Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
Department of Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
PLoS One. 2023 Aug 1;18(8):e0289145. doi: 10.1371/journal.pone.0289145. eCollection 2023.
Skilled birth attendant (SBA) delivery is defined as assisting birth by a trained healthcare provider, which is vital for the health of mothers and newborns. Improving maternal health is one of the world health organization's (WHO) key priorities and skilled birth attendant delivery is one of the four pillars of the initiative for safe motherhood to reduce maternal mortality. Therefore, this study aimed to assess the individual and community-level factors associated with SBA delivery in Ethiopia.
A secondary data analysis was conducted using the 2019 Mini Ethiopian demographic and health survey. A total of 5,527 (weighted) live births were included in the analysis. A multi-level logistic regression model was fitted using Stata 14.0 to identify individual and community-level factors associated with SBA delivery. Finally, AOR with 95% CI and random effects were reported.
In this study after fitting a multilevel model, women with poor (AOR = 0.44 95%CI 0.32-0.61) and middle wealth index (AOR = 0.64;95% CI 0.46-0.87), multipara (AOR = 0.39;95% CI 0.28-0.55) and grand multipara (AOR = 0.46;95% CI 0.29-0.72), women from rural areas (AOR = 0.34;95% CI 0.16-0.72) and high community poverty level (AOR = 0.40;95% CI 0.21-0.76) had decreased odds of having SBA delivery. Whereas those who initiated Antenatal care (ANC) visits in the first trimester (AOR = 2.65; 95% CI 1.52-4.65) and second trimester (AOR = 1.87:95%CI 1.09-3.20) had increased odds of having SBA delivery in Ethiopia.
In this study socioeconomic factors like wealth index, parity, the timing of ANC visits, place of residency, and community poverty level were significantly associated with SBA delivery. Therefore, it is better to increase timely ANC initiation particularly for women with low levels of income to improve skilled birth attendant delivery.
熟练接生员（SBA）的分娩是指由经过培训的医疗保健提供者协助分娩，这对母婴的健康至关重要。改善产妇健康是世界卫生组织（WHO）的重点之一，而 SBA 分娩是安全孕产倡议的四大支柱之一，旨在降低产妇死亡率。因此，本研究旨在评估埃塞俄比亚与 SBA 分娩相关的个体和社区层面因素。
使用 2019 年微型埃塞俄比亚人口和健康调查的二次数据分析。共纳入 5527 名（加权）活产儿进行分析。使用 Stata 14.0 拟合多水平逻辑回归模型，以确定与 SBA 分娩相关的个体和社区层面因素。最后，报告了比值比（AOR）及其 95%置信区间和随机效应。
在这项研究中，在拟合多水平模型后，经济状况较差（AOR=0.44；95%CI 0.32-0.61）和中等财富指数（AOR=0.64；95%CI 0.46-0.87）、多胎（AOR=0.39；95%CI 0.28-0.55）和超高龄产妇（AOR=0.46；95%CI 0.29-0.72）、农村地区的妇女（AOR=0.34；95%CI 0.16-0.72）和高社区贫困水平（AOR=0.40；95%CI 0.21-0.76）的女性 SBA 分娩的可能性降低。而那些在孕早期（AOR=2.65；95%CI 1.52-4.65）和孕中期（AOR=1.87；95%CI 1.09-3.20）开始接受产前护理（ANC）的女性，SBA 分娩的可能性增加。
在这项研究中，社会经济因素如财富指数、生育次数、ANC 就诊时间、居住地点和社区贫困水平与 SBA 分娩显著相关。因此，最好增加及时的 ANC 启动，特别是对收入水平较低的妇女，以提高 SBA 分娩的水平。
