Independent Researcher, Yangon, Myanmar
Population and Family Health Department, University of Public Health, Yangon, Myanmar.
BMJ Open. 2023 May 3;13(5):e066706. doi: 10.1136/bmjopen-2022-066706.
To examine the prevalence of institutional delivery and postnatal care after home delivery and to identify their determinants in Myanmar mothers who received at least four antenatal care visits.
The study used the Myanmar Demographic and Health Survey data (2015-2016), a nationally representative cross-sectional study.
The study included women aged 15-49 years who had at least one birth within the 5 years preceding the survey and completed four or more antenatal visits.
Institutional delivery and postnatal care after home delivery were used as outcomes. We used two separate samples, that is, 2099 women for institutional delivery and 380 mothers whose most recent birth was within 2 years before the survey and delivered at home for postnatal care utilisation. We used multivariable binary logistic regression analyses.
Fourteen states/regions and Nay Pyi Taw Union Territory in Myanmar.
The prevalence of institutional delivery was 54.7% (95% CI: 51.2%, 58.2%) and postnatal care utilisation was 76% (95% CI: 70.2%, 80.9%). Women who lived in urban areas, women who had higher education, women who had higher wealth status, women who had educated husbands and women having their first childbirth were more likely to have institutional delivery than their counterparts. The institutional delivery was lower among women who live in rural areas, poor women and women with husbands who worked in agriculture than their counterparts. Postnatal care utilisation was significantly higher among women living in central plains and coastal regions, women who received all seven components of antenatal care and women who had skilled assistance at birth than their counterparts.
Policymakers should address the identified determinants to improve the service continuum and reduce maternal mortality in Myanmar.
调查在缅甸接受至少 4 次产前护理的产妇中，在家分娩后选择住院分娩和产后护理的比例，并确定其决定因素。
本研究使用了 2015-2016 年缅甸人口与健康调查（Myanmar Demographic and Health Survey）的数据，这是一项具有全国代表性的横断面研究。
研究包括年龄在 15-49 岁之间、在调查前 5 年内至少分娩过一次且完成了 4 次或更多次产前检查的妇女。
住院分娩和在家分娩后的产后护理被用作结局。我们使用了两个独立的样本，即 2099 名妇女用于住院分娩，380 名最近一次分娩是在调查前 2 年内且在家分娩的母亲用于产后护理利用情况。我们使用了多变量二项逻辑回归分析。
缅甸的 14 个邦/地区和内比都联邦特区。
住院分娩的比例为 54.7%（95%可信区间：51.2%，58.2%），产后护理利用率为 76%（95%可信区间：70.2%，80.9%）。与对照组相比，居住在城市地区、受过高等教育、拥有较高财富地位、丈夫受过教育和初次分娩的妇女更有可能选择住院分娩。居住在农村地区、贫困妇女和丈夫从事农业工作的妇女的住院分娩比例较低。与对照组相比，居住在中央平原和沿海地区、接受了全部 7 项产前护理内容和有熟练助产士帮助分娩的妇女，产后护理利用率显著更高。
决策者应针对已确定的决定因素采取措施，以改善服务连续性，降低缅甸的孕产妇死亡率。
