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尼日利亚西北部吉加瓦州基本产科急诊和新生儿护理的地理空间分布、可及性及利用情况

Geospatial Distribution, Accessibility and Utilization of Basic Emergency Obstetric and New-born Care in Jigawa State, Northwest Nigeria.

作者信息

Babandi Zaharaddeen Shuaibu, Usman Suleiman, Abubakar Bilkisu Gulma, Umar Ahmad Ayuba, Suleiman Auwal Garba, Aliyu Aqqad Tilde, Isa Maryam Fadila, Dahiru Tukur

机构信息

Department of Community Medicine, Ahmadu Bello University Zaria, Nigeria.

Department of Community Medicine, Ahmadu Bello University Teaching Hospital Zaria, Nigeria.

出版信息

Niger Med J. 2025 Jan 10;65(6):865. doi: 10.60787/nmj-v65i6.403. eCollection 2024 Nov-Dec.

Abstract

BACKGROUND

High maternal mortality has remained a problem, especially in developing countries. Ensuring availability and utilization of Basic Emergency Obstetric and Newborn Care services (BEmONC) reduce maternal morbidity and mortality. The study aimed to determine the geospatial distribution, accessibility and utilization of BEmONC services in Jigawa State.

METHODOLOGY

A cross-sectional study was conducted using the WHO "30 by 7" cluster sampling technique and two-stage sampling to select 630 women and 15 Primary Health Care facilities (PHCFs) respectively. The Geo coordinates of the PHCFs and households of respondents were taken using the global positioning system (GPS) on Android devices. Data were analysed using IBM SPSS version 25 and Arc GIS version 10.6.

RESULTS

A dispersed distribution was observed for the BEmONC facilities in two LGAs and majority of the respondents (71.9%) fall within 5 Km radius to a BEmONC facility. Only 27% of the respondents utilized BEmONC services for obstetric complications. Predictors of utilization of BEmONC were living within 5 Km to the nearest BEmONC (aOR=3.3; 95% CI=1.565 - 6.822), use of bicycle (aOR=1.930; 95% CI=1.012 - 3.679), cars (aOR=1.838; 95% CI=1.127 - 2.998), and tricycles (aOR=1.833; 95% CI=1.017 - 3.309) as means of transportation to PHCs.

CONCLUSIONS

A dispersed distribution and good physical accessibility to BEmONC facilities were found, however, utilization was poor. Distance and mode of transportation were predictors of utilization of BEmONC services. Jigawa State Government should intensify awareness campaigns to improve the utilization of BEmONC services and provide emergency transport schemes for women with obstetric complications.

摘要

背景

孕产妇高死亡率一直是个问题,尤其是在发展中国家。确保基本急诊产科和新生儿护理服务(BEmONC)的可及性和利用率可降低孕产妇发病率和死亡率。本研究旨在确定吉加瓦州BEmONC服务的地理空间分布、可及性和利用率。

方法

采用世界卫生组织“30 by 7”整群抽样技术和两阶段抽样进行横断面研究,分别选取630名妇女和15个初级卫生保健机构(PHCF)。使用安卓设备上的全球定位系统(GPS)获取PHCF和受访者家庭的地理坐标。数据采用IBM SPSS 25版和Arc GIS 10.6版进行分析。

结果

在两个地方政府辖区观察到BEmONC设施分布分散,大多数受访者(71.9%)居住在距离BEmONC设施半径5公里范围内。只有27%的受访者因产科并发症使用了BEmONC服务。BEmONC服务利用的预测因素包括居住在距离最近的BEmONC设施5公里范围内(调整后比值比[aOR]=3.3;95%置信区间[CI]=1.565 - 6.822)、使用自行车(aOR=1.930;95% CI=1.012 - 3.679)、汽车(aOR=1.838;95% CI=1.127 - 2.998)和三轮车(aOR=1.833;95% CI=1.017 - 3.309)作为前往初级卫生保健机构的交通工具。

结论

发现BEmONC设施分布分散且实际可及性良好,但利用率较低。距离和交通方式是BEmONC服务利用的预测因素。吉加瓦州政府应加强宣传活动,以提高BEmONC服务的利用率,并为患有产科并发症的妇女提供紧急运输方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/937f/11770669/4cb2b21be962/nmj-65-865-f1.jpg

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