塞内加尔的产前检查就诊情况及相关因素：对2023年人口与健康调查的多层次泊松回归分析
Antenatal care visits and associated factors in Senegal: a multilevel poisson regression analysis of the 2023 DHS survey.
作者信息
Negash Habtu Kifle, Gebiru Ashebir Mamay, Getnet Mihret, Melese Mihret, Mengistie Berihun Agegn, Bitew Desalegn Anmut, Godana Tilahun Nega, Bizuneh Yosef Belay, Getahun Amare Belete, Tilahun Mikias Mered, Baykemagn Nebebe Demis, Tassew Worku Chekol
机构信息
Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
出版信息
Front Glob Womens Health. 2025 May 27;6:1524361. doi: 10.3389/fgwh.2025.1524361. eCollection 2025.
BACKGROUND
Maternal health is crucial for women's well-being during pregnancy, childbirth, and postpartum. Antenatal care (ANC) is essential for monitoring health and preventing complications, yet only 35.5% of women in low- and middle-income regions attend the recommended ANC visits. This study explores the socioeconomic and regional factors influencing ANC visits in Senegal.
METHODS
Data from the 2023 Senegal Demographic and Health Survey (DHS) on maternal health were analyzed. A stratified two-stage sampling design selected 400 enumeration areas, and 4,543 women aged 15-49 participated. Independent variables included age, education, wealth, healthcare access, and region. Multilevel Poisson regression in Stata 17 was used to assess factors affecting ANC visits, considering both individual and community-level variables to examine regional disparities and healthcare access.
RESULTS
Among the 4,543 women, 97.63% attended at least one ANC visit, but only 7.69% completed eight or more. Wealth, media access, education, and regional location significantly influenced ANC attendance. Women from middle-income households attended 6% more visits (AIRR: 1.06, 95% CI: 1.02-1.11), and those from wealthy households attended 8% more (AIRR: 1.08, 95% CI: 1.03-1.14). Women with media access attended 11% more visits (AIRR: 1.11, 95% CI: 1.06-1.15). Regional disparities were evident, with women in Thiès (AIRR: 0.80, 95% CI: 0.73-0.87), Matam (AIRR: 0.83, 95% CI: 0.75-0.92), and Kédougou (AIRR: 0.83, 95% CI: 0.75-0.91) attending fewer visits compared to those in Dakar.
CONCLUSIONS
This study identifies significant socioeconomic and regional disparities in ANC utilization in Senegal. Wealth, education, media access, and regional location strongly influence ANC attendance. Targeted policies focusing on maternal health education, healthcare infrastructure, and financial support, particularly in underserved areas, are necessary to improve ANC access and maternal and child health outcomes.
背景
孕产妇健康对于女性在孕期、分娩期及产后的幸福至关重要。产前保健（ANC）对于监测健康状况和预防并发症必不可少，但在低收入和中等收入地区，仅有35.5%的女性接受了建议的产前保健访视。本研究探讨了影响塞内加尔产前保健访视的社会经济和地区因素。
方法
对2023年塞内加尔人口与健康调查（DHS）中有关孕产妇健康的数据进行了分析。采用分层两阶段抽样设计选取了400个普查区，4543名年龄在15至49岁的女性参与调查。自变量包括年龄、教育程度、财富状况、医疗保健可及性和地区。使用Stata 17软件进行多水平泊松回归，以评估影响产前保健访视的因素，同时考虑个体和社区层面的变量，以研究地区差异和医疗保健可及性。
结果
在4543名女性中，97.63%的人至少接受了一次产前保健访视，但只有7.69%的人完成了八次或更多次访视。财富状况、媒体接触情况、教育程度和地区位置对产前保健访视率有显著影响。中等收入家庭的女性访视次数多6%（调整发病率比：1.06，95%置信区间：1.02 - 1.11），富裕家庭的女性访视次数多8%（调整发病率比：1.08，95%置信区间：1.03 - 1.14）。有媒体接触的女性访视次数多11%（调整发病率比：1.11，95%置信区间：1.06 - 1.15）。地区差异明显，与达喀尔的女性相比，捷斯（调整发病率比：0.80，95%置信区间：0.73 - 0.87）、马塔姆（调整发病率比：0.83，95%置信区间：0.75 - 0.92）和凯杜古（调整发病率比：o.83，95%置信区间：0.75 - 0.91）的女性访视次数较少。
结论
本研究发现塞内加尔在产前保健利用方面存在显著的社会经济和地区差异。财富、教育、媒体接触情况和地区位置对产前保健访视率有很大影响。有必要制定针对性政策，重点关注孕产妇健康教育、医疗保健基础设施和财政支持，特别是在服务不足地区，以改善产前保健可及性以及孕产妇和儿童健康状况。
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