Dost Kamila, Nakamura Keiko, Alemi Sharifullah, Tashiro Yuri, Seino Kaoruko, Hemat Shafiqullah
Department of Global Health Entrepreneurship, Division of Public Health, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Japan.
Center for Brain Science, RIKEN, Japan.
J Rural Med. 2024 Oct;19(4):221-231. doi: 10.2185/jrm.2024-017. Epub 2024 Oct 1.
The association between the sex of newborns and the utilization of prenatal healthcare services during pregnancy and childbirth has not been thoroughly studied. This study investigated the association between the sex of newborns and the extent to which women used prenatal healthcare services in Afghanistan.
This study used data obtained from a nationally representative demographic and health survey. The participants in this analysis were women who had given birth in the last five years (n=19,126). Four indicators related to prenatal healthcare utilization were used: (1) number of antenatal care (ANC) visits, (2) number of ANC services provided by skilled professionals, (3) quality of ANC services, and (4) institutional delivery. Multivariate linear and logistic regression models were employed to examine the association between the sex of newborns and the use of prenatal healthcare services after adjusting for sociodemographic and decision-making autonomy variables.
There was a significant association between the sex of newborns and use of prenatal healthcare services. Women with female newborns used ANC services fewer times (β =-0.10, 95% CI: -0.17, -0.03), used ANC services provided by skilled professionals fewer times (β=-0.11, 95% CI: -0.18, -0.04), were less likely to receive high-quality ANC (adjusted odds ratio (AOR)=0.78, 95% confidence interval (CI): 0.67, 0.90), and were less likely to deliver their babies at health institutions (AOR=0.83, 95% CI: 0.77, 0.91) than those with male newborns, after adjusting for other variables.
The findings revealed a negative association between female newborns and the utilization of prenatal healthcare services among women of reproductive age in Afghanistan. It is important to pay attention to this issue and ensure that all women have equal access to healthcare services regardless of their newborn's sex.
新生儿性别与孕期及分娩期间产前保健服务利用之间的关联尚未得到充分研究。本研究调查了阿富汗新生儿性别与女性使用产前保健服务程度之间的关联。
本研究使用了从具有全国代表性的人口与健康调查中获得的数据。该分析的参与者为过去五年内分娩的女性（n = 19126）。使用了四个与产前保健利用相关的指标：（1）产前检查（ANC）次数；（2）由专业人员提供的ANC服务次数；（3）ANC服务质量；（4）机构分娩。在对社会人口统计学和决策自主权变量进行调整后，采用多元线性和逻辑回归模型来检验新生儿性别与产前保健服务使用之间的关联。
新生儿性别与产前保健服务的使用之间存在显著关联。与生育男婴的女性相比，生育女婴的女性产前检查次数更少（β = -0.10，95%置信区间：-0.17，-0.03），由专业人员提供的ANC服务次数更少（β = -0.11，95%置信区间：-0.18，-0.04），接受高质量ANC的可能性更低（调整后的优势比（AOR）= 0.78，95%置信区间：0.67，0.90），在医疗机构分娩的可能性更低（AOR = 0.83，95%置信区间：0.77，0.91）。
研究结果显示，阿富汗育龄女性中，女婴出生与产前保健服务利用之间存在负相关。关注这一问题并确保所有女性无论其新生儿性别均能平等获得医疗服务非常重要。
