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产前护理服务的利用情况及其影响因素:基于 2019 年埃塞俄比亚迷你人口与健康调查的多水平分析

Antenatal care component utilization and associated factors among pregnant women in Ethiopia: Multilevel analysis of Ethiopian Mini Demographic and Health survey 2019.

机构信息

Department of Epidemiology, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

Department of Public Health, Institute of Health Sciences, Dambi Dollo University, Dembi Dollo, Ethiopia.

出版信息

PLoS One. 2024 May 29;19(5):e0303118. doi: 10.1371/journal.pone.0303118. eCollection 2024.

Abstract

INTRODUCTION

Maternal and neonatal health are among the top prioritised agendas of global health care with due emphasis given to developing countries, where the burden is profound. Antenatal care accompanied by its recommended components is highly beneficial for both maternal health and birth outcome.

OBJECTIVE

The objective of this study was to identify the proportion of pregnant women who received adequate Antenatal care components and associated factors among Ethiopian women.

METHODS AND MATERIALS

We used a nation-wide data from Mini Ethiopian Demographic and Health Survey (MEDHS) of 2019. All women of age 15-49 and who had at least one ANC visit, who were either permanent residents of the selected households or visitors who slept in the household the night before the survey, were eligible to be interviewed. Since we utilised multilevel logistic regression model, the STATA output had two components, the fixed effect and the random effect. In our model, the fixed effect part was displayed by odds ratio while the random effect was addressed by variance and intra-cluster correlation (ICC).

RESULTS

From the total women with at least one antenatal care (ANC) visit 55.41% (95% CI 53.60%, 57.20%) of them received adequate components of the care. In the final model after adjusting for the cluster and individual level variables, attending primary (AOR = 1.45; 95% CI: 1.15 to 1.84), secondary (AOR = 2.21; 95% CI: 1.51 to 3.24) and higher education (AOR = 2.42; 95% CI: 1.38 to 4.26) were significantly associated with higher odds of receiving adequate components of ANC. Similarly, wealth index of middle (AOR = 1.51; 95% CI: 1.06, 2.14), richer (AOR = 1.92; 95% CI: 1.32, 2.80), and richest (AOR = 3.86; 95% CI: 2.35, 6.33) compared to poorest index and having two or more ANC visits were significantly associated with receiving adequate components of ANC. On the other hand, being from Oromia region, from female headed household and protestant religion were negatively associated with receiving adequate components of ANC.

CONCLUSION

The proportion of women who received adequate ANC component was much lower compared to the universal recommendation for every woman on ANC visit. Educational status, wealth index, number of ANC visit, region of residence and type of health facility were significantly associated with the odds of receiving adequate components of ANC. The government should pay attention to those without any formal education, encouraging pregnant women to receive the optimum number of ANC visits, and devising techniques to address those in poorest wealth index so that the proportion of adequate components of ANC will be increased.

摘要

简介

孕产妇健康是全球医疗保健的重点议程之一,发展中国家尤为重视这一问题,因为发展中国家的负担更为沉重。伴随推荐的组成部分的产前护理对产妇健康和分娩结果都非常有益。

目的

本研究的目的是确定在埃塞俄比亚妇女中,接受足够的产前护理组成部分的孕妇比例以及相关因素。

方法和材料

我们使用了 2019 年全国范围内的迷你埃塞俄比亚人口与健康调查(MEDHS)数据。所有年龄在 15-49 岁之间、至少有一次 ANC 就诊的妇女,无论是选定家庭的常住居民还是在前一天晚上在家庭中睡觉的访客,都有资格接受采访。由于我们使用了多水平逻辑回归模型,STATA 的输出有两个部分,固定效应和随机效应。在我们的模型中,固定效应部分由优势比表示,而随机效应则由方差和组内相关系数(ICC)表示。

结果

在至少有一次产前护理(ANC)就诊的所有妇女中,有 55.41%(95%CI 53.60%,57.20%)接受了足够的护理组成部分。在调整了聚类和个体水平变量后的最终模型中,参加小学(AOR=1.45;95%CI:1.15 至 1.84)、中学(AOR=2.21;95%CI:1.51 至 3.24)和高等教育(AOR=2.42;95%CI:1.38 至 4.26)与接受足够的 ANC 组成部分的几率显著相关。同样,中产阶级(AOR=1.51;95%CI:1.06 至 2.14)、较富裕(AOR=1.92;95%CI:1.32 至 2.80)和最富裕(AOR=3.86;95%CI:2.35 至 6.33)的财富指数与最贫穷的指数相比,以及进行两次或两次以上的 ANC 就诊与接受足够的 ANC 组成部分显著相关。另一方面,来自奥罗米亚地区、女性户主家庭和新教宗教的妇女与接受足够的 ANC 组成部分的几率呈负相关。

结论

与 ANC 就诊时每位妇女的普遍建议相比,接受足够 ANC 组成部分的妇女比例要低得多。教育程度、财富指数、ANC 就诊次数、居住地和医疗机构类型与接受足够 ANC 组成部分的几率显著相关。政府应关注那些没有任何正规教育的人,鼓励孕妇接受最佳数量的 ANC 就诊,并制定技术方案,以解决最贫穷的财富指数人群的问题,从而提高接受足够 ANC 组成部分的比例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de66/11135780/e81171a4c923/pone.0303118.g001.jpg

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