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埃塞俄比亚农村育龄妇女意外怀孕的患病率及其决定因素

Prevalence and determinants of unintended pregnancy among rural reproductive age women in Ethiopia.

作者信息

Jejaw Melak, Demissie Kaleb Assegid, Tiruneh Misganaw Guadie, Abera Kaleab Mesfin, Tsega Yawkal, Endawkie Abel, Negash Wubshet D, Workie Amare Mesfin, Yohannes Lamrot, Getnet Mihret, Worku Nigusu, Belay Adina Yeshambel, Asmare Lakew, Alemu Hiwot Tadesse, Geberu Demiss Mulatu, Hagos Asebe

机构信息

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Health Policy and Systems, Institute of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.

出版信息

Sci Rep. 2025 Jan 5;15(1):860. doi: 10.1038/s41598-024-81067-w.

Abstract

Despite growing utilization of family planning in Ethiopia, many pregnancies in rural areas are still unintended and unintended pregnancy remains a major global challenge in public and reproductive health, with devastating impact on women and child health, and the general public. Hence, this study was aimed to determine the prevalence and associated factors of unintended pregnancy in rural women of Ethiopia. This study used a 2016 Ethiopian Demography and Health Survey data. A total weighted samples of 974 reproductive-aged rural women were included in this analysis. Multilevel mixed logistic regression analysis was employed to consider the effect of hierarchal nature of EDHS data using Stata version 14 to determine individual and community level factors. Variables significantly associated with unintended pregnancy were declared at p-value < 0.05 with adjusted odds ratio and 95% confidence interval (CI). The prevalence of unintended pregnancy in rural women was 31.66% ( 95%CI 28.8%, 34.66%). Never had media exposure (AOR: 2.67, 95%CI 1.48, 4.83), don't have work (AOR: 0.33, 95%CI 0.21, 0.52), being from household size of one to three (AOR: 0.44 95%CI 0.2, 0.96), being primiparous (AOR: 0.41, 95%CI 0.17, 0.99), women from poor families (AOR: 2.4, 95%CI 1.24, 4.56), lacking the intention to use contraceptive (AOR: 0.24, 95%CI 0.14, 0.44) were individual-level factors significantly associated with unintended pregnancy. Women from large central region (AOR: 4.2, 95%CI 1.19, 14.62) and being from poor community wealth status (AOR: 4.3, 95%CI 1.85, 10.22) were community-level factors statistically associated with unintended pregnancy. The present study prevalence of unintended pregnancy in rural women was relatively high. Maternal occupation, household size, media exposure, parity, women wealth, intention to use contraceptive, region and community level wealth were factors statistically associated with unintended pregnancy. Hence, demographer and public health practitioners has to give great emphasis on designing an intervention with implementation strategies to increase accessibility of media for reproductive-age women's and improve women financial capacity, and strengthen maternal health services. These strategies helps to decrease adverse birth outcomes associated with unintended pregnancy in rural areas.

摘要

尽管埃塞俄比亚计划生育的使用率在不断提高,但农村地区仍有许多怀孕是意外怀孕,意外怀孕仍是全球公共卫生和生殖健康领域的一项重大挑战,对妇女和儿童健康以及普通公众都有毁灭性影响。因此,本研究旨在确定埃塞俄比亚农村妇女意外怀孕的患病率及其相关因素。本研究使用了2016年埃塞俄比亚人口与健康调查数据。本分析纳入了974名育龄农村妇女的总加权样本。采用多水平混合逻辑回归分析,使用Stata 14版本来考虑埃塞俄比亚人口与健康调查数据的分层性质的影响,以确定个体和社区层面的因素。与意外怀孕显著相关的变量以p值<0.05、调整后的优势比和95%置信区间(CI)来判定。农村妇女意外怀孕的患病率为31.66%(95%CI 28.8%,34.66%)。从未接触过媒体(优势比:2.67,95%CI 1.48,4.83)、没有工作(优势比:0.33,95%CI 0.21,0.52)、家庭规模为1至3人(优势比:0.44,95%CI 0.2,0.96)、初产(优势比:0.41,95%CI 0.17,0.99)、来自贫困家庭的妇女(优势比:2.4,95%CI 1.24,4.56)、缺乏使用避孕药具的意愿(优势比:0.24,95%CI 0.14,0.44)是与意外怀孕显著相关的个体层面因素。来自中部大区域的妇女(优势比:4.2,95%CI 1.19,14.62)以及来自社区财富状况较差的地区(优势比:4.3,95%CI 1.85,10.22)是与意外怀孕有统计学关联的社区层面因素。本研究中农村妇女意外怀孕的患病率相对较高。孕产妇职业、家庭规模、媒体接触、产次、妇女财富状况、使用避孕药具的意愿、地区和社区层面的财富是与意外怀孕有统计学关联的因素。因此,人口统计学家和公共卫生从业者必须高度重视设计具有实施策略的干预措施,以增加育龄妇女接触媒体的机会,提高妇女的经济能力,并加强孕产妇保健服务。这些策略有助于减少农村地区与意外怀孕相关的不良生育结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/379b/11701125/f5f53e80e396/41598_2024_81067_Fig1_HTML.jpg

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