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埃塞俄比亚接受产前护理的妇女中的家庭分娩,基于设计的逻辑回归分析。

Home delivery among women who receive antenatal care in Ethiopia, design-based logistic regression analysis.

作者信息

Yimer Yimer Seid, Tesfaye Tariku, Zemelak Awgichew Kifle, Ferede Solomon Emyu

机构信息

Preventive Medicine, Addis Ababa University School of Public Health, Addis Ababa, Ethiopia.

Department of Public Health, Wollega University, Nekemte, Ethiopia.

出版信息

BMJ Public Health. 2024 Feb 28;2(1):e000399. doi: 10.1136/bmjph-2023-000399. eCollection 2024 Jun.

Abstract

BACKGROUND

In Ethiopia, a significant proportion of women who receive antenatal care (ANC) deliver at home. This study aims to investigate home delivery among pregnant women who receive ANC during pregnancy in Ethiopia. Increased coverage of ANC is advised to improve institutional delivery, which in turn prevents maternal and neonatal morbidity and mortality.

PATIENTS AND METHODS

We used data from the Performance Monitoring for Action Ethiopia panel study, which followed pregnant women 1 year through post partum. A total of 1749 women who received ANC during pregnancy were included in this study. To identify risk factors associated with home delivery, a design-based binary logistic regression analysis was used.

RESULTS

Of 1749 women who received ANC, 515 (29.4%) gave birth at home. Discussions on place of delivery with partner (adjusted OR (AOR)=0.56, 95% CI=0.35 to 0.90); desire to deliver at home (AOR=3.35, 95% CI=2.15 to 5.22); multiple birth readiness topics during ANC visits (AOR=0.39, 95% CI=0.21 to 0.63); and had ANC by a professional healthcare provider (AOR=0.40, 95% CI=0.23 to 0.70) were found to be significant predictors of home delivery.

CONCLUSION

This study found that one-third of women who received ANC gave birth at home. Discussions on place of delivery with partner, birth readiness topics, women's desire for place of delivery and type of ANC provider were found to be independent predictors. Our results indicate for special attention to the evaluation and improvement of health extension workers' competency in ANC delivery, and counselling women on various aspects of birth readiness during ANC visits.

摘要

背景

在埃塞俄比亚,很大一部分接受产前护理(ANC)的妇女在家分娩。本研究旨在调查埃塞俄比亚孕期接受ANC的孕妇的家庭分娩情况。建议提高ANC覆盖率以增加机构分娩率,进而预防孕产妇和新生儿发病及死亡。

患者与方法

我们使用了埃塞俄比亚行动绩效监测小组研究的数据,该研究对孕妇进行了为期1年的跟踪直至产后。本研究共纳入了1749名孕期接受ANC的妇女。为确定与家庭分娩相关的风险因素,采用了基于设计的二元逻辑回归分析。

结果

在1749名接受ANC的妇女中,有515名(29.4%)在家分娩。与伴侣讨论分娩地点(调整后比值比(AOR)=0.56,95%置信区间=0.35至0.90);希望在家分娩(AOR=3.35,95%置信区间=2.15至5.22);在ANC就诊期间讨论多个分娩准备主题(AOR=0.39,95%置信区间=0.21至0.63);以及由专业医护人员提供ANC(AOR=0.40,95%置信区间=0.23至0.70)被发现是家庭分娩的重要预测因素。

结论

本研究发现,接受ANC的妇女中有三分之一在家分娩。与伴侣讨论分娩地点、分娩准备主题、妇女对分娩地点的期望以及ANC提供者类型被发现是独立的预测因素。我们的结果表明,应特别关注评估和提高健康推广工作者提供ANC的能力,并在ANC就诊期间就分娩准备的各个方面为妇女提供咨询。

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