Health Services Academy, Islamabad, Pakistan.
PLoS One. 2023 Nov 16;18(11):e0294225. doi: 10.1371/journal.pone.0294225. eCollection 2023.
This study investigates the factors associated with maternal health services utilization in Pakistan using two outcome indicators, ideal antenatal care (IANC), defined as the pregnant woman receiving all the essential services included in standard antenatal care, and skilled birth attendance (SBA).
This study used the Pakistan Maternal Mortality Survey 2019 data. The study utilized binary logistic regression models to investigate the adjusted association between the outcome variables, separately for IANC and SBA, and the independent variables, education, wealth, parity, and residence.
Wealth showed a positive association with utilization of IANC (adjusted odds ratio [AOR] = 11.48, 95% CI = 7.76, 16.99) and SBA (AOR = 4.37, 95% CI = 3.30,5. 80). Maternal age was associated only with IANC for women aged 35 or more years (AOR = 1.31, 95% CI = 1.06, 1.62). Increased likelihood of utilization of IANC and SBA services was also observed for women with formal education. Women who had 3-5 previous live births had higher odds of using IANC and SBA than women who had 1-2 or more than five previous live births. Urban residency was not correlated with either IANC or SBA.
When compared to the wealthy and educated quintile, women in the lower wealth quintile and those without any formal education were less likely to utilize ANC and SBA services. A comprehensive and multipronged approach from the health and education sectors is needed to improve maternal health in Pakistan.
本研究使用两个结果指标(理想产前护理(IANC)和熟练分娩护理(SBA)),调查了巴基斯坦产妇卫生服务利用的相关因素。
本研究使用了 2019 年巴基斯坦产妇死亡率调查数据。研究采用二元逻辑回归模型,分别对 IANC 和 SBA 的结果变量与教育、财富、生育次数和居住地等独立变量进行了调整后关联的分析。
财富与 IANC(调整后的优势比[OR] = 11.48,95%置信区间[CI] = 7.76,16.99)和 SBA(OR = 4.37,95% CI = 3.30,5.80)的利用呈正相关。产妇年龄仅与 35 岁及以上的妇女的 IANC 相关(OR = 1.31,95% CI = 1.06,1.62)。具有正规教育的妇女也更有可能利用 IANC 和 SBA 服务。与生育 1-2 次或更多次的妇女相比,生育 3-5 次的妇女更有可能利用 IANC 和 SBA 服务。城市居住与 IANC 或 SBA 均无相关性。
与富人和受过教育的五分位数相比,处于较低财富五分位数和没有任何正规教育的妇女利用 ANC 和 SBA 服务的可能性较低。需要从卫生和教育部门采取综合和多管齐下的方法,以改善巴基斯坦的产妇健康。