Diallo Mamadou Abdoulaye, Mbaye Ngoné, Aidara Ibrahima
Consortium pour la Recherche Economique et Sociale (CRES), Dakar, Senegal.
Ecole Nationale de la Statistique et de l'Analyse Economique (ENSAE), Dakar, Senegal.
Int J Health Plann Manage. 2023 May;38(3):773-789. doi: 10.1002/hpm.3624. Epub 2023 Feb 12.
Senegal has certainly made significant efforts in adult literacy and in the fight against maternal and infant mortality. However, a large proportion of the female population is illiterate, and the country's maternal and infant mortality rates are still higher than WHO recommendations. This article examined the effect of women's literacy on maternal and child health in Senegal.
Data were extracted from the last Senegal Demographic and Health Surveys (DHS) collected in 2019. A binary logistic model was performed to assess the effect of women's literacy on ten outcomes of maternal and child health indicators.
Results indicate that women's literacy has a positive and significant effect on nine of key indicators outcomes. For instance, women's literacy increases the odds of contraceptive use by 1.29 (95% Confidence Interval [CI], 1.13-1.48; p < 0.01), compliance with the number of prenatal visits by 1.57 (95% CI, 1.35-1.83; p < 0.01) and consultation in the first trimester of pregnancy by 1.52 (95% CI, 1.31-1.78; p < 0.01). Literacy is associated with increased odds of breastfeeding up to six months (Odds Ratio [OR], 1.17; 95% CI, 0.97-1.42; p < 0.1) and healthy birth interval (OR, 1.18; 95% CI, 0.97-1.44; p < 0.1) only in rural areas. Women literacy reduces the risk of stunting by 0.81 (95% CI, 0.68-0.96; p < 0.05) and the risk of underweight by 0.72 (95% CI, 0.59-0.87; p < 0.01) among children under five years. The mother's ability to read and write favors compliance with the increase of odds of DPT vaccination record of her children, especially in rural areas (OR, 1.69; 95% CI, 1.05-2.74; p < 0.05). Moreover, there are serval other factors influencing positively the maternal and child health, like health insurance access, media exposure, and clean water and improved sanitation facilities access.
This study emphasizes on the need to strengthen adult literacy programs, especially for women in rural areas. Indeed, this could help generalize health insurance by income-sensitive premiums or exemptions for the poor as well as increased awareness campaigns to promote reproductive and maternal health benefits, via the radio or television. Furthermore, improving access to clean water supply and improved sanitation facilities would greatly ameliorate maternal and child health.
塞内加尔在成人扫盲以及降低母婴死亡率方面确实做出了重大努力。然而，该国很大一部分女性人口仍是文盲，且母婴死亡率仍高于世界卫生组织的建议水平。本文研究了塞内加尔女性识字率对母婴健康的影响。
数据取自2019年收集的上一次塞内加尔人口与健康调查（DHS）。采用二元逻辑模型评估女性识字率对母婴健康指标的十个结果的影响。
结果表明，女性识字率对九个关键指标结果有积极且显著的影响。例如，女性识字使使用避孕药具的几率增加1.29（95%置信区间[CI]，1.13 - 1.48；p < 0.01），按时进行产前检查的几率增加1.57（95% CI，1.35 - 1.83；p < 0.01），在怀孕头三个月进行产检的几率增加1.52（95% CI，1.31 - 1.78；p < 0.01）。识字仅在农村地区与六个月内母乳喂养几率增加（优势比[OR]，1.17；95% CI，0.97 - 1.42；p < 0.1）以及健康生育间隔几率增加（OR，1.18；95% CI，0.97 - 1.44；p < 0.1）相关。女性识字使五岁以下儿童发育迟缓风险降低0.81（95% CI，0.68 - 0.96；p < 0.05），体重不足风险降低0.72（95% CI，0.59 - 0.87；p < 0.01）。母亲的读写能力有助于提高其子女接种百白破疫苗记录的几率，尤其是在农村地区（OR，1.69；95% CI，1.05 - 2.74；p < 0.05）。此外，还有其他几个因素对母婴健康有积极影响，如获得医疗保险、接触媒体以及获得清洁水和改善卫生设施。
本研究强调需要加强成人扫盲项目，特别是针对农村地区的女性。确实，这有助于通过对穷人实行按收入敏感的保费或豁免来推广医疗保险，以及通过广播或电视开展更多提高认识的活动，以促进生殖和孕产妇健康福利。此外，改善清洁水供应和卫生设施的获取将极大地改善母婴健康。
