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残疾育龄妇女获得性与生殖健康服务的现况及相关因素分析:基于社区的横断面研究。

Prevalence and factors associated with sexual and reproductive health services use among reproductive age women with disabilities: a community based cross-sectional study.

机构信息

Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia.

出版信息

BMC Womens Health. 2023 May 2;23(1):215. doi: 10.1186/s12905-023-02373-5.

Abstract

BACKGROUND

According to International Convention on the Right of Person with Disabilities (CRPD), all nations should discern Sexual and Reproductive Health (SRH) as human rights and needs of all people living with disabilities. Women and girls with disabilities are highly vulnerable to SRH disparities including unintended pregnancy, acquiring sexual transmitted infections and unsafe abortion. Little has known about SRH service uptake and influencing factors among reproductive aged women living with disabilities.

METHODS

A community-based cross-sectional study was conducted from January 1-30, 2021, the central Gondar zone selected districts. A total of 535 reproductive-age (18-49 years) women with disabilities had been interviewed through face-to-face using structured questionnaire. Multistage cluster sampling method was applied. A binary logistic regression model was computed to look the relationship between independent variables and uptake of SRH, and p-value < 0.05 was a cut-off point to declare statistical significance.

RESULTS

A total of 33.27% (178/535) women with disabilities used at least one SRH service in the last twelve months preceding the survey. Those who had three or more children [AOR = 4.85; 95% CI (1.24-9.71)], autonomy to visit health care facilities [AOR = 3.30; 95% CI (1.45-6.92)], lived with sexual partner [AOR = 9.2; 95% CI (2.84-13.60)], subjected to radio/television in daily bases [AOR = 5.9; 95% CI (1.26-13.04)], autonomy to visit friends and relatives [AOR = 3.95; 95% CI (1.28-12.17)], had a discussion with family members about sexual and reproductive health [AOR = 9.36; 95% CI (3.44-17.47)], and engaged in sexual activity after the age of 18 years [AOR = 7.2; 95% CI (2.51-14.45)] were important predictors for service uptake.

CONCLUSIONS

Only one in three reproductive age women with disabilities used at least one SRH service. These findings suggest that accessing information through mainstream media exposure, having full autonomous to visit friends and families, open discussion with family members, live with sexual partner, having optimal family size and starting sexual act at the recommended age improve the uptake of SRH services. Therefore, the stakeholders (both governmental and non-governmental) need to make efforts to increase the uptake of SRH services.

摘要

背景

根据《残疾人权利国际公约》(CRPD),所有国家都应将性健康和生殖健康视为所有人的人权和基本需求,包括残疾人士。残疾妇女和女孩在性健康和生殖健康方面面临严重的不平等,包括意外怀孕、性传播感染和不安全堕胎。关于残疾育龄妇女获得性健康和生殖健康服务的情况及其影响因素,人们知之甚少。

方法

这是一项基于社区的横断面研究,于 2021 年 1 月 1 日至 30 日在中央贡德尔地区选定的地区进行。通过面对面的方式,使用结构化问卷对 535 名 18-49 岁的残疾育龄妇女进行了访谈。采用多阶段聚类抽样方法。采用二元逻辑回归模型来研究独立变量与性健康和生殖健康服务利用之间的关系,p 值<0.05 为统计学显著性的截止值。

结果

在调查前的 12 个月内,共有 33.27%(178/535)的残疾妇女至少使用了一种性健康和生殖健康服务。那些有三个或更多孩子的人(AOR=4.85;95%CI(1.24-9.71))、自主前往医疗保健机构的人(AOR=3.30;95%CI(1.45-6.92))、与性伴侣一起生活的人(AOR=9.2;95%CI(2.84-13.60))、每天通过广播/电视获取信息的人(AOR=5.9;95%CI(1.26-13.04))、自主拜访亲友的人(AOR=3.95;95%CI(1.28-12.17))、与家庭成员讨论过性健康和生殖健康的人(AOR=9.36;95%CI(3.44-17.47))、18 岁以后开始性行为的人(AOR=7.2;95%CI(2.51-14.45)),是服务利用的重要预测因素。

结论

只有三分之一的残疾育龄妇女至少使用了一种性健康和生殖健康服务。这些发现表明,通过主流媒体接触获取信息、充分自主地拜访朋友和家人、与家人进行开放的讨论、与性伴侣一起生活、拥有最佳家庭规模并在推荐年龄开始性行为,都可以提高性健康和生殖健康服务的利用程度。因此,利益攸关方(包括政府和非政府)需要努力增加性健康和生殖健康服务的利用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4d4a/10155295/dc39e4caf187/12905_2023_2373_Fig1_HTML.jpg

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