尼日利亚西北部产后服务的未利用情况：2003年至2018年趋势及社会决定因素分析

Non-utilisation of postpartum services in northwestern Nigeria: analyses of trend and social determinants from 2003 to 2018.

作者信息

Yakubu Abubakar Abbani, Sawangdee Yothin, Widyastari Dyah Anantalia, Hunchangsith Pojjana

机构信息

Department of Demography, Institute for Population and Social Research, Mahidol University, Salaya, Putthamonthon, Nakhon Pathom, Thailand.

Department of Demography and Social Statistics, Federal University Birnin Kebbi, Kebbi State, Nigeria.

出版信息

BMJ Open. 2025 Jan 2;15(1):e086121. doi: 10.1136/bmjopen-2024-086121.

DOI:10.1136/bmjopen-2024-086121

PMID:39753260

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11749572/

Abstract

OBJECTIVE

To assess the prevalence of non-utilisation of postpartum services in northwestern Nigeria from 2003 to 2018 and to identify and estimate the influence of social determinants, a crucial step in improving maternal and child health in the region.

DESIGN

The 2003, 2008, 2013 and 2018 Nigeria Demographic and Health Survey rounds were used. Descriptive, trend and multivariable logistic regression analyses were used to show the trend and assess the influence of social determinants. The sample consisted of 17 294 women aged 15-49 who responded to questions on postpartum attendance during the period.

SETTING

Northwestern geographical subregion of Nigeria.

OUTCOME

The non-use of postpartum services.

RESULTS

The non-utilisation of postpartum services has increased from 77% in 2003 to 87% in 2018, with an overall prevalence of 88% of all women not using the services. The odds of not using postpartum services were higher for women with no education (adjusted OR (AOR): 1.27; CI: 1.03 to 1.58), those with no knowledge of contraceptives (AOR: 1.72; CI: 1.35 to 2.19), those who never used contraceptives (AOR: 1.71; CI: 1.39 to 2.09), those with parity of four or more births (AOR: 1.58; CI: 1.34 to 1.86), those in polygynous marriage (AOR: 1.16; CI: 1.03 to 1.30) and those from the poorest (AOR: 2.34; CI: 1.67 to 3.28) and poorer (AOR: 2.05; CI: 1.50 to 2.78) households. The odds were lower for women who wanted to delay pregnancy (AOR: 0.74; CI: 0.55 to 0.99) and those with full (AOR: 0.56; CI: 0.42 to 0.75) or joint (AOR: 0.67; CI: 0.53 to 0.83) autonomy in healthcare decisions.

CONCLUSION

The findings are crucial for understanding and addressing the non-utilisation of postpartum services in northwestern Nigeria. Policymakers should aim to address the impacts of the identified social determinants to promote the use of postpartum services, prevent maternal deaths and meet the SDG-3.1 target.

摘要

目的

评估2003年至2018年尼日利亚西北部产后服务未利用情况的流行程度，并识别和评估社会决定因素的影响，这是改善该地区母婴健康的关键一步。

设计

采用2003年、2008年、2013年和2018年尼日利亚人口与健康调查轮次的数据。使用描述性、趋势性和多变量逻辑回归分析来显示趋势并评估社会决定因素的影响。样本包括17294名年龄在15 - 49岁之间的女性，她们在该时期回答了关于产后就诊情况的问题。

地点

尼日利亚西北部地理次区域。

结果

产后服务的未利用率从2003年的77%上升至2018年的87%，所有女性中未使用该服务的总体患病率为88%。未接受教育的女性（调整后比值比（AOR）：1.27；可信区间：1.03至1.58）、不了解避孕方法的女性（AOR：1.72；可信区间：1.35至2.19）、从未使用过避孕方法的女性（AOR：1.71；可信区间：1.39至2.09）、生育四个或更多子女的女性（AOR：1.58；可信区间：1.34至1.86）、处于一夫多妻制婚姻中的女性（AOR：1.16；可信区间：1.03至1.30）以及来自最贫困（AOR：2.34；可信区间：1.67至3.28）和较贫困（AOR：2.05；可信区间：1.50至2.78）家庭的女性，未使用产后服务的几率更高。想要推迟怀孕的女性（AOR：0.74；可信区间：0.55至0.99）以及在医疗保健决策方面拥有完全（AOR：0.56；可信区间：0.42至0.75）或共同（AOR：0.67；可信区间：0.53至0.83）自主权的女性，几率较低。