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使用修正泊松回归模型对育龄妇女终止妊娠的患病率及影响因素:2022年坦桑尼亚人口与健康调查(TDHS)的横断面研究

Prevalence and determinants of pregnancy termination for childbearing women using the modified Poisson regression model: a cross-sectional study of the Tanzania Demographic and Health Survey (TDHS) 2022.

作者信息

Mbona Sizwe Vincent, Chifurira Retius, Ndlovu Bonginkosi Duncan, Ananth Anisha

机构信息

Department of Statistics, Faculty of Applied Sciences, Durban University of Technology, Durban, South Africa.

School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa.

出版信息

BMC Public Health. 2025 Jan 7;25(1):56. doi: 10.1186/s12889-024-21203-3.

Abstract

BACKGROUND

Termination of pregnancy continues to be one of the major public health problems. The prevalence and determinants associated with pregnancy termination among women from low-middle income countries such as Tanzania have previously not been thoroughly investigated. Therefore, this study aims to explore the prevalence and determinants associated with pregnancy termination among Tanzanian women.

METHODS

Data for this study was extracted from the 2022 Tanzania Demographic and Health Survey (TDHS). A total of 15,254 women aged 15-49 years, clustered in selected enumerated areas, participated in the survey. A modified Poisson regression model with sampling weights was used to find the factors that are associated with pregnancy termination.

RESULTS

The prevalence of pregnancy termination was 14.3% (95% CI: 13.81-14.75%). Our findings reveal that several factors are significantly associated with pregnancy termination. In particular, women's age, level of education, marital status, history of pregnancy losses, wealth status, attempt to delay or avoid getting pregnant outside the ideal birth spacing, and recent internet use, total children ever born, desire for more children, were significantly associated with pregnancy termination. Women who reside in rural areas, those covered by health insurance and those using contraceptives had a significantly lower likelihood of terminating pregnancy compared to their counterparts.

CONCLUSIONS

The findings highlighted that the prevalence of terminating pregnancy is alarming in Tanzania, signaling a significant public health challenge. To address the concerning rates of pregnancy termination, the government of Tanzania and other institutions are advised to enhance the accessibility and quality of healthcare services for women, particularly in rural and underserved areas. Bridging socio-economic inequalities and removing geographic barriers to healthcare access will ensure women receive timely and adequate support.

摘要

背景

终止妊娠仍然是主要的公共卫生问题之一。此前,像坦桑尼亚这样的低收入和中等收入国家女性终止妊娠的患病率及相关决定因素尚未得到充分调查。因此,本研究旨在探讨坦桑尼亚女性终止妊娠的患病率及相关决定因素。

方法

本研究数据取自2022年坦桑尼亚人口与健康调查(TDHS)。共有15254名年龄在15至49岁之间、聚集在选定普查区域的女性参与了该调查。采用带有抽样权重的修正泊松回归模型来找出与终止妊娠相关的因素。

结果

终止妊娠的患病率为14.3%(95%置信区间:13.81 - 14.75%)。我们的研究结果表明,有几个因素与终止妊娠显著相关。特别是,女性的年龄、教育水平、婚姻状况、流产史、财富状况、试图推迟或避免在理想生育间隔之外怀孕以及近期使用互联网情况、曾生育子女总数、想要更多孩子的意愿,都与终止妊娠显著相关。与居住在城市地区的女性相比,居住在农村地区的女性、参加医疗保险的女性以及使用避孕药具的女性终止妊娠的可能性显著更低。

结论

研究结果突出表明,坦桑尼亚终止妊娠的患病率令人担忧,这标志着一项重大的公共卫生挑战。为应对令人担忧的终止妊娠率,建议坦桑尼亚政府和其他机构提高女性获得医疗服务的可及性和质量,特别是在农村和医疗服务不足的地区。弥合社会经济不平等并消除获得医疗服务的地理障碍将确保女性获得及时和充分的支持。

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