性别规范和妇女赋权是阻碍设施分娩的因素：利用世界价值观调查对尼日利亚 26 个州进行的基于人群的横断面研究。
Gender norms and women's empowerment as barriers to facility birth: A population-based cross-sectional study in 26 Nigerian states using the World Values Survey.
机构信息
Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
出版信息
PLoS One. 2022 Aug 18;17(8):e0272708. doi: 10.1371/journal.pone.0272708. eCollection 2022.
BACKGROUND
Central and western Africa struggle with the world's lowest regional proportion of facility birth at 57%. The aim of the current study was to compare beliefs related to maternal health care services, science/technology, gender norms, and empowerment in states with high vs. low proportions of facility birth in Nigeria.
METHODS
Face-to-face interviews were performed as part of a nationally representative survey in Nigeria using a new module to measure values and beliefs related to gender and sexual and reproductive health and rights collected as part the 2018 World Values Survey. We compared beliefs related to maternal health care services, science/technology, gender norms, and empowerment between Nigerian states with facility birth proportions > 50% vs. < 25% as presented in the 2018 Nigerian Demographic Health Survey report. Pearson's chi-squared test, the independent t-test, and univariable and multivariable logistic and linear regression were used for analyses. Results were also stratified by gender.
RESULTS
Among the 1,273 participants interviewed, 653 resided in states with high and 360 resided in states with low proportions of facility birth. There were no significant differences between the groups in perceived safety of facility birth (96% vs. 94%) and confidence in antenatal care (91% vs 94%). However, in states with low proportions of facility birth, participants had higher confidence in traditional birth attendants (61% vs. 39%, adjusted odds ratio [aOR] 2.1, [1.5-2.8]), men were more often perceived as the ones deciding whether a woman should give birth at a clinic (56% vs. 29%, aOR 2.4 [1.8-3.3]), and participants experienced less freedom over their own lives (56% vs. 72%, aOR 0.56 [0.41-0.76]). Most differences in responses between men and women were not statistically significant.
CONCLUSIONS
In order to increase facility births in Nigeria and other similar contexts, transforming gender norms and increasing women's empowerment is key.
背景
中非地区面临着全球最低的地区设施分娩比例，仅为 57%。本研究旨在比较尼日利亚高比例和低比例设施分娩的州在产妇保健服务、科学/技术、性别规范和赋权方面的信念。
方法
作为在尼日利亚进行的全国代表性调查的一部分，进行了面对面访谈，使用新模块测量与性别以及性和生殖健康与权利相关的价值观和信念，这些数据是作为 2018 年世界价值观调查的一部分收集的。我们比较了尼日利亚高比例（>50%）和低比例（<25%）设施分娩州在产妇保健服务、科学/技术、性别规范和赋权方面的信念，这些比例是根据 2018 年尼日利亚人口与健康调查报告呈现的。采用 Pearson's 卡方检验、独立 t 检验、单变量和多变量逻辑和线性回归进行分析。结果还按性别分层。
结果
在接受访谈的 1273 名参与者中，有 653 人居住在高比例设施分娩的州，360 人居住在低比例设施分娩的州。两组在对设施分娩安全性的看法（96%对 94%）和对产前保健的信心（91%对 94%）方面没有显著差异。然而，在低比例设施分娩的州，参与者对传统助产妇的信心更高（61%对 39%，调整后的优势比[OR]2.1，[1.5-2.8]），男性更常被认为是决定女性是否应该在诊所分娩的人（56%对 29%，OR 2.4[1.8-3.3]），而且参与者对自己生活的自由度较低（56%对 72%，OR 0.56[0.41-0.76]）。男性和女性之间大多数回答差异没有统计学意义。
结论
为了增加尼日利亚和其他类似情况下的设施分娩，改变性别规范和增强妇女赋权是关键。
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