Jamee Ahsan Rahman, Kumar Sen Kanchan, Bari Wasimul
Department of Statistics University of Dhaka Dhaka Bangladesh.
Health Sci Rep. 2022 Aug 16;5(5):e791. doi: 10.1002/hsr2.791. eCollection 2022 Sep.
Essential newborn care (ENC) practices play an important role in reducing the risk of infant mortality and morbidity. Therefore, more studies are needed on ENC practices. Skilled maternal healthcare can be a good strategy to increase the practice. Learn about the independent and joint effects of skilled maternal healthcare during pregnancy and childbirth on newborn care practices.
The study used a cross-sectional data obtained from Bangladesh Multiple Indicator Cluster Survey, 2019. To investigate the association between maternal healthcare utilization and good ENC practice (cord care, delayed bathing, and immediate breast-feeding), test and -test in bivariate and binary logistic regression analysis, respectively have been performed after taking into account complex survey design.
Only about 24% (95% confidence interval [CI]: 22.95%-25.89%) women given birth at home in rural Bangladesh followed good newborn care practice. The results obtained from adjusted regression analysis showed that a woman was 24%, 49%, and 75% more likely of having good ENC practice if she received four or more skilled checkups during antenatal period only (adjusted odds ratios [AOR]: 1.24, 95% CI: 0.97, 1.60), received assistance from SBA during delivery only (AOR: 1.49, 95% CI 1.12, 1.97) and received skilled healthcare in both pregnancy and delivery (AOR: 1.75, 95% CI 1.13, 2.71), respectively compared to a woman who did not get an opportunity to receive skilled healthcare during pregnancy and delivery. Among the selected confounders, maternal age at birth, birth order, education of household heads and religion showed a significant association with good ENC practice.
The study revealed that proper maternal healthcare during pregnancy and childbirth from skilled health personnel can improve the rate of ENC practices. For this, more training programs should be started, especially at the community level, and health promotion activities are needed to create awareness about efficient maternal healthcare practices.
基本新生儿护理(ENC)措施在降低婴儿死亡率和发病率风险方面发挥着重要作用。因此,需要对ENC措施开展更多研究。熟练的孕产妇保健可能是增加这些措施实施的一个良好策略。了解孕期和分娩期间熟练的孕产妇保健对新生儿护理措施的独立和联合影响。
该研究使用了从2019年孟加拉国多指标类集调查中获得的横断面数据。为了调查孕产妇保健利用情况与良好的ENC措施(脐带护理、延迟洗澡和即时母乳喂养)之间的关联,在考虑复杂的调查设计后,分别在双变量和二元逻辑回归分析中进行了检验和检验。
在孟加拉国农村地区,只有约24%(95%置信区间[CI]:22.95%-25.89%)的在家分娩妇女遵循良好的新生儿护理措施。调整后的回归分析结果显示,如果一名妇女仅在孕期接受四次或更多次熟练检查(调整后的优势比[AOR]:1.24,95%CI:0.97,1.60)、仅在分娩时获得熟练接生员(SBA)的协助(AOR:1.49,95%CI 1.12,1.97)以及在孕期和分娩时均获得熟练的医疗保健(AOR:1.75,95%CI 1.13,2.71),与在孕期和分娩时没有机会获得熟练医疗保健的妇女相比,其采取良好ENC措施的可能性分别高出24%、49%和75%。在选定的混杂因素中,产妇生育年龄、产次、户主教育程度和宗教与良好的ENC措施存在显著关联。
该研究表明,熟练卫生人员在孕期和分娩期间提供适当的孕产妇保健可提高ENC措施的实施率。为此,应启动更多培训项目,尤其是在社区层面,并开展健康促进活动以提高对有效孕产妇保健措施的认识。