Rotenberg Sara H, Davey Calum, McFadden Emily
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom.
International Centre for Evidence in Disability, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Afr J Disabil. 2024 Jul 31;13:1327. doi: 10.4102/ajod.v13i0.1327. eCollection 2024.
Quality maternal health care is central to the Sustainable Development Goals efforts to reduce maternal mortality, yet there remain limited quantitative data on maternal care inequities for women with disabilities in sub-Saharan Africa.
This study aims to understand the differences in maternal care providers for women with and without disabilities.
We used Multiple Indicator Cluster Surveys from 13 sub-Saharan African countries conducted between 2017-2020. We used logistic and multinomial logistic regression to examine the relationship between disability (Washington Group definition) and antenatal care attendance and the type of care provider for antenatal care, skilled birth attendance, and postnatal and postpartum checks. All analyses were adjusted for age, wealth, country, and location.
The sample included 10 021 women, including 306 (3.1%) women with disabilities. There were small absolute and no relative differences in antenatal care attendance, qualified antenatal care provider, postnatal, and postpartum checks, for disabled and women without disabilities. Women with disabilities had some evidence of higher odds of having a doctor at their birth compared to women without disabilities (aOR = 1.52, 95% CI: 0.99-2.33).
This study shows small absolute and no relative differences between women with and without disabilities for antenatal access and provider types for maternal care, though these findings are limited by a small sample and no data on care quality, acceptability, or outcomes. More research on care quality and outcomes is needed.
This study is the first quantitative, multi-country study in sub-Saharan Africa to examine maternal care seeking patterns, demonstrating important data on maternal health indicators for women with disabilities.
优质的孕产妇保健对于可持续发展目标中降低孕产妇死亡率的努力至关重要，但撒哈拉以南非洲地区残疾妇女孕产妇保健不平等的定量数据仍然有限。
本研究旨在了解残疾和非残疾妇女在孕产妇保健提供者方面的差异。
我们使用了2017年至2020年间在13个撒哈拉以南非洲国家进行的多指标类集调查。我们使用逻辑回归和多项逻辑回归来检验残疾（华盛顿小组定义）与产前检查出勤率以及产前护理、熟练接生、产后和产后检查的护理提供者类型之间的关系。所有分析均针对年龄、财富、国家和地点进行了调整。
样本包括10021名妇女，其中306名（3.1%）为残疾妇女。残疾妇女和非残疾妇女在产前检查出勤率、合格的产前护理提供者、产后和产后检查方面存在微小的绝对差异，但无相对差异。与非残疾妇女相比，有证据表明残疾妇女分娩时有医生在场的几率略高（调整后的比值比=1.52，95%置信区间：0.99-2.33）。
本研究表明，残疾和非残疾妇女在获得产前护理和孕产妇护理提供者类型方面存在微小的绝对差异，但无相对差异，不过这些发现受到样本量小以及缺乏护理质量、可接受性或结果数据的限制。需要对护理质量和结果进行更多研究。
本研究是撒哈拉以南非洲地区第一项关于孕产妇就医模式的定量、多国研究，展示了有关残疾妇女孕产妇健康指标的重要数据。
