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埃塞俄比亚南部产后妇女在医疗保健决策中的自主权及相关因素:一项横断面研究

Women Autonomy in Health Care Decision Making and Associated Factors Among Postpartum Women in Southern Ethiopia: A Cross-Sectional Study.

作者信息

Haile Addisalem, Lonsako Arega Abebe, Kebede Fekadu Abera, Adisu Aklilu, Elias Amanuel, Kasse Tsehaynew

机构信息

College of Medicine and Health Sciences Arba Minch University Arba Minch Ethiopia.

College of Health Sciences Oda Bultum University Chiro Ethiopia.

出版信息

Health Sci Rep. 2024 Dec 9;7(12):e70245. doi: 10.1002/hsr2.70245. eCollection 2024 Dec.

Abstract

BACKGROUND AND AIMS

Women's autonomy in healthcare decision-making is crucial for improving maternal and child health. Despite its importance, there is limited evidence on autonomous healthcare decision making particularly in postpartum women. Thus, this study aimed to assess the prevalence of postpartum women's autonomy in healthcare decision making and its associated factors in Chencha town, Gamo zone, southern Ethiopia.

METHODS

A community based cross-sectional study was conducted among 617 postpartum women in southern Ethiopia from October 1 to November 30, 2023. A study participants were selected by a simple random sampling technique. The data were collected through pretested and interviewer administered questionnaire. Following coding and entry into Epi-data version 3.1, the data were exported into statistical package for social science software (SPSS version 26) for analysis. A logistic regression model was fitted and, variables with  < 0.05 were declared to be significantly associated with women autonomy in healthcare decision-making.

RESULTS

In this study, 61.6% of postpartum women have autonomous in their health care decision making with 95% confidence interval (CI): 57.4, 65.3. Women age over 35 years (AOR = 3.2, 95% CI: 1.7, 6.0), enrollment in community-based health insurance (AOR = 1.5 95% CI: 1.0, 2.3), having four and above antenatal care visits (AOR = 2.5, 95% CI: 1.6, 3.8), using skilled delivery service (AOR = 4.3, 95% CI: 2.9, 6.6), having primary educational level (AOR = 4.9, 95% CI: 3.0, 8.0), and secondary and above educational level (AOR = 5, 95% CI: 3.1, 8.0) were positively associated with women autonomy in health care decision making.

CONCLUSION

This study revealed that majority of postpartum women were autonomous in their healthcare decision making. Maternal age, educational status, enrollment in community-based health insurance, having frequent ANC follow-up and using skilled delivery service were factors significantly associated with women's autonomy. Focus should be given to improve women antenatal care follow-up and the enrollment of community-based health insurance.

摘要

背景与目的

女性在医疗决策中的自主权对于改善母婴健康至关重要。尽管其重要性,但关于自主医疗决策的证据有限,尤其是在产后女性中。因此,本研究旨在评估埃塞俄比亚南部加莫地区陈查镇产后女性在医疗决策中的自主权患病率及其相关因素。

方法

2023年10月1日至11月30日,在埃塞俄比亚南部对617名产后女性进行了一项基于社区的横断面研究。研究参与者通过简单随机抽样技术选取。数据通过预先测试并由访谈员管理的问卷收集。经过编码并录入Epi - data 3.1版本后,数据被导出到社会科学统计软件包(SPSS 26版本)进行分析。拟合了逻辑回归模型,P < 0.05的变量被宣布与女性在医疗决策中的自主权显著相关。

结果

在本研究中,61.6%的产后女性在医疗决策中具有自主权,95%置信区间(CI)为:57.4, 65.3。35岁以上的女性(调整后比值比[AOR] = 3.2,95% CI:1.7, 6.0)、参加社区医疗保险(AOR = 1.5,95% CI:1.0, 2.3)、进行四次及以上产前检查(AOR = 2.5,95% CI:1.6, 3.8)、使用熟练接生服务(AOR = 4.3,95% CI:2.9, 6.6)、具有小学教育水平(AOR = 4.9,95% CI:3.0, 8.0)以及具有中学及以上教育水平(AOR = 5,95% CI:3.1, 8.0)与女性在医疗决策中的自主权呈正相关。

结论

本研究表明,大多数产后女性在医疗决策中具有自主权。产妇年龄、教育状况、参加社区医疗保险、频繁进行产前检查随访以及使用熟练接生服务是与女性自主权显著相关的因素。应注重改善女性产前检查随访情况以及社区医疗保险的参保率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2b56/11628633/9be4fa1f0a04/HSR2-7-e70245-g001.jpg

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