHS) data from 33 sub-Saharan African countries from 2010 to 2020. The total sample size of 337,297 postpartum period women with children aged 0-36 months (about 3 years) was employed in the analysis by STATA version 14. A multilevel logistic regression model was fitted, and intraclass correlation coefficient (ICC), median odds ratio (M), proportion change in variance (PCV), and deviance were used for model fitness and comparison. Adjusted odds ratio (A) with its 95% confidence interval () was presented. Variables with a value of < 0.05 were declared significant determinants of completion of the maternity continuum of care.
The pooled prevalence of completion of the maternity continuum of care was 35.81%; [95% CI, 35.64%, 35.9%]. Higher educational level [A = 3.62; 95% 2.25, 4.46], wanted pregnancy [A = 2.51; 95% 1.82, 3.12], history of terminated pregnancy [A = 3.21; 95% 2.86, 4.21], distance to the nearby health facility [A = 2.11; 95% 1.68, 2.36], women as primary decision maker [A = 2.15; 95% 2.02, 2.87], nouse of traditional medication during pregnancy [A = 1.01; 95% 1.00, 1.45], antenatal care (ANC) visit within second trimester [A = 2.76; 95% 2.01, 3.47], informed about pregnancy complication [A = 2.73; 95% 2.10, 3.21], healthcare provider support [A = 1.77; 95% 1.02, 2.44], and being eastern and western African [A = 1.55; 95% 1.11, 2.44 and A = 2.01; 95% 1.88, 2.76, respectively] were determinant factors of completion of maternity continuum of care.
The completion of the maternity continuum of care in sub-Sahara African countries was low. Emphasis on women's education, type, history of pregnancy, distance to the nearby health facility, region, assessing the exposure of traditional medication, and informed about pregnancy complications, healthcare provider's support can improve the prevalence of completion of the maternity continuum of care.
提高孕产妇连续照护的覆盖率是撒哈拉以南非洲国家实现可持续发展目标的优先领域。尽管如此，关于撒哈拉以南非洲国家孕产妇连续照护完成情况的合并患病率及其决定因素的信息却很少。因此，本研究旨在评估撒哈拉以南非洲国家妇女中孕产妇连续照护完成情况的合并患病率及其决定因素。
本研究基于2010年至2020年33个撒哈拉以南非洲国家的人口与健康调查（DHS）数据进行。采用STATA 14版对337297名产后有0至36个月（约3岁）子女的妇女进行分析。拟合了一个多水平逻辑回归模型，并使用组内相关系数（ICC）、中位数优势比（M）、方差变化比例（PCV）和偏差进行模型拟合和比较。呈现了调整后的优势比（A）及其95%置信区间（）。P值<0.05的变量被确定为孕产妇连续照护完成情况的显著决定因素。
孕产妇连续照护完成情况的合并患病率为35.81%；[95%置信区间，35.64%，35.9%]。较高的教育水平[A = 3.62；95%置信区间2.25，4.46]、意愿妊娠[A = 2.51；95%置信区间1.82，3.12]、终止妊娠史[A = 3.21；95%置信区间2.86，4.21]、到附近医疗机构的距离[A = 2.11；95%置信区间1.68，2.36]、女性作为主要决策者[A = 2.15；95%置信区间2.02，2.87]、孕期未使用传统药物[A = 1.01；95%置信区间1.00，1.45]、孕中期进行产前检查（ANC）[A = 2.76；95%置信区间2.01，3.47]、了解妊娠并发症[A = 2.73；95%置信区间2.10，3.21]、医疗服务提供者的支持[A = 1.77；95%置信区间1.02，2.44]以及属于东非和西非地区[A = 1.55；95%置信区间1.11，2.44和A = 2.01；95%置信区间1.88，2.76]是孕产妇连续照护完成情况的决定因素。
撒哈拉以南非洲国家孕产妇连续照护的完成率较低。重视妇女教育、妊娠类型、妊娠史、到附近医疗机构的距离、地区、评估传统药物的使用情况以及了解妊娠并发症、医疗服务提供者的支持，可以提高孕产妇连续照护的完成率。
