埃塞俄比亚孕产妇医疗保健服务利用延续情况及其相关因素的多水平分析:一项横断面研究。
Multilevel analysis of continuation of maternal healthcare services utilization and its associated factors in Ethiopia: A cross-sectional study.
作者信息
Chaka Eshetu E
机构信息
Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
出版信息
PLOS Glob Public Health. 2022 May 24;2(5):e0000517. doi: 10.1371/journal.pgph.0000517. eCollection 2022.
Continuum of care (CoC) has been recognized as a crucial strategy for minimizing maternal, neonatal, and child mortality. CoC promotes integrated Maternal Neonatal and Child Health (MNCH) services by linking together three aspects of maternal health care antenatal care, skilled birth attendance, and postnatal care. The study aimed to assess continuation of maternal healthcare services utilization and its associated factors among reproductive age women at pregnancy, delivery and postnatal stages in Ethiopia. Cross-sectional study design conducted using Ethiopian 2016 Demographic and Health Survey data. All women with the most recent live birth in the last five years preceding the 2016 survey were the study population. The sample size was 7590, 2415, and 1342 at service entry (ANC use), COC at a delivery level, and CoC at Postpartum level respectively. COC was measured at three levels of maternal health care (during pregnancy, delivery, and postpartum). The CoC is constructed from four or more antenatal care visits (ANC4+), skilled birth attendance (SBA), and postnatal care (PNC). About 9.1% of women received all components of CoC. Educational attainment, wealth quintile, and media exposure were associated with four or more antenatal care visits and COC at the delivery level. Perception of getting money for healthcare, having blood pressure measured and urine sample taken during ANC was associated with continuity of care at the delivery level and continuity of care at a postpartum level. Birth order, residence, and region were common factors associated with each outcome of interest. The proportion of women who received all ANC4+, SBA, and PNC across the CoC was low in Ethiopia. Effort needed to increase CoC at each stage. The study shows that focusing on place of residence and regional state variation is necessary to improve CoC at each level. Thus, contextualizing the strategies and further research are critical.
连续护理(CoC)已被视为将孕产妇、新生儿和儿童死亡率降至最低的关键策略。连续护理通过将孕产妇保健的三个方面——产前护理、熟练接生服务和产后护理联系起来,促进孕产妇、新生儿和儿童综合健康(MNCH)服务。该研究旨在评估埃塞俄比亚育龄妇女在怀孕、分娩和产后阶段孕产妇保健服务利用的持续性及其相关因素。使用埃塞俄比亚2016年人口与健康调查数据进行横断面研究设计。在2016年调查前的最后五年中有过最近一次活产的所有妇女为研究人群。在服务开始(使用产前护理)、分娩水平的连续护理和产后水平的连续护理阶段,样本量分别为7590、2415和1342。连续护理在孕产妇保健的三个层面(孕期、分娩期和产后)进行测量。连续护理由四次或更多次产前检查(ANC4+)、熟练接生服务(SBA)和产后护理(PNC)构成。约9.1%的妇女接受了连续护理的所有组成部分。教育程度、财富五分位数和媒体接触与四次或更多次产前检查以及分娩水平的连续护理相关。在产前检查期间对获得医疗保健资金的认知、测量血压和采集尿样与分娩水平的护理连续性和产后水平的护理连续性相关。产次、居住地和地区是与每个感兴趣结果相关的常见因素。在埃塞俄比亚,在整个连续护理过程中接受所有ANC4+、SBA和PNC的妇女比例较低。在每个阶段都需要努力提高连续护理水平。该研究表明,关注居住地和地区差异对于在每个层面改善连续护理是必要的。因此,将策略因地制宜并进一步开展研究至关重要。