School of Public Health, Chongqing Medical University, Chongqing, China.
Second Affiliated Hospital of Soochow University, Jiangsu, China.
BMC Womens Health. 2023 Oct 21;23(1):544. doi: 10.1186/s12905-023-02709-1.
Papua New Guinea (PNG) has recorded the highest maternal mortality ratio in the Western Pacific Region and faces major challenges in achieving SDG 3. Antenatal care (ANC), skilled birth attendant (SBA) and postnatal care (PNC) services are critical components of maternal healthcare services (MHS) for reducing maternal mortality and promoting maternal health in PNG. The study sought to assess the prevalence and determinants of ANC, SBA and PNC services amongst women in PNG.
The study was conducted using the 2016-2018 Papua New Guinea Demographic and Health Survey. A total of 5248 reproductive-age women were considered as the analytical sample. The outcome variables were utilisation of ANC, SBA and PNC services. Chi-square test, multivariable logistic regression and dominance analysis were conducted. Statistical significance was set at p < 0.05.
The prevalence rates of ANC, SBA and PNC services were 52.3%, 58.7% and 26.6%, respectively. Women's employment, education, media exposure, distance to health facility, household wealth, region, residence and parity were determinants of MHS utilisation. ANC, SBA and PNC services utilisation were all primarily influenced by enabling factors, followed by predisposing and need factors.
This study demonstrated that enabling factors such as media exposure, distance to health facility, household wealth, region and residence have the greatest impact on MHS utilisation, followed by predisposing (working, education) and need factors (parity). Therefore, enabling factors should be prioritised when developing maternal health programmes and policies. For example, transport and health infrastructure should be strengthened and women's education and vocational training should be increased, especially in Highlands region, Momase region and rural areas, to increase the utilisation of MHS.
巴布亚新几内亚（PNG）在西太平洋地区拥有最高的孕产妇死亡率，在实现可持续发展目标 3 方面面临重大挑战。产前护理（ANC）、熟练助产士（SBA）和产后护理（PNC）服务是降低 PNG 孕产妇死亡率和促进孕产妇健康的孕产妇保健服务（MHS）的重要组成部分。本研究旨在评估 PNG 妇女中 ANC、SBA 和 PNC 服务的流行率和决定因素。
本研究使用了 2016-2018 年巴布亚新几内亚人口与健康调查。共有 5248 名育龄妇女被视为分析样本。因变量为 ANC、SBA 和 PNC 服务的利用情况。采用卡方检验、多变量逻辑回归和优势分析。统计显著性设为 p<0.05。
ANC、SBA 和 PNC 服务的流行率分别为 52.3%、58.7%和 26.6%。妇女的就业、教育、媒体接触、距医疗机构的距离、家庭财富、地区、住所和胎次是 MHS 利用的决定因素。ANC、SBA 和 PNC 服务的利用主要受促进因素影响，其次是倾向因素和需求因素。
本研究表明，媒体接触、距医疗机构的距离、家庭财富、地区和住所等促进因素对 MHS 利用的影响最大，其次是倾向因素（就业、教育）和需求因素（胎次）。因此，在制定孕产妇健康方案和政策时，应优先考虑促进因素。例如，应加强交通和卫生基础设施建设，增加妇女的教育和职业培训，特别是在高地地区、马马萨地区和农村地区，以提高 MHS 的利用率。
