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埃塞俄比亚西北部阿姆哈拉地区使用产妇候产之家对孕产妇和围产期分娩结局的影响及其面临的挑战。

Effect of maternity waiting homes use on maternal and perinatal birth outcomes and its challenges in Amhara region, Northwest Ethiopia.

作者信息

Molla Muluye, Tesfa Mulugeta, Alle Atsede, Molla Firehiwot, Aschale Abiot, Endalew Bekalu, Gietaneh Wodaje

机构信息

Health Services Management and Health Economics Unit, Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

Epidemiology and Biostatistics Unit, Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

Front Glob Womens Health. 2023 Jan 4;3:978486. doi: 10.3389/fgwh.2022.978486. eCollection 2022.

Abstract

BACKGROUND

Women's death due to complications of pregnancy and childbirth is still high. Maternity waiting homes are one of the strategies to reduce it. However, there is limited evidence on the effect of using maternity waiting homes on birth outcomes, particularly in this study area. Therefore, this study was aimed to estimate the effect of staying in maternity waiting homes use on maternal and perinatal birth outcomes and its challenges in the Amhara region, Northwest Ethiopia 2018.

METHODS

Institutional-based comparative cross-sectional study using both quantitative and qualitative approaches was conducted. Data were collected using structured questionnaire interviews, in-depth interview and chart reviews. Propensity score matching analysis was used to estimate the effect of maternity waiting homes use on birth outcomes. Propensity score matching analysis was used to match potential differences in background characteristics that affect pregnancy outcomes between comparison groups. We used thematic analysis for qualitative data.

RESULT

A total of 548 pregnant mothers (274 stayed in maternity waiting homes 274 did not stay) took part in this study. The proportion of adverse birth outcomes of mothers who stayed in maternity waiting homes were 15(5.5%) which is lower than those who didn't stay 35 (12.8%). After matching with baseline covariates, mean difference of adverse maternal birth outcomes, the difference between didn't use maternity waiting home and used was 10.4%, at (t = 3.78) at 5% level of significance. Similarly, the mean adverse perinatal birth outcomes difference between mothers who didn't use MWHs and used was 11% (t = 4.33).

CONCLUSIONS

Maternity waiting home showed a significant positive effect on birth outcomes. Mothers who stayed in the maternity waiting homes had low adverse maternal and perinatal birth outcomes compared to non-users. Accommodations and quality health care services were the challenges mothers faced during their stay in the maternity waiting homes. Therefore, all concerned bodies should give attention accordingly to maternity waiting home services to reduce adverse birth outcomes through the strengthening of the quality of health care provided.

摘要

背景

孕产妇因妊娠和分娩并发症导致的死亡人数仍然居高不下。产妇候产之家是降低这一死亡率的策略之一。然而,关于使用产妇候产之家对分娩结局的影响,证据有限,尤其是在本研究区域。因此,本研究旨在评估2018年埃塞俄比亚西北部阿姆哈拉地区使用产妇候产之家对孕产妇和围产期分娩结局的影响及其面临的挑战。

方法

采用基于机构的比较横断面研究,同时运用定量和定性方法。通过结构化问卷调查、深入访谈和病历审查收集数据。倾向得分匹配分析用于评估使用产妇候产之家对分娩结局的影响。倾向得分匹配分析用于匹配影响对照组之间妊娠结局的背景特征的潜在差异。我们对定性数据进行了主题分析。

结果

共有548名孕妇参与了本研究(274名入住产妇候产之家,274名未入住)。入住产妇候产之家的母亲不良分娩结局比例为15例(5.5%),低于未入住的母亲35例(12.8%)。在与基线协变量匹配后,不良孕产妇分娩结局的平均差异,未使用产妇候产之家与使用产妇候产之家之间的差异为10.4%,在5%显著性水平下(t = 3.78)。同样,未使用产妇候产之家与使用产妇候产之家的母亲之间围产期不良分娩结局的平均差异为11%(t = 4.33)。

结论

产妇候产之家对分娩结局显示出显著的积极影响。与未使用者相比,入住产妇候产之家的母亲孕产妇和围产期不良分娩结局较低。住宿和优质医疗服务是母亲们在入住产妇候产之家期间面临的挑战。因此,所有相关机构应相应关注产妇候产之家服务,通过加强提供的医疗保健质量来减少不良分娩结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3d9/9848737/4fa0510ccb24/fgwh-03-978486-g001.jpg

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