一项孕产妇和新生儿健康综合干预措施对孟加拉国农村地区孕产妇医疗保健利用情况的影响，该干预措施旨在解决医疗保健不平等问题。

Effect of an integrated maternal and neonatal health intervention on maternal healthcare utilisation addressing inequity in Rural Bangladesh.

作者信息

Ahmed Anisuddin, Rahman Fariya, Sayeed Abu, Tanwi Tania Sultana, Siddique Abu Bakkar, Hossain Aniqa Tasnim, Ether Saraban Tahura, Akter Ema, Tahsina Tazeen, Rahman Syed Moshfiqur, Arifeen Shams El, Rahman Ahmed Ehsanur

机构信息

Department of Women's and Children's Health, Uppsala University, Uppsala, 75205, Sweden.

International Centre for Diarrheal Disease Research, Bangladesh, Shaheed Tajuddin Ahmed Sarani, 1212, Mohakhali, Dhaka, Bangladesh.

出版信息

Arch Public Health. 2023 Aug 22;81(1):153. doi: 10.1186/s13690-023-01155-7.

DOI:10.1186/s13690-023-01155-7

PMID:37608340

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10464052/

Abstract

BACKGROUND

Although Bangladesh has made significant improvements in maternal, neonatal, and child health, the disparity between rich and poor remains a matter of concern.

OBJECTIVE

The study aimed to increase coverage of skilled maternal healthcare services while minimising the inequity gap among mothers in different socioeconomic groups.

METHODS

We implemented an integrated maternal and neonatal health (MNH) intervention between 2009 and 2012, in Shahjadpur sub-district of Sirajganj district, Bangladesh. The study was quasi-experimental in design for the evaluation. Socioeconomic status was derived from household assets using principal component analysis. Inequity in maternal healthcare utilisation was calculated using rich-poor ratio and concentration index to determine the changes in inequity between the baseline and the endline time period.

RESULT

The baseline and endline surveys included 3,158 (mean age 23.5 years) and 3,540 (mean age 24.3 years) recently delivered mothers respectively. Reduction in the rich-poor ratio was observed in the utilisation of skilled 4+ antenatal care (ANC) (2.4:1 to 1.1:1) and related concentration index decreased from 0.220 to 0.013 (p < 0.001). The rich-poor ratio for skilled childbirth reduced from 1.7:1 to 1.0:1 and the related concentration index declined from 0.161 to -0.021 (p < 0.001). A similar reduction was also observed in the utilisation of skilled postnatal care (PNC); where the rich-poor gap decreased from 2.5:1 to 1.0:1 and the related concentration index declined from 0.197 to -0.004 (p < 0.001).

CONCLUSION

The MNH intervention was successful in reducing inequity in receiving skilled 4+ ANC, delivery, and PNC in rural Bangladesh.

摘要

背景

尽管孟加拉国在孕产妇、新生儿和儿童健康方面取得了显著进步，但贫富差距仍然令人担忧。

目的

本研究旨在提高熟练的孕产妇保健服务覆盖率，同时尽量缩小不同社会经济群体母亲之间的不公平差距。

方法

2009年至2012年期间，我们在孟加拉国锡拉杰甘杰县的沙贾德布尔分区实施了一项综合孕产妇和新生儿健康（MNH）干预措施。该研究在设计上为准实验性评估。社会经济地位通过主成分分析从家庭资产中得出。使用贫富比和集中指数计算孕产妇保健利用的不公平性，以确定基线期和终末期之间不公平性的变化。

结果

基线调查和终末期调查分别纳入了3158名（平均年龄23.5岁）和3540名（平均年龄24.3岁）近期分娩的母亲。在熟练的4次及以上产前护理（ANC）利用方面，贫富比有所降低（从2.4:1降至1.1:1），相关集中指数从0.220降至0.01 < 0.001）。熟练分娩的贫富比从1.7:1降至1.0:1，相关集中指数从0.161降至-0.021（p < 0.001）。熟练产后护理（PNC）的利用也出现了类似的下降；贫富差距从2.5:1降至1.0:1，相关集中指数从0.197降至-0.004（p < 0.001）。