Bado Aristide Romaric, Badolo Hermann, Johnson Ermel, Komboigo Evelyne Bewendin, Padonou Sètondji Géraud R, Diawara Fatou
Département Biomedical et Santé Publique, Institut de Recherche en Sciences de la Santé (IRSS), Ouagadougou, Burkina Faso.
Department of Public Health and Research, West African Health Organization, Bobo Dioulasso, Burkina Faso.
Front Reprod Health. 2022 Feb 17;4:808070. doi: 10.3389/frph.2022.808070. eCollection 2022.
Identifying and understanding the factors associated with homebirths can contribute to improving maternal and child health and achieving the Sustainable Development Goals (SDGs). This study aimed to perform a comparative analysis of the factors associated with homebirths in Benin and Mali.
This study is based on the most recent data from the Demographic Health Surveys conducted in Mali and Benin in 2018. The dependent variable was homebirth, and the explanatory variables were the individual characteristics of the woman, the distance to the health center, the place of residence, the number of prenatal consultations had, the frequency of media exposure, and the use of the Internet. The primary survey unit (PSU) was considered in the analysis to measure the effect of context on the choice of the place of delivery. Further, descriptive statistics and multilevel logistic regression analysis were used in the study.
Educational level was associated with homebirth in Benin and Mali; Women with either no education or primary education are more likely to give birth at home. Women who didn't live close to a health facility were more likely to give birth at home than those who didn't face this problem in both countries. Not making visits for antenatal care (ANC) increases the odds of having a homebirth by 31.3 times (CI = 24.10-40.70) in Benin and 12.91 times (CI = 10.21-16.33) in Mali. Similarly, women who went on 1-2 ANC visits were more likely to give birth at home compared with women who made five or more ANC visits in both countries. The number of children per woman was also a significant factor in both countries. Women who often or regularly paid attention to the media messages were less likely to give birth at home compared with those who did not follow relevant media inputs (aOR = 0.42 [CI = 0.26-0.67] in Benin and aOR = 0.65 [CI = 0.50-0.85] in Mali).
Increasing the demand and uptake of women's health services by improving the availability and quality of services and establishing community health centers could help reduce the incidence of homebirths that can be risky and, thus, combat maternal and infant mortality.
识别并理解与在家分娩相关的因素有助于改善母婴健康，实现可持续发展目标（SDGs）。本研究旨在对贝宁和马里与在家分娩相关的因素进行比较分析。
本研究基于2018年在马里和贝宁进行的人口与健康调查的最新数据。因变量是在家分娩，解释变量包括女性的个人特征、到医疗中心的距离、居住地、产前检查次数、媒体接触频率以及互联网使用情况。分析中考虑了初级抽样单位（PSU），以衡量背景因素对分娩地点选择的影响。此外，本研究还使用了描述性统计和多水平逻辑回归分析。
教育水平与贝宁和马里的在家分娩有关；未受过教育或仅接受过小学教育的女性更有可能在家分娩。在这两个国家，居住地离医疗机构较远的女性比没有这个问题的女性更有可能在家分娩。在贝宁，未进行产前检查（ANC）会使在家分娩的几率增加31.3倍（CI = 24.10 - 40.70），在马里则增加12.91倍（CI = 10.21 - 16.33）。同样，在这两个国家，进行1 - 2次产前检查的女性比进行五次或更多次产前检查的女性更有可能在家分娩。每个女性的子女数量在这两个国家也是一个重要因素。与不关注相关媒体信息的女性相比，经常或定期关注媒体信息的女性在家分娩的可能性较小（在贝宁，调整后的比值比[aOR] = 0.42 [CI = 0.26 - 0.67]；在马里，aOR = 0.65 [CI = 0.50 - 0.85]）。
通过提高服务的可及性和质量以及建立社区卫生中心来增加对妇女健康服务的需求和利用率，有助于降低可能存在风险的在家分娩发生率，从而降低母婴死亡率。
