埃塞俄比亚育龄妇女延迟开始产前护理就诊的空间分布及其相关因素：2019 年微型人口与健康调查的空间和多层次分析。
Spatial distribution of delayed initiation of antenatal care visits and associated factors among reproductive age women in Ethiopia: spatial and multilevel analysis of 2019 mini-demographic and health survey.
机构信息
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
BMJ Open. 2023 Aug 24;13(8):e069095. doi: 10.1136/bmjopen-2022-069095.
OBJECTIVES
This study aimed to assess the spatial distribution, wealth-related inequality and determinants for delayed initiation of antenatal care (ANC) visits among reproductive-age women in Ethiopia.
DESIGN
Cross-sectional study design.
SETTING
Ethiopia.
PARTICIPANTS
A total of 2924 reproductive-age women who had given birth in the 5 years preceding the survey.
OUTCOME MEASURE
Delayed initiation of ANC visits.
RESULTS
The magnitude of delayed initiation of ANC visits among reproductive-age women in Ethiopia was 62.63% (95% CI 60.86%, 64.37%). Women aged 35-49 (AOR=1.42; 95% CI 1.04, 1.94), being protestant religion followers (AOR=1.43; 95% CI 1.06, 1.94), being in higher wealth index (AOR=0.53; 95% CI 0.41, 0.69), living in rural residence (AOR=1.50; 95% CI 1.02, 2.19) and living in the metropolitan region (AOR=0.45; 95% CI 0.26, 0.77) were significantly associated with delayed initiation of ANC visit. Southern Nations Nationalities and Peoples Region (SNNPR), Somalia, Benishangul Gumuz, Southern Addis Ababa and Gambella regions were hot spot regions for delayed initiation of ANC visits. The SaTScan analysis result identified 107 primary clusters of delayed initiation of ANC visits located in regions of SNNPR, Gambella, Southern Addis Ababa, Eastern Oromia and Benishangul Gumuz.
CONCLUSIONS
Significant spatial clustering of delayed initiation of ANC visits was observed in Ethiopia. More than half of women had delayed initiation of ANC visits in Ethiopia. Women's age, religion, wealth index, residence and region were significant predictors of delayed initiation of ANC visits. There is a disproportional pro-poor distribution of delayed initiation of ANC visits in Ethiopia. Therefore, interventions should be designed in the hot spot areas where delayed initiation of ANC visits was high to enhance the timely initiation of ANC visits.
目的
本研究旨在评估埃塞俄比亚育龄妇女中产前保健（ANC）就诊延迟的空间分布、与财富相关的不平等状况及其决定因素。
设计
横断面研究设计。
地点
埃塞俄比亚。
参与者
共有 2924 名在调查前 5 年内分娩过的育龄妇女。
结局测量
ANC 就诊延迟。
结果
埃塞俄比亚育龄妇女 ANC 就诊延迟的比例为 62.63%（95%CI 60.86%，64.37%）。35-49 岁的妇女（AOR=1.42；95%CI 1.04，1.94）、新教宗教信徒（AOR=1.43；95%CI 1.06，1.94）、较高的财富指数（AOR=0.53；95%CI 0.41，0.69）、农村居民（AOR=1.50；95%CI 1.02，2.19）和大都市地区（AOR=0.45；95%CI 0.26，0.77）与 ANC 就诊延迟显著相关。南方各族人民民族州（SNNPR）、索马里、本尚古勒-古马兹州、亚的斯亚贝巴南部和甘贝拉州是 ANC 就诊延迟的热点地区。SaTScan 分析结果确定了 107 个 ANC 就诊延迟的初级聚集区，分布在 SNNPR、甘贝拉、亚的斯亚贝巴南部、东奥罗莫和本尚古勒-古马兹州。
结论
埃塞俄比亚 ANC 就诊延迟存在显著的空间聚集。超过一半的妇女在埃塞俄比亚延迟了 ANC 就诊。妇女的年龄、宗教、财富指数、居住地和地区是 ANC 就诊延迟的显著预测因素。埃塞俄比亚 ANC 就诊延迟呈明显的有利于穷人的分布不均。因此，应在 ANC 就诊延迟较高的热点地区设计干预措施，以促进 ANC 就诊的及时启动。
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