孟加拉国医疗设施的可用性和准备情况及其对产前护理服务利用率的影响。

Availability and readiness of healthcare facilities and their effects on antenatal care services uptake in Bangladesh.

机构信息

Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Namapara, Mymensingh, 2220, Bangladesh.

School of Medicine and Public Health, College of Health, Medicine and Well-Being, The University of Newcastle, NSW 2308, Callaghan, Australia.

出版信息

BMC Health Serv Res. 2024 Apr 5;24(1):431. doi: 10.1186/s12913-024-10824-4.

DOI:10.1186/s12913-024-10824-4

PMID:38575980

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10996239/

Abstract

BACKGROUND

Sustainable Development Goal (SDG) 3.7 aims to ensure universal access to sexual and reproductive healthcare services, where antenatal care (ANC) is a core component. This study aimed to examine the influence of health facility availability and readiness on the uptake of four or more ANC visits in Bangladesh.

METHODS

The 2017/18 Bangladesh Demographic and Health Survey data were linked with the 2017 Health Facility Survey and analyzed in this study. The associations of health facility-level factors with the recommended number of ANC uptakes were determined. A multilevel mixed-effect logistic regression model was used to determine the association, adjusting for potential confounders.

RESULTS

Nearly 44% of mothers reported four or more ANC uptakes, with significant variations across several areas in Bangladesh. The average distance of mothers' homes from the nearest health facilities was 6.36 km, higher in Sylhet division (8.25 km) and lower in Dhaka division (4.45 km). The overall uptake of the recommended number of ANC visits was positively associated with higher scores for the management (adjusted odds ratio (aOR) 1.85; 95% CI, 1.16-2.82) and infrastructure (aOR, 1.59; 95% CI, 1.09-2.19) of health facilities closest to mothers' homes. The odds of using the recommended number of ANC in mothers increased by 3.02 (95% CI, 2.01-4.19) and 2.36 (95% CI, 2.09-3.16) folds for each unit increase in the availability and readiness scores to provide ANC services at the closest health facilities, respectively. Every kilometer increase in the average regional-level distance between mothers' homes and the nearest health facilities reduced the likelihood of receiving the recommended number of ANC visits by nearly 42% (aOR, 0.58, 95% CI, 0.42-0.74).

CONCLUSION

The availability of healthcare facilities close to residence, as well as their improved management, infrastructure, and readiness to provide ANC, plays a crucial role in increasing ANC services uptake. Policies and programs should prioritize increasing the availability, accessibility, and readiness of health facilities to provide ANC services.

摘要

背景

可持续发展目标 3.7 旨在确保普及性生殖健康服务，而产前护理 (ANC) 是其核心组成部分。本研究旨在探讨卫生设施的可用性和准备情况对孟加拉国接受四次或更多 ANC 检查的影响。

方法

本研究将 2017/18 年孟加拉国人口与健康调查数据与 2017 年卫生设施调查数据相联系，并进行了分析。确定了卫生设施水平因素与推荐 ANC 次数的关系。使用多水平混合效应逻辑回归模型，调整潜在混杂因素，确定关联性。

结果

近 44%的母亲报告接受了四次或更多 ANC 检查，在孟加拉国各地存在显著差异。母亲住所与最近的卫生设施之间的平均距离为 6.36 公里，在锡尔赫特分区较高（8.25 公里），在达卡分区较低（4.45 公里）。推荐的 ANC 检查次数的总体接受率与离家最近的卫生设施的管理（调整后的优势比（aOR）1.85；95%置信区间（CI），1.16-2.82）和基础设施（aOR，1.59；95%CI，1.09-2.19）得分呈正相关。离家最近的卫生设施中 ANC 服务的可用性和准备情况每增加一个单位，母亲使用推荐的 ANC 次数的可能性分别增加 3.02（95%CI，2.01-4.19）和 2.36（95%CI，2.09-3.16）倍。母亲住所与最近的卫生设施之间平均区域水平距离每增加一公里，接受推荐的 ANC 检查次数的可能性就会降低近 42%（aOR，0.58，95%CI，0.42-0.74）。