Pickard Anita, Islam Md Irteja, Ahmed Md Sabbir, Martiniuk Alexandra
Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Research, Innovation and Grants, Spreeha Foundation, Gulshan 2, Dhaka, Bangladesh.
PLOS Glob Public Health. 2024 Mar 4;4(3):e0002518. doi: 10.1371/journal.pgph.0002518. eCollection 2024.
Numerous studies have identified factors that are associated with increased access to reproductive health services in lower-middle-income countries (LMICs). However, limited studies examined the influence of access to internet or a mobile phone, media exposure and domestic migration on reproductive health services use in LMICs like Bangladesh. This study investigated the role of such factors on the use of contraceptives, antenatal care (ANC) and postnatal care (PNC) by married adolescents and young women in Bangladesh and whether it was varied by area. Secondary data for 1665 married women aged 15-24 years, sourced from the 2019 Multiple Indicator Cluster Surveys, were included in both bivariate analyses and logistic regression modelling to examine the role of access to internet and/or mobile phone, media exposure and domestic migration on the outcome variables (contraceptive, ANC and PNC). All regression models were controlled for age, wealth, education and number of existing children. Among all participants, 69.8% were aged 20-24 years and 85.6% lived in rural areas. Of the total sample, 67.5% used contraceptives, 75.7% utilised ANC and 48.7% accessed PNC. Domestic migration significantly increased contraceptive use, with women who had moved locally within the last five years 1.84 times more likely to use contraception than those who had never moved (95% CI: 1.41-2.41, p<0.001). Women with internet or mobile phone access were more likely to receive ANC (aOR: 1.57, 95% CI: 1.22-2.00, p<0.001) compared to those without internet/mobile phone access. Media exposure was found to increase the likelihood of receiving ANC in urban areas. No significant influence was found on the use of PNC. Internet/mobile-based platforms are promising avenues for public health messaging regarding ANC in Bangladeshi married adolescents and young women. Further research is required into determinants of PNC service use in low-resource settings.
众多研究已确定了与中低收入国家（LMICs）增加获得生殖健康服务机会相关的因素。然而，在孟加拉国等中低收入国家，研究互联网或手机接入、媒体曝光以及国内迁移对生殖健康服务利用的影响的研究有限。本研究调查了这些因素对孟加拉国已婚青少年和年轻女性使用避孕药具、产前护理（ANC）和产后护理（PNC）的作用，以及其是否因地区而异。来自2019年多指标类集调查的1665名年龄在15 - 24岁的已婚女性的二手数据，被纳入双变量分析和逻辑回归模型，以检验互联网和/或手机接入、媒体曝光以及国内迁移对结果变量（避孕药具、ANC和PNC）的作用。所有回归模型均对年龄、财富、教育程度和现有子女数量进行了控制。在所有参与者中，69.8%的年龄在20 - 24岁之间，85.6%生活在农村地区。在总样本中，67.5%使用避孕药具，75.7%利用了ANC，48.7%获得了PNC。国内迁移显著增加了避孕药具的使用，过去五年内当地迁移的女性使用避孕药具的可能性是从未迁移女性的1.84倍（95%置信区间：1.41 - 2.41，p<0.001）。与没有互联网/手机接入的女性相比，有互联网或手机接入的女性更有可能接受ANC（调整后比值比：1.57，95%置信区间：1.22 - 2.00，p<0.001）。在城市地区，发现媒体曝光增加了接受ANC的可能性。未发现对PNC使用有显著影响。基于互联网/手机的平台是向孟加拉国已婚青少年和年轻女性传递关于ANC的公共卫生信息的有前景的途径。需要进一步研究低资源环境下PNC服务利用的决定因素。
