Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America.
Microbiology Department, Kabul University of Medical Science, Kabul, Afghanistan.
PLoS One. 2022 Jul 12;17(7):e0271165. doi: 10.1371/journal.pone.0271165. eCollection 2022.
Theological beliefs play an important role in cultural norms and could impact women's prenatal and postpartum decisions in South Asia, which has a high burden of disease in children and pregnant women. The aim of this study is to identify any associations religion may have in affecting a woman's decision-making ability, and how that in turn affects maternal and child health, at a group level in multiple South Asian countries.
Cross-sectional study utilizing secondary data analysis.
We used Demographic and Health Surveys (DHS) between 2014 and 2018 in Afghanistan, Bangladesh, India, Maldives, Myanmar, Nepal, and Pakistan. Not every country's survey asked about religion, so we imputed these results based on Census data. We assessed maternal and child health through a composite coverage index (CCI), which accounts for family planning, attendance of a skilled attendant at birth, antenatal care, BCG vaccinations, 3 doses of diphtheria-tetanus-pertussis vaccine, measles vaccine, oral rehydration therapy, and seeking care if the child has pneumonia. The relationship between religion, women's empowerment, and CCI was assessed through linear regression models.
The sample included 57,972 mothers who had children aged 12-23 months. CCI is observed to be affected by family income, in addition to religion and country. CCI was higher in Hindus (2.8%, 95% CI: 2.4%, 3.1%) and Buddhists (2.0%, 95% CI: 1.2%, 2.9%) than Muslims. Mother's age, education, income, decision-making autonomy, and attitude towards beatings were all related to CCI. In a model stratified by religion, age, education, and income were significant predictors of CCI for both Muslims and non-Muslims, but were more impactful among Muslims.
Though multiple imputation had to be used to fill in gaps in religion data, this study demonstrates that maternal and child health outcomes continue to be a concern in South Asia, especially for Muslim women. Given the importance of religious beliefs, utilizing a simple indicator, such as the CCI could be helpful for monitoring these outcomes and provides a tangible first step for communities to address gaps in care resulting from disparities in maternal empowerment.
神学信仰在文化规范中起着重要作用，可能会影响南亚女性的产前和产后决策，南亚儿童和孕妇的疾病负担很高。本研究的目的是确定宗教可能在影响女性决策能力方面的任何关联，以及这种关联如何反过来影响母婴健康，在多个南亚国家的群体层面上。
利用 2014 年至 2018 年期间的人口与健康调查（DHS）进行的横断面研究。
我们使用了阿富汗、孟加拉国、印度、马尔代夫、缅甸、尼泊尔和巴基斯坦的 2014 年至 2018 年期间 Demographic and Health Surveys（DHS）的数据。并非每个国家的调查都询问宗教信仰，因此我们根据人口普查数据进行了推断。我们通过综合覆盖指数（CCI）评估母婴健康状况，CCI 考虑了计划生育、由熟练助产士接生、产前护理、卡介苗接种、3 剂白喉-破伤风-百日咳疫苗、麻疹疫苗、口服补液疗法以及如果孩子患有肺炎则寻求治疗。通过线性回归模型评估宗教、妇女赋权与 CCI 之间的关系。
该样本包括 57972 名有 12-23 个月大子女的母亲。CCI 除了受到宗教和国家的影响外，还受到家庭收入的影响。印度教徒（2.8%，95%置信区间：2.4%，3.1%）和佛教徒（2.0%，95%置信区间：1.2%，2.9%）的 CCI 高于穆斯林。母亲的年龄、教育、收入、决策自主权和对殴打态度都与 CCI 有关。在按宗教划分的模型中，年龄、教育和收入是穆斯林和非穆斯林 CCI 的重要预测因素，但在穆斯林中影响更大。
尽管必须使用多重插补来填补宗教数据的空白，但本研究表明，南亚的母婴健康状况仍然令人担忧，特别是穆斯林妇女。鉴于宗教信仰的重要性，使用 CCI 等简单指标可以帮助监测这些结果，并为社区提供一个切实可行的第一步，以解决由于孕产妇赋权差异导致的护理差距。
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