Abdikarim Hodo, Muse Abdisalam Hassan, Hassan Mukhtar Abdi, Muse Yahye Hassan
Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama, Somalia.
Faculty of Science and Humanities, School of Postgraduate Studies and Research (SPGSR), Amoud University, Borama, Somalia; School of Graduate Studies, University of Hargeisa, Hargeisa, Somalia.
Aten Primaria. 2025 Feb;57(2):103082. doi: 10.1016/j.aprim.2024.103082. Epub 2024 Sep 16.
This cross-sectional study aimed to identify the determinants of home deliveries among women in Somaliland, with the objective of informing targeted interventions to improve maternal and child health outcomes.
A cross-sectional study design was employed, utilizing data from a nationally representative sample of 3250 women in Somaliland. A multivariate logistic regression analysis was conducted to examine the factors influencing the likelihood of home delivery. SITE: The study was conducted in Somaliland, a region where home delivery remains prevalent.
The study included 3250 women of reproductive age in Somaliland who had given birth.
No specific interventions were administered as part of this study. The focus was on understanding the factors associated with home deliveries.
Sociodemographic, economic, and regional factors were examined as potential determinants of home deliveries. Education levels of women and their husbands, maternal age at first marriage and first birth, and household wealth were among the main measurements analyzed.
The analysis revealed that higher education levels were associated with a decreased likelihood of home delivery. Women with secondary (OR: 0.42, 95% CI: 0.32-0.55) or higher (OR: 0.21, 95% CI: 0.12-0.37) education were less likely to deliver at home than those with no education. Similarly, women whose husbands had a secondary (OR: 0.55, 95% CI: 0.41-0.73) or higher (OR: 0.43, 95% CI: 0.28-0.66) education were less likely to deliver at home. Increased maternal age at first marriage (OR: 1.04, 95% CI: 1.02-1.06) and first birth (OR: 1.03, 95% CI: 1.01-1.05) were significant predictors of home delivery. Lower household wealth was also associated with a higher likelihood of home delivery. Significant regional variations were observed, with certain regions showing higher rates of home deliveries compared to others.
The findings highlight the importance of targeted interventions to address sociodemographic and regional disparities in the utilization of institutional delivery services in Somaliland. Strategies should focus on improving access to and quality of maternal healthcare services, empowering women's decision-making, and engaging men to address gender norms within households.
本横断面研究旨在确定索马里兰地区在家分娩的女性的相关决定因素，以便为改善母婴健康结局的针对性干预措施提供信息。
采用横断面研究设计，利用来自索马里兰全国具有代表性的3250名女性的样本数据。进行多因素逻辑回归分析以检验影响在家分娩可能性的因素。
该研究在索马里兰进行，该地区在家分娩仍然普遍。
该研究纳入了索马里兰3250名已生育的育龄妇女。
本研究未实施特定干预措施。重点在于了解与在家分娩相关的因素。
社会人口学、经济和地区因素被作为在家分娩的潜在决定因素进行研究。女性及其丈夫的教育水平、初婚和初育时的产妇年龄以及家庭财富是分析的主要测量指标。
分析显示，较高的教育水平与在家分娩可能性降低相关。接受过中等教育（比值比：0.42，95%置信区间：0.32 - 0.55）或更高教育（比值比：0.21，95%置信区间：0.12 - 0.37）的女性比未受过教育的女性在家分娩的可能性更低。同样，丈夫接受过中等教育（比值比：0.55，95%置信区间：0.41 - 0.73）或更高教育（比值比：0.43，95%置信区间：0.28 - 0.66）的女性在家分娩的可能性也更低。初婚（比值比：1.04，95%置信区间：1.02 - 1.06）和初育（比值比：1.03，95%置信区间：1.01 - 1.05）时产妇年龄增加是在家分娩的显著预测因素。较低的家庭财富也与在家分娩的较高可能性相关。观察到显著的地区差异，某些地区的在家分娩率高于其他地区。
研究结果凸显了针对性干预措施对于解决索马里兰地区在机构分娩服务利用方面的社会人口学和地区差异的重要性。策略应侧重于改善孕产妇医疗服务的可及性和质量、增强女性的决策能力以及促使男性参与以解决家庭内部的性别规范问题。
