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Post-natal care: a vital chance to save mothers and infants! Exploring barriers and factors associated with it: a mixed study. 产后护理:拯救母亲和婴儿的重要机会!探索与之相关的障碍和因素:一项混合研究。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-25 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1272943
Bekem Dibaba Degefa, Gizu Tola Feyisa, Dagne Deresa Dinagde, Gemeda Wakgari Kitil, Agmasie Damtew Walle

Introduction: The most effective maternal health intervention for enhancing mother and baby survival is postnatal care, yet it is also the most neglected service in Ethiopia. Less is known about postnatal care despite earlier studies concentrating on pregnancy and delivery service utilization. Postnatal care is the subject of few national and local area studies. Therefore this research aims to evaluate postnatal care utilization and barriers and associated characteristics among women in Ilubabor Zone and Buno Bedele Zone.

Methods: A mixed-methods study involving women who visited immunization clinics was conducted in Southwest Ethiopia. For the quantitative part, a cross-sectional survey was conducted between June 12 and July 12, 2022. The data collected through interviews was analyzed using SPSS version 26. An adjusted odds ratio (AOR) with a 95% confidence interval (CI) and p-value was constructed to evaluate the associations between postnatal care service utilization and explanatory variables. The usage of postnatal care services was determined to be significantly correlated with explanatory variables in multivariable logistic regression with a p-value less than 0.05. This qualitative study used two focused group discussions and two in-depth interviews to gather data from purposely selected mothers, and thematic analysis was used to analyze the data.

Results and discussion: A total of 422 participants with a 100% response rate were included in the analysis. 234 (55.5%) of these underwent postnatal checks. In the quantitative section, postnatal care counseling and appointment setting, counseling on danger signs, and prior postnatal care utilization all demonstrated a statistically significant association with the use of postnatal care services (AOR = 3.6, 95% CI (1.47-7.23)), [AOR = 2, 95% CI (1.05-3.64)], and [AOR = 3, 95% CI (1.36-58), respectively). At the qualitative level, it was determined that the themes of knowledge and access were obstacles to the use of postpartum care services. Generally this study revealed that the Ilubabor Zone and Buno Bedele Zone have a poor total PNC service utilization rate. Furthermore, ignorance, conventional wisdom, religious activity, distance from facilities, environmental exposure, and waiting time were identified as barriers to postnatal care service utilization. To optimize this service, all parties involved should address these factors.

前言:提高母婴存活率的最有效的孕产妇保健干预措施是产后护理,但它也是埃塞俄比亚最被忽视的服务。尽管早期的研究集中于妊娠和分娩服务的利用,但对产后护理的了解较少。产后护理是少数国家和地方研究的主题。因此,本研究旨在评估妇女产后护理的利用和障碍及相关特征在伊卢巴博区和布诺比德勒区。方法:在埃塞俄比亚西南部进行了一项涉及到免疫诊所的妇女的混合方法研究。在定量部分,横断面调查于2022年6月12日至7月12日进行。通过访谈收集的数据使用SPSS version 26进行分析。构建具有95%置信区间(CI)和p值的调整优势比(AOR)来评估产后护理服务利用与解释变量之间的关系。经多变量logistic回归分析,产后护理服务的使用与解释变量显著相关,p值小于0.05。本定性研究采用两次焦点小组讨论和两次深度访谈的方式,从有目的地选择的母亲中收集数据,并采用专题分析的方式对数据进行分析。结果与讨论:共纳入422名参与者,回复率为100%。其中234例(55.5%)接受了产后检查。在定量部分,产后护理咨询和预约设置、危险迹象咨询、产前护理利用均与产后护理服务的使用有统计学显著相关(AOR = 3.6, 95% CI (1.47-7.23)), [AOR = 2, 95% CI (1.05-3.64)], [AOR = 3, 95% CI(1.36-58)]。在质量方面,确定了知识和获取的主题是使用产后护理服务的障碍。总的来说,本研究揭示了Ilubabor区和Buno Bedele区PNC服务的总利用率较低。此外,无知、传统智慧、宗教活动、与设施的距离、环境暴露和等待时间被确定为产后护理服务利用的障碍。为了优化此服务,所有相关方都应该解决这些因素。
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引用次数: 0
Editorial: Emerging trends in global women's health-sex and gender differences in disease. 社论:全球妇女健康的新趋势——疾病的性别和性别差异。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-23 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1304382
Irene Göttgens, Sabine Oertelt-Prigione
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引用次数: 0
Gender-based roles, psychosocial variation, and power relations during delivery and postnatal care: a qualitative case study in rural Ethiopia. 分娩和产后护理期间基于性别的角色、心理社会变异和权力关系:埃塞俄比亚农村的定性案例研究。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-23 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1155064
Ketema Shibeshi, Yohannes Lemu, Lakew Gebretsadik, Abebe Gebretsadik, Sudhakar Morankar

Introduction: The World Health Organization (WHO) strongly encouraged men to support women in receiving maternal healthcare. However, especially in developing countries, maternal healthcare has traditionally been viewed as an issue in women, with men making little or no contribution, even though sexuality and children are shared products. The study aims to understand how gender-based roles, psychosocial variation, and power relations are related to child delivery and postnatal care (PNC) services.

Methods: The study was conducted in three rural districts of Oromia regional state, Jimma Zone, Ethiopia. An in-depth interview and focus group discussion were held with carefully chosen health professionals, health extension workers, community health development armies, and religious leaders. The data was collected, translated, and transcribed by experienced men and women qualitative researchers. For data analysis, ATLAS.ti version 9 was used. The data were coded and categorized concerning delivery and PNC service utilization. Independent and shared gender-based roles were identified as a means to improve maternal healthcare service delivery.

Results: The result obtained three categories, namely, gender-based roles, psychosocial variation, and power relations. Men can persuade pregnant women to use delivery services and PNC. The place of delivery is determined by the levels of gender-based power relations at the household level, but women are usually the last decision-makers. The belief of the community that giving birth in a health facility makes women look clean and neat, as opposed to home delivery, increases their intention to use maternal healthcare services.

Discussion: The study contributes that the role of a man as a husband is crucial in mobilizing others to carry pregnant women to health facilities, contributing to early intervention during labor. The decision-making capacity of women has improved over time, with men accepting their right to make decisions about their health and fetuses. Home delivery and men not being present during delivery are perceived as signs of backwardness, whereas giving birth in health institutes is seen as a sign of modernization and the rights of women.

简介:世界卫生组织(世界卫生组织)大力鼓励男子支持妇女接受孕产妇保健。然而,特别是在发展中国家,产妇保健传统上被视为女性的一个问题,尽管性和儿童是共同的产品,但男性几乎没有或根本没有做出贡献。该研究旨在了解基于性别的角色、心理社会变异和权力关系如何与分娩和产后护理(PNC)服务相关。方法:本研究在奥罗米亚州的三个农村地区进行,即埃塞俄比亚的金马地区。与精心挑选的卫生专业人员、卫生推广工作者、社区卫生发展部队和宗教领袖进行了深入访谈和焦点小组讨论。这些数据是由经验丰富的男性和女性定性研究人员收集、翻译和转录的。数据分析使用ATLAS.ti版本9。对有关交付和PNC服务利用的数据进行了编码和分类。独立和共享的基于性别的角色被确定为改善孕产妇保健服务提供的一种手段。结果:研究结果分为三类,即基于性别的角色、心理社会变异和权力关系。男性可以说服孕妇使用分娩服务和PNC。分娩地点由家庭一级基于性别的权力关系水平决定,但妇女通常是最后的决策者。社区认为,与在家分娩相比,在卫生机构分娩会让女性看起来干净整洁,这增加了她们使用孕产妇保健服务的意愿。讨论:这项研究表明,男性作为丈夫的作用在动员他人将孕妇送往医疗机构方面至关重要,有助于分娩期间的早期干预。随着时间的推移,女性的决策能力有所提高,男性接受了她们对自己的健康和胎儿做出决定的权利。在家分娩和分娩时男性不在场被视为落后的标志,而在卫生机构分娩被视为现代化和妇女权利的标志。
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引用次数: 0
Moving policy to practice: role of advocacy in enabling provision of injectable contraceptives by pharmacists in Kenya. 将政策付诸实践:倡导在肯尼亚药剂师提供注射避孕药方面的作用。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-11 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1218220
Sally Njiri, Sam Mulyanga, Irene Choge, Beatrice Kwachi, Rammah Mwalimu, Susan Ontiri

Expanding access to contraceptive services by making them available in pharmacies and drug shops is a family planning high-impact practice. In 2018, Kenya's Ministry of Health amended its family planning guidelines to allow pharmacists and pharmaceutical technologists throughout the country to provide subcutaneous and intramuscular depot medroxyprogesterone acetate. Amending the policy did not necessarily mean that the policy would be implemented. The Advance Family Planning project launched an advocacy campaign to engage key stakeholders to work with the Ministry of Health to implement the policy. Consequently, a family planning training package for pharmacists and pharmaceutical technologists was developed and rolled out. The advocacy process also led to strengthening family planning reporting by the trained pharmacists and pharmaceutical technologists. To further enhance sustainability by ensuring a continuous pool of pharmacy professionals equipped with skills to provide family planning services, Advance Family Planning and its partners advocated with universities and the Pharmacy and Poisons Board to revise the pre-service training curriculum to include family planning as a competence area for pharmacists and pharmaceutical technologists. A key lesson learned is that policy formulation does not necessarily translate to policy implementation. Advocacy is often needed to move policy to practice, especially where resources are required. Policy implementation also requires incremental achievement of milestones and the need for advocacy for each step in the process. Implementation of the policy provision that allows pharmacists and pharmaceutical technologists to provide injectable contraceptives has implications beyond family planning programs. It provides a point of reference for allowing pharmacists to offer other primary health care services, such as immunization, injectable HIV prophylaxis, and other interventions that might not be provided for in policy.

通过在药店和药店提供避孕服务来扩大获得避孕服务的机会是一种计划生育的高影响力做法。2018年,肯尼亚卫生部修订了计划生育指南,允许全国各地的药剂师和制药技术人员提供皮下和肌内储备的醋酸甲羟孕酮。修改该政策并不一定意味着该政策将得到实施。“提前计划生育”项目发起了一场宣传运动,让主要利益攸关方与卫生部合作执行该政策。因此,为药剂师和制药技术人员制定并推出了一套计划生育培训方案。宣传过程还导致受过培训的药剂师和制药技术人员加强了计划生育报告。为了进一步提高可持续性,确保有一批具备提供计划生育服务技能的药学专业人员,Advance family planning及其合作伙伴与大学和药房及毒药管理局合作,修订职前培训课程,将计划生育纳入药剂师和制药技术人员的能力领域。吸取的一个重要教训是,政策制定不一定转化为政策执行。宣传往往是将政策付诸实践所必需的,尤其是在需要资源的情况下。政策的执行还需要逐步实现里程碑,并需要对过程中的每一步进行宣传。允许药剂师和制药技术人员提供注射避孕药具的政策规定的实施影响超出了计划生育计划。它为允许药剂师提供其他初级卫生保健服务提供了一个参考点,如免疫接种、注射性艾滋病毒预防和其他政策中可能没有提供的干预措施。
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引用次数: 0
A cross-sectional survey on mother-to-child transmission of HIV among the migrant population in Dongguan, China. 中国东莞外来人口HIV母婴传播的横断面调查。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-06 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1106959
Congcong Pan, Haiyan Pan, Dongmei Liang, Yuanyuan Liu, Sichun Yin, Jianbo Zhong, Songmei He

Introduction: The migrant population, consisting of individuals who relocate from rural to urban areas, faces unique challenges that heighten their vulnerability to HIV infection. These challenges stem from a combination of sociodemographic factors and limited access to healthcare services. Understanding the dynamics of HIV transmission within this population is crucial for the development of effective prevention strategies.

Methods: To investigate the factors contributing to HIV vulnerability among migrants, we conducted a cross-sectional study at Dongguan People's Hospital from January 1, 2018, to December 31, 2021. Our study focused on pregnant women living with HIV and their infants, with a particular emphasis on sociodemographic characteristics, HIV testing and treatment profiles, and neonatal clinical data. Data were systematically collected using standardized forms.

Results: Analysis of data from 98 participants revealed noteworthy findings. No significant associations were observed between age, marital status, and educational background regarding HIV vulnerability. Similarly, factors such as the status of sexual partners, spousal therapy, and the number of children had no significant impact. However, our analysis highlighted the critical role of treatment strategies for HIV-positive women and the timing of antiretroviral therapy initiation for women with HIV, both of which were associated with HIV transmission (P < 0.05). Additionally, factors such as feeding type, neonatal antiretroviral prophylaxis, and preventive treatment strategies showed significant associations, while the preventive treatment program for neonates demonstrated no significant impact.

Discussion: These findings provide valuable insights into the specific risk factors and barriers to HIV prevention faced by the migrant population in Dongguan. They underscore the importance of targeted interventions and policies aimed at curtailing mother-to-child HIV transmission. By addressing the unique challenges experienced by migrant mothers and their infants, this study contributes significantly to broader efforts in controlling the spread of HIV, ultimately enhancing the health outcomes and well-being of Dongguan's migrant population. Furthermore, our research introduces a distinctive perspective within the extensively examined domain of Prevention of Mother-to-Child Transmission (PMTCT) programs, focusing on the internally migrant Chinese population, an understudied demographic group in this context. This study, conducted in Dongguan, China, represents one of the pioneering investigations into pregnant women with HIV and their infants within this migrant community.

引言:移民人口由从农村迁移到城市的个人组成,他们面临着独特的挑战,这些挑战使他们更容易感染艾滋病毒。这些挑战源于社会人口因素和获得医疗服务的机会有限。了解艾滋病毒在这一人群中传播的动态对于制定有效的预防战略至关重要。方法:为了调查移民易感染艾滋病毒的因素,我们于2018年1月1日至2021年12月31日在东莞市人民医院进行了一项横断面研究。我们的研究重点关注感染艾滋病毒的孕妇及其婴儿,特别强调社会人口学特征、艾滋病毒检测和治疗概况以及新生儿临床数据。使用标准化表格系统地收集数据。结果:对98名参与者的数据进行分析,发现了值得注意的发现。未观察到年龄、婚姻状况和教育背景与艾滋病毒易感性之间存在显著关联。同样,性伴侣的状况、配偶治疗和子女数量等因素也没有显著影响。然而,我们的分析强调了艾滋病毒阳性妇女的治疗策略和艾滋病毒感染妇女开始抗逆转录病毒治疗的时机的关键作用,这两者都与艾滋病毒的传播有关(P 讨论:这些发现为了解东莞外来人口在预防艾滋病毒方面面临的具体风险因素和障碍提供了宝贵的见解。它们强调了旨在遏制艾滋病毒母婴传播的有针对性的干预措施和政策的重要性。通过应对外来母亲及其婴儿所面临的独特挑战,本研究为控制艾滋病毒传播的更广泛努力做出了重大贡献,最终提高了东莞外来人口的健康状况和福祉。此外,我们的研究在预防母婴传播(PMTCT)计划的广泛研究领域中引入了一个独特的视角,重点关注中国境内流动人口,这是一个在这方面研究不足的人口群体。这项在中国东莞进行的研究是对这个移民社区中感染艾滋病毒的孕妇及其婴儿进行的开创性调查之一。
{"title":"A cross-sectional survey on mother-to-child transmission of HIV among the migrant population in Dongguan, China.","authors":"Congcong Pan,&nbsp;Haiyan Pan,&nbsp;Dongmei Liang,&nbsp;Yuanyuan Liu,&nbsp;Sichun Yin,&nbsp;Jianbo Zhong,&nbsp;Songmei He","doi":"10.3389/fgwh.2023.1106959","DOIUrl":"10.3389/fgwh.2023.1106959","url":null,"abstract":"<p><strong>Introduction: </strong>The migrant population, consisting of individuals who relocate from rural to urban areas, faces unique challenges that heighten their vulnerability to HIV infection. These challenges stem from a combination of sociodemographic factors and limited access to healthcare services. Understanding the dynamics of HIV transmission within this population is crucial for the development of effective prevention strategies.</p><p><strong>Methods: </strong>To investigate the factors contributing to HIV vulnerability among migrants, we conducted a cross-sectional study at Dongguan People's Hospital from January 1, 2018, to December 31, 2021. Our study focused on pregnant women living with HIV and their infants, with a particular emphasis on sociodemographic characteristics, HIV testing and treatment profiles, and neonatal clinical data. Data were systematically collected using standardized forms.</p><p><strong>Results: </strong>Analysis of data from 98 participants revealed noteworthy findings. No significant associations were observed between age, marital status, and educational background regarding HIV vulnerability. Similarly, factors such as the status of sexual partners, spousal therapy, and the number of children had no significant impact. However, our analysis highlighted the critical role of treatment strategies for HIV-positive women and the timing of antiretroviral therapy initiation for women with HIV, both of which were associated with HIV transmission (<i>P</i> < 0.05). Additionally, factors such as feeding type, neonatal antiretroviral prophylaxis, and preventive treatment strategies showed significant associations, while the preventive treatment program for neonates demonstrated no significant impact.</p><p><strong>Discussion: </strong>These findings provide valuable insights into the specific risk factors and barriers to HIV prevention faced by the migrant population in Dongguan. They underscore the importance of targeted interventions and policies aimed at curtailing mother-to-child HIV transmission. By addressing the unique challenges experienced by migrant mothers and their infants, this study contributes significantly to broader efforts in controlling the spread of HIV, ultimately enhancing the health outcomes and well-being of Dongguan's migrant population. Furthermore, our research introduces a distinctive perspective within the extensively examined domain of Prevention of Mother-to-Child Transmission (PMTCT) programs, focusing on the internally migrant Chinese population, an understudied demographic group in this context. This study, conducted in Dongguan, China, represents one of the pioneering investigations into pregnant women with HIV and their infants within this migrant community.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1106959"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10587463/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49694758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Time to initiation of antenatal care visit and its predictors among reproductive age women in Ethiopia: Gompertz inverse Gaussian shared frailty model. 埃塞俄比亚育龄妇女开始产前检查的时间及其预测因素:Gompertz逆高斯共有虚弱模型。
IF 2.3 Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-03 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.917895
Daniel Gashaneh Belay, Melaku Birhanu Alemu, Fantu Mamo Aragaw, Melaku Hunie Asratie

Background: Early initiation of antenatal care (ANC) is essential for the early detection of pregnancy-related problems and unfavorable pregnancy outcomes. However, a significant number of mothers do not initiate ANC at the recommended time. Therefore, this study aimed to determine the median time of ANC initiation and its predictors among reproductive-age women in Ethiopia.

Methods: We used the Ethiopian Demographic and Health Survey (EDHS) 2016 data set. The proportional hazard assumption was assessed using Schoenfeld residual test and log-log plot. A life table was used to determine the median survival time (time of ANC initiation). The Gompertz inverse Gaussian shared frailty model was the best-fitting model for identifying the predictors for the early initiation of ANC booking. Finally, the adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was used to determine the significance of predictors.

Results: A total of 7,501 reproductive-aged women gave recent birth in the last 5 years preceding the survey. Nearly three in five women [61.95% (95% CI: 60.85-63.04%)] booked their first ANC visit with a median time of 4.4 months. Women who attended primary education (AHR = 1.10, 95% CI: 1.01-1.20), secondary and above (AHR = 1.26, 95% CI: 1.11-1.44), media exposure (AHR = 1.07, 95% CI: 1.00-1.16), rich wealthy (AHR = 1.17, 95% CI: 1.06-1.30), grand multiparous (AHR = 0.82, 95% CI: 0.72-0.93), unwanted pregnancy (AHR = 0.88, 95% CI: 0.81-0.96), small periphery region (AHR = 0.58, 95% CI: 0.51-0.67), and rural residence (AHR = 0.86, 95% CI: 0.75-0.99) were significantly associated with first ANC visit.

Conclusion: According to this study, a significant number of women missed their first ANC visit. The education status of women, place of residence, region, wealth index, media exposure, unintended pregnancy, and multi-parity were significantly associated with the time of initiation of the first ANC visit. Therefore, policymakers should focus on improving the socioeconomic status (education, media coverage, and wealth) of reproductive-aged women by prioritizing women who live in small periphery regions and rural residences to improve the early initiation of ANC.

背景:早期开始产前护理(ANC)对于早期发现妊娠相关问题和不良妊娠结局至关重要。然而,相当多的母亲没有在建议的时间开始ANC。因此,本研究旨在确定埃塞俄比亚育龄妇女开始ANC的中位时间及其预测因素。方法:我们使用2016年埃塞俄比亚人口与健康调查(EDHS)数据集。使用Schoenfeld残差检验和对数-对数图评估比例风险假设。使用寿命表来确定中位生存时间(ANC开始的时间)。Gompertz逆高斯共享脆弱性模型是确定ANC预订早期启动预测因素的最佳拟合模型。最后,使用具有95%置信区间(CI)的调整后危险比(AHR)来确定预测因素的显著性。结果:在调查之前的过去5年中,共有7501名育龄妇女近期分娩。近五分之三的女性[61.95%(95%置信区间:60.85-63.04%)]预订了她们的第一次ANC就诊,中位时间为4.4个月。接受初等教育的妇女(AHR = 1.10,95%置信区间:1.01-1.20),二级及以上(AHR = 1.26,95%可信区间:1.11-1.44),介质暴露(AHR = 1.07,95%置信区间:1.00-1.16),富人(AHR = 1.17,95%可信区间:1.06-1.30),大多胎(AHR = 0.82,95%可信区间:0.72-0.93),意外妊娠(AHR = 0.88,95%可信区间:0.81-0.96),小周边区(AHR = 0.58,95%置信区间:0.51-0.67),以及农村住宅(AHR = 0.86,95%CI:0.75-0.99)与首次ANC访视显著相关。结论:根据这项研究,相当多的女性错过了第一次ANC就诊。妇女的教育状况、居住地、地区、财富指数、媒体曝光率、意外怀孕和多胞胎与首次非国大访问的时间显著相关。因此,政策制定者应将重点放在提高育龄妇女的社会经济地位(教育、媒体报道和财富)上,优先考虑居住在小周边地区和农村地区的妇女,以改善ANC的早期启动。
{"title":"Time to initiation of antenatal care visit and its predictors among reproductive age women in Ethiopia: Gompertz inverse Gaussian shared frailty model.","authors":"Daniel Gashaneh Belay, Melaku Birhanu Alemu, Fantu Mamo Aragaw, Melaku Hunie Asratie","doi":"10.3389/fgwh.2023.917895","DOIUrl":"10.3389/fgwh.2023.917895","url":null,"abstract":"<p><strong>Background: </strong>Early initiation of antenatal care (ANC) is essential for the early detection of pregnancy-related problems and unfavorable pregnancy outcomes. However, a significant number of mothers do not initiate ANC at the recommended time. Therefore, this study aimed to determine the median time of ANC initiation and its predictors among reproductive-age women in Ethiopia.</p><p><strong>Methods: </strong>We used the Ethiopian Demographic and Health Survey (EDHS) 2016 data set. The proportional hazard assumption was assessed using Schoenfeld residual test and log-log plot. A life table was used to determine the median survival time (time of ANC initiation). The Gompertz inverse Gaussian shared frailty model was the best-fitting model for identifying the predictors for the early initiation of ANC booking. Finally, the adjusted hazard ratio (AHR) with a 95% confidence interval (CI) was used to determine the significance of predictors.</p><p><strong>Results: </strong>A total of 7,501 reproductive-aged women gave recent birth in the last 5 years preceding the survey. Nearly three in five women [61.95% (95% CI: 60.85-63.04%)] booked their first ANC visit with a median time of 4.4 months. Women who attended primary education (AHR = 1.10, 95% CI: 1.01-1.20), secondary and above (AHR = 1.26, 95% CI: 1.11-1.44), media exposure (AHR = 1.07, 95% CI: 1.00-1.16), rich wealthy (AHR = 1.17, 95% CI: 1.06-1.30), grand multiparous (AHR = 0.82, 95% CI: 0.72-0.93), unwanted pregnancy (AHR = 0.88, 95% CI: 0.81-0.96), small periphery region (AHR = 0.58, 95% CI: 0.51-0.67), and rural residence (AHR = 0.86, 95% CI: 0.75-0.99) were significantly associated with first ANC visit.</p><p><strong>Conclusion: </strong>According to this study, a significant number of women missed their first ANC visit. The education status of women, place of residence, region, wealth index, media exposure, unintended pregnancy, and multi-parity were significantly associated with the time of initiation of the first ANC visit. Therefore, policymakers should focus on improving the socioeconomic status (education, media coverage, and wealth) of reproductive-aged women by prioritizing women who live in small periphery regions and rural residences to improve the early initiation of ANC.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"917895"},"PeriodicalIF":2.3,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Successful surgical closure and continence rate of obstetric fistula in Africa: systematic review and meta-analysis. 非洲产科瘘管的成功手术闭合和控制率:系统综述和荟萃分析。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-03 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1188809
Henok Kumsa, Esuyawkal Mislu, Mulugeta Wedaje Arage, Atitegeb Abera, Tilahun Hailu, Lebeza Alemu Tenaw

Background: A female genital fistula is an abnormal connection between a woman's reproductive tract and her urinary tract or rectum. While numerous studies have aimed to determine the success rate of obstetric fistula closure in different health settings, there remains a significant scarcity of data on closure success rates and incontinence rates for various types of fistulas at the regional and sub-regional levels. The success rate reflects the continent's healthcare setup in regard to the World Health Organization standards. Thus, this study aims to determine the success of surgical closure and the continence rate of obstetric fistula in Africa.

Methods: This systematic review and meta-analysis review includes studies conducted up to February 2023. Search engines like EMBBASE, Medline, Google, PubMed, Google Scholar, African Journals Online, and ScienceDirect databases were utilized to find articles. The Joanna Briggs Institute critical evaluation checklist was used to evaluate the quality of our review, which was conducted in accordance with PRISMA criteria. Heterogeneity was indicated by a p-value for I2 statistics of less than 0.05. Publication bias was assessed using the Egger regression asymmetry test. Data were entered into Microsoft Excel and analyzed using STATA 16.

Result: This review includes 85 studies. A total of 24 countries from East, West, Central, North, and Southern African sub-regions were included. The overall pooled estimated rate of successful obstetric fistula closure is 86.15 (95% CI: 83.88-88.42). Moreover, the pooled estimated rate of successfully closed vesico-vaginal fistulas but with ongoing or residual incontinence (wet) was revealed as 13.41% (95% CI: 11.15-15.68). The pooled estimated rate of successfully closed rectovaginal fistulas and combined VVF and RVF are 91.06% (95% CI: 86.08-96.03) and 62.21% (95% CI: 48.94-75.49), respectively.

Conclusions: The rate of successful obstetric fistula closure in Africa is 86.15, which is higher than the WHO target. However, the surgical closure rate of a combined VVF and RVF is 62.2%, which is significantly lower than the WHO target.

背景:女性生殖道瘘是女性生殖道和泌尿道或直肠之间的异常连接。尽管许多研究旨在确定不同卫生环境下产科瘘管闭合的成功率,但关于区域和次区域各级各类瘘管闭合成功率和失禁率的数据仍然非常匮乏。成功率反映了非洲大陆的医疗体系符合世界卫生组织的标准。因此,本研究旨在确定非洲产科瘘手术闭合的成功率和控制率。方法:本系统综述和荟萃分析综述包括截至2023年2月进行的研究。EMBBASE、Medline、Google、PubMed、Google Scholar、African Journals Online和ScienceDirect数据库等搜索引擎被用来查找文章。乔安娜·布里格斯研究所的关键评估清单用于评估我们的审查质量,该审查是根据PRISMA标准进行的。I2统计的p值小于0.05表示异质性。使用Egger回归不对称性检验评估发表偏倚。将数据输入到Microsoft Excel中,并使用STATA 16进行分析。结果:本综述包括85项研究。共有来自东非、西非、中非、北非和南部非洲次区域的24个国家被包括在内。产科瘘管闭合的总体合并估计成功率为86.15(95%CI:83.88-88.42)。此外,成功闭合膀胱阴道瘘但伴有持续或残余失禁(湿性)的合并估计率为13.41%(95%CI:111.15-15.68)。成功闭合直肠阴道瘘和VVF和RVF的合并估计比率分别为91.06%(95%CI:86.08-96.03)和62.21%(95%CI:48.94-75.49)。结论:非洲产科瘘管闭合成功率为86.15,高于世界卫生组织的目标。然而,联合VVF和RVF的手术闭合率为62.2%,明显低于世界卫生组织的目标。
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引用次数: 0
Maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals of the South West Shewa Zone, Ethiopia, 2022. 2022年,埃塞俄比亚西南谢瓦地区公立医院分娩母亲对产时护理的满意度及相关因素。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-03 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1203798
Fikadu Tolesa, Adugna Alemu, Moges Beya, Mulugeta Feyisa, Andualem Gezahagn, Abdi Negash, Erean Shigign, Asfaw Getaye, Abraham Negash, Bacha Merga

Background: Maternal satisfaction with intrapartum care is a multidimensional assumption of satisfaction with self and with the physical environment of the delivery ward and quality of care. Maternal satisfaction with intrapartum care affects the selection of birthplace and helps to identify gaps between actual and intended healthcare outcomes. This study aims to assess factors that affect maternal satisfaction with intrapartum care.

Objectives: To assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in the South-west Shewa Zone, Ethiopia, 2022.

Methods: A cross-sectional study approach among 420 mothers was conducted between April 14 and June 14, 2022. Systematic random sampling was used to select mothers for face-to-face interviews every two intervals. Bivariate and multivariable logistic regression analyses were carried out. P-values of <0.25 in association with study variables were transferred to multivariable logistic regression models. An adjusted odds ratio with a 95% confidence interval was computed, and p-values of <0.05 were considered statistically significant in the multivariable model. The results of this study are presented using text, tables, and charts.

Results: Data were collected from 420 participants, and 413 mothers completed the interview, giving a response rate of 98.33%. The overall maternal satisfaction with intrapartum care was 245 (59.32%) [95% CI: 55-64]. Mothers who were considered normal during labor and delivery (AOR = 2.57 (95% CI: 1.30-5.07), had a labor duration of 12 h or less (AOR = 1.59 (95% CI: 1.03-2.44), and experienced a waiting time of <15 min (AOR = 2.06 (95% CI: 1.21-3.52) were significantly associated with maternal satisfaction with intrapartum care.

Conclusion and recommendations: More than half of mothers were satisfied with the overall intrapartum care they received. Health facility managers and healthcare providers work together to improve maternal satisfaction with intrapartum care.

背景:产妇对产时护理的满意度是对自我、产房物理环境和护理质量的多维满意度假设。产妇对产时护理的满意度影响出生地的选择,并有助于确定实际和预期医疗保健结果之间的差距。本研究旨在评估影响产妇对产时护理满意度的因素。目的:评估2022年埃塞俄比亚西南谢瓦地区公立医院分娩母亲对产时护理的满意度及其相关因素。方法:2022年4月14日至6月14日,对420名母亲进行了横断面研究。每隔两个时间间隔,采用系统随机抽样的方法选择母亲进行面对面的访谈。进行了双变量和多变量逻辑回归分析。结果P值的P值:从420名参与者中收集数据,413名母亲完成了访谈,回答率为98.33%。产妇对产时护理的总体满意度为245(59.32%)[95%CI:55-64]。在分娩和分娩期间被认为正常的母亲(AOR = 2.57(95%CI:1.30-5.07),产程为12 h或更小(AOR = 1.59(95%可信区间:1.03-2.44),并经历了一段等待时间的结论和建议:超过一半的母亲对她们所接受的整体产时护理感到满意。卫生机构管理人员和医疗保健提供者共同努力,提高产妇对产时护理的满意度。
{"title":"Maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals of the South West Shewa Zone, Ethiopia, 2022.","authors":"Fikadu Tolesa,&nbsp;Adugna Alemu,&nbsp;Moges Beya,&nbsp;Mulugeta Feyisa,&nbsp;Andualem Gezahagn,&nbsp;Abdi Negash,&nbsp;Erean Shigign,&nbsp;Asfaw Getaye,&nbsp;Abraham Negash,&nbsp;Bacha Merga","doi":"10.3389/fgwh.2023.1203798","DOIUrl":"https://doi.org/10.3389/fgwh.2023.1203798","url":null,"abstract":"<p><strong>Background: </strong>Maternal satisfaction with intrapartum care is a multidimensional assumption of satisfaction with self and with the physical environment of the delivery ward and quality of care. Maternal satisfaction with intrapartum care affects the selection of birthplace and helps to identify gaps between actual and intended healthcare outcomes. This study aims to assess factors that affect maternal satisfaction with intrapartum care.</p><p><strong>Objectives: </strong>To assess maternal satisfaction with intrapartum care and associated factors among mothers who gave birth in public hospitals in the South-west Shewa Zone, Ethiopia, 2022.</p><p><strong>Methods: </strong>A cross-sectional study approach among 420 mothers was conducted between April 14 and June 14, 2022. Systematic random sampling was used to select mothers for face-to-face interviews every two intervals. Bivariate and multivariable logistic regression analyses were carried out. <i>P</i>-values of <0.25 in association with study variables were transferred to multivariable logistic regression models. An adjusted odds ratio with a 95% confidence interval was computed, and <i>p</i>-values of <0.05 were considered statistically significant in the multivariable model. The results of this study are presented using text, tables, and charts.</p><p><strong>Results: </strong>Data were collected from 420 participants, and 413 mothers completed the interview, giving a response rate of 98.33%. The overall maternal satisfaction with intrapartum care was 245 (59.32%) [95% CI: 55-64]. Mothers who were considered normal during labor and delivery (AOR = 2.57 (95% CI: 1.30-5.07), had a labor duration of 12 h or less (AOR = 1.59 (95% CI: 1.03-2.44), and experienced a waiting time of <15 min (AOR = 2.06 (95% CI: 1.21-3.52) were significantly associated with maternal satisfaction with intrapartum care.</p><p><strong>Conclusion and recommendations: </strong>More than half of mothers were satisfied with the overall intrapartum care they received. Health facility managers and healthcare providers work together to improve maternal satisfaction with intrapartum care.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1203798"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10579941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam. 妇女向越南第一个母乳库捐赠母乳量的特点和影响因素。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-10-02 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1185097
Hoang Thi Tran, Tuan Thanh Nguyen, Oanh Thi Xuan Nguyen, Debbie Barnett, Gillian Weaver, Roger Mathisen

Background: Donor human milk (DHM) is essential to the operation of human milk banks (HMB). This study examined characteristics and factors associated with higher volumes of DHM donation at the first HMB in Vietnam.

Method: Data from an online HMB monitoring system collected between February 2017 and July 2022 included demographic characteristics, child information, the timing of donation, and the volume of DHM. Higher volume is defined as equal to or greater than the median DHM volume per donor of 14.4 liters (L). Potential contributors to higher DHM volume were examined using the chi-square test in univariate and multivariable logistic regression analysis.

Results: During the 5.5-year operation, this HMB recruited 517 donors with an average age of 28.6 years. Approximately 60.9% of donors had a college or higher degree and 97.3% gave birth in Da Nang city. Of these donors, the prevalence of cesarean birth was 48.2%, preterm births was 40.2%, and 27.9% had babies with a birth weight of less than 1,500 g. There was a similar proportion of donors between the hospital (48.2%) and community (51.8%). On average, hospital donors started their donations 15 days after birth when their newborns were 33.9 weeks corrected age compared to 63 days and 47.7 weeks among community-based donors. The overall median volume of DHM per donor was 14.4 L over a period of 46 days. The amount and duration were higher in community-based donors (17.5 L in 72 days, 300 ml/day) than those in the hospital (8.4 L in 30 days, 258 ml/day). More than 37% of donors contacted the HMB themselves; the remainder were introduced by health professionals. Factors associated with higher volumes of DHM included higher education (OR: 1.77; 95% CI: 1.09, 2.87), having a full-term newborn (OR: 2.46; 95% CI: 1.46, 4.13), and community-based donors (OR: 2.15; 95% CI: 1.22, 3.78).

Conclusions: Mothers with higher education and from the community donate more breastmilk over a longer duration than those with lower education and from the hospital. Breastfeeding protection, promotion, and support should be offered to all mothers with specialized breastfeeding support for mothers of preterm and sick infants. This will ensure mothers have sufficient breastmilk for their newborns and potentially surplus breastmilk for donation.

背景:供体母乳(DHM)对母乳库(HMB)的运作至关重要。本研究调查了越南第一家HMB DHM捐赠量较高的特征和因素。方法:2017年2月至2022年7月期间收集的HMB在线监测系统数据包括人口统计学特征、儿童信息、捐赠时间和DHM数量。更高的体积被定义为等于或大于每个供体的中位DHM体积14.4 升(L)。在单变量和多变量逻辑回归分析中,使用卡方检验来检验DHM体积增加的潜在因素。结果:在5.5年的手术中,该HMB招募了517名捐赠者,平均年龄28.6岁。大约60.9%的捐赠者拥有大学或更高学历,97.3%的捐赠者在岘港市分娩。在这些捐献者中,剖宫产的发生率为48.2%,早产为40.2%,27.9%的婴儿出生体重低于1500 g.医院(48.2%)和社区(51.8%)的捐赠者比例相似。平均而言,医院捐赠者在出生后15天开始捐赠,当时他们的新生儿矫正年龄为33.9周,而社区捐赠者为63天和47.7周。每个供体DHM的总体中位体积为14.4 L,为期46天。以社区为基础的捐助者的金额和持续时间较高(17.5 L 72天,300 ml/天)高于住院患者(8.4 L在30天内,258 ml/天)。超过37%的捐赠者自己联系了HMB;其余由卫生专业人员介绍。与较高DHM量相关的因素包括受过高等教育(OR:1.77;95%CI:1.09,2.87)、有足月新生儿(OR:2.46;95%CI:1.46,4.13)和社区捐献者(OR:2.15;95%CI:1.22,3.78)。应向所有母亲提供母乳喂养保护、宣传和支持,并为早产儿和患病婴儿的母亲提供专门的母乳喂养支持。这将确保母亲为新生儿提供足够的母乳,并可能有多余的母乳可供捐赠。
{"title":"Characteristics and factors influencing the volume of breastmilk donated by women to the first human milk bank in Vietnam.","authors":"Hoang Thi Tran,&nbsp;Tuan Thanh Nguyen,&nbsp;Oanh Thi Xuan Nguyen,&nbsp;Debbie Barnett,&nbsp;Gillian Weaver,&nbsp;Roger Mathisen","doi":"10.3389/fgwh.2023.1185097","DOIUrl":"10.3389/fgwh.2023.1185097","url":null,"abstract":"<p><strong>Background: </strong>Donor human milk (DHM) is essential to the operation of human milk banks (HMB). This study examined characteristics and factors associated with higher volumes of DHM donation at the first HMB in Vietnam.</p><p><strong>Method: </strong>Data from an online HMB monitoring system collected between February 2017 and July 2022 included demographic characteristics, child information, the timing of donation, and the volume of DHM. Higher volume is defined as equal to or greater than the median DHM volume per donor of 14.4 liters (L). Potential contributors to higher DHM volume were examined using the chi-square test in univariate and multivariable logistic regression analysis.</p><p><strong>Results: </strong>During the 5.5-year operation, this HMB recruited 517 donors with an average age of 28.6 years. Approximately 60.9% of donors had a college or higher degree and 97.3% gave birth in Da Nang city. Of these donors, the prevalence of cesarean birth was 48.2%, preterm births was 40.2%, and 27.9% had babies with a birth weight of less than 1,500 g. There was a similar proportion of donors between the hospital (48.2%) and community (51.8%). On average, hospital donors started their donations 15 days after birth when their newborns were 33.9 weeks corrected age compared to 63 days and 47.7 weeks among community-based donors. The overall median volume of DHM per donor was 14.4 L over a period of 46 days. The amount and duration were higher in community-based donors (17.5 L in 72 days, 300 ml/day) than those in the hospital (8.4 L in 30 days, 258 ml/day). More than 37% of donors contacted the HMB themselves; the remainder were introduced by health professionals. Factors associated with higher volumes of DHM included higher education (OR: 1.77; 95% CI: 1.09, 2.87), having a full-term newborn (OR: 2.46; 95% CI: 1.46, 4.13), and community-based donors (OR: 2.15; 95% CI: 1.22, 3.78).</p><p><strong>Conclusions: </strong>Mothers with higher education and from the community donate more breastmilk over a longer duration than those with lower education and from the hospital. Breastfeeding protection, promotion, and support should be offered to all mothers with specialized breastfeeding support for mothers of preterm and sick infants. This will ensure mothers have sufficient breastmilk for their newborns and potentially surplus breastmilk for donation.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1185097"},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10577291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41241788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Geospatial variations and determinants of contraceptive utilization among married reproductive age women in Ethiopia: spatial and multilevel analysis of Ethiopian Demographic and Health Survey, 2019. 埃塞俄比亚已婚育龄妇女避孕药具使用的地理空间变化和决定因素:2019年埃塞俄比亚人口与健康调查的空间和多层次分析。
Q2 OBSTETRICS & GYNECOLOGY Pub Date : 2023-09-22 eCollection Date: 2023-01-01 DOI: 10.3389/fgwh.2023.1151031
Bewuketu Terefe, Mihret Getnet, Yonas Akalu, Yitayeh Belsti, Mengistie Diress, Yibeltal Yismaw Gela, Amare Belete Getahun, Desalegn Anmut Bitew, Daniel Gashaneh Belay
<p><strong>Introduction: </strong>Contraception is the most effective method of preventing unwanted pregnancies and their associated disadvantages. It is critical to recognize one's desire to utilize contraceptives before drafting and implementing a good family planning program, especially in developing nations like Ethiopia.</p><p><strong>Objective: </strong>This study aimed to identify the geospatial variations and determinants affecting the utilization of contraceptives among married reproductive age women in Ethiopia.</p><p><strong>Method: </strong>This study was based on an extensive national survey, the Ethiopian Demographic and Health Survey. A total weighted sample of 5,743 married reproductive-age women was included. Because of the hierarchical nature of the DHS data, a spatial analysis multilevel logistic regression model was used to study individual and community-level factors that may influence contraceptives. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of contraceptive usage. ArcGIS version 10.3 was used to visualize the distribution of contraceptives. A 95% confidence interval and a <i>p</i>-value of less than 0.05 were used to declare statistical significance.</p><p><strong>Result: </strong>The overall utilization of contraceptives was discovered at 41.25% (39.98, 42.53). Participants age range of 25-34 years [AOR = 0.80, CI: (0.66, 0.96,)] and 35-49 years [AOR = 0.50, CI 95%:(0.66, 0.96)] times less likely to use contraceptives than 15-24 years old respectively. Having primary [AOR = 1.47, CI 95%: (1.25, 1.73)], secondary [AOR = 1.42, CI 95%: (1.09, 1.83)] and higher education level [AOR = 1.92, CI 95%: (1.41, 2.60)], middle wealth [AOR = 1.48, CI 95%: (1.14, 1.90)], richer [AOR = 1.41, CI 95%: (1.07, 1.86)] and richest [AOR = 2.17, CI 95%: (1.52, 3.11)], having 1-4 ANC follow up have [AOR = 1.60, CI 95%: (1.26, 2.03)], gave birth at age of 35-44 [AOR = 0.29, CI 95%: (0.22, 0.37)], having 3-5 children [AOR = 1.26, CI 95%: (1.03, 1.52)], being from community of high level women education [AOR = 1.61, CI 95%: (1.21, 2.15)] were associated positively. Participants from Amhara, Oromia, Benishangul and SNNPR regions have revealed [AOR = 2.40, CI 95%: (1.53, 3.77)], [AOR = 1.64, CI 95%: (1.05, 2.56)], [AOR = 1.62, CI 95%: (1.01, 2.62)] and [AOR = 2.04, CI 95: (1.31, 3.19)], in contrast, Somali and Afar regions have shown [AOR = 011, CI 95%: (0.05, 0.22)] and [AOR = 0.31, CI 95%: (0.18, 0.54)] times less likely to use contraceptive services than Tigray Region respectively. The spatial analysis of contraceptive usage discovered that the northern, central and southern parts of the country had higher utilization of contraceptives than the eastern and northeastern of the country.</p><p><strong>Conclusion: </strong>The study revealed that contraceptive usage among married women is comparatively low, with wide regional variation. Raising awareness among mothers ab
引言:避孕是预防意外怀孕及其相关不利因素的最有效方法。在起草和实施一项良好的计划生育计划之前,尤其是在埃塞俄比亚等发展中国家,认识到自己使用避孕药具的愿望至关重要。目的:本研究旨在确定埃塞俄比亚已婚育龄妇女使用避孕药具的地理空间差异和决定因素。方法:本研究基于一项广泛的全国性调查,即埃塞俄比亚人口与健康调查。纳入了5743名已婚育龄妇女的加权样本。由于DHS数据的层次性,使用空间分析多层次逻辑回归模型来研究可能影响避孕药具的个人和社区层面的因素。伯努利模型是通过使用SaTScan软件应用Kuldorff方法来分析避孕药具使用的纯空间聚类而使用的。ArcGIS 10.3版用于可视化避孕药具的分布情况。95%的置信区间和小于0.05的p值用于声明统计学显著性。结果:避孕药具的总体使用率为41.25%(39.98,42.53)。参与者年龄范围为25-34岁[AOR = 0.80,CI:(0.66,0.96,)]和35-49岁[AOR = 0.50,CI 95%:(0.66,0.96)]使用避孕药的可能性分别是15-24岁的两倍。具有主要[AOR = 1.47,CI 95%:(1.25,1.73)],次要[AOR = 1.42,CI 95%:(1.09,1.83)]和高等教育水平[AOR = 1.92,置信区间95%:(1.41,2.60)],中等财富[AOR = 1.48,CI 95%:(1.14,1.90)],更浓[AOR = 1.41,CI 95%:(1.07,1.86)]和最富[AOR = 2.17,CI 95%:(1.52,3.11)],有1-4次ANC随访有[AOR = 1.60,CI 95%:(1.26,2.03)],35-44岁分娩[AOR = 0.29,CI 95%:(0.22,0.37)],有3-5个孩子[AOR = 1.26,CI 95%:(1.03,1.52)],来自高水平女性教育社区[AOR = 1.61,CI 95%:(1.21,2.15)]呈正相关。来自阿姆哈拉、奥罗米亚、贝尼尚古尔和SNNPR地区的参与者透露 = 2.40,CI 95%:(1.53,3.77)],[AOR = 1.64,CI 95%:(1.05,2.56)],[AOR = 1.62,CI 95%:(1.01,2.62)]和[AOR = 2.04,CI 95:(1.31,3.19)],相比之下,索马里和阿法尔地区显示了[AOR = 011,CI 95%:(0.05,0.22)]和[AOR = 0.31,置信区间95%:使用避孕服务的可能性分别是提格雷地区的(0.18,0.54)]倍。对避孕药具使用情况的空间分析发现,该国北部、中部和南部地区的避孕药具利用率高于该国东部和东北部地区。结论:研究表明,已婚妇女的避孕药具使用率相对较低,区域差异较大。提高母亲对产前护理重要性的认识,帮助经济困难或无法使用卫生设施的母亲,将有助于提供更好的计划生育服务。改善社区和区域一级的避孕信息传播是避免潜在障碍的关键。
{"title":"Geospatial variations and determinants of contraceptive utilization among married reproductive age women in Ethiopia: spatial and multilevel analysis of Ethiopian Demographic and Health Survey, 2019.","authors":"Bewuketu Terefe,&nbsp;Mihret Getnet,&nbsp;Yonas Akalu,&nbsp;Yitayeh Belsti,&nbsp;Mengistie Diress,&nbsp;Yibeltal Yismaw Gela,&nbsp;Amare Belete Getahun,&nbsp;Desalegn Anmut Bitew,&nbsp;Daniel Gashaneh Belay","doi":"10.3389/fgwh.2023.1151031","DOIUrl":"10.3389/fgwh.2023.1151031","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Contraception is the most effective method of preventing unwanted pregnancies and their associated disadvantages. It is critical to recognize one's desire to utilize contraceptives before drafting and implementing a good family planning program, especially in developing nations like Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to identify the geospatial variations and determinants affecting the utilization of contraceptives among married reproductive age women in Ethiopia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This study was based on an extensive national survey, the Ethiopian Demographic and Health Survey. A total weighted sample of 5,743 married reproductive-age women was included. Because of the hierarchical nature of the DHS data, a spatial analysis multilevel logistic regression model was used to study individual and community-level factors that may influence contraceptives. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of contraceptive usage. ArcGIS version 10.3 was used to visualize the distribution of contraceptives. A 95% confidence interval and a &lt;i&gt;p&lt;/i&gt;-value of less than 0.05 were used to declare statistical significance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;The overall utilization of contraceptives was discovered at 41.25% (39.98, 42.53). Participants age range of 25-34 years [AOR = 0.80, CI: (0.66, 0.96,)] and 35-49 years [AOR = 0.50, CI 95%:(0.66, 0.96)] times less likely to use contraceptives than 15-24 years old respectively. Having primary [AOR = 1.47, CI 95%: (1.25, 1.73)], secondary [AOR = 1.42, CI 95%: (1.09, 1.83)] and higher education level [AOR = 1.92, CI 95%: (1.41, 2.60)], middle wealth [AOR = 1.48, CI 95%: (1.14, 1.90)], richer [AOR = 1.41, CI 95%: (1.07, 1.86)] and richest [AOR = 2.17, CI 95%: (1.52, 3.11)], having 1-4 ANC follow up have [AOR = 1.60, CI 95%: (1.26, 2.03)], gave birth at age of 35-44 [AOR = 0.29, CI 95%: (0.22, 0.37)], having 3-5 children [AOR = 1.26, CI 95%: (1.03, 1.52)], being from community of high level women education [AOR = 1.61, CI 95%: (1.21, 2.15)] were associated positively. Participants from Amhara, Oromia, Benishangul and SNNPR regions have revealed [AOR = 2.40, CI 95%: (1.53, 3.77)], [AOR = 1.64, CI 95%: (1.05, 2.56)], [AOR = 1.62, CI 95%: (1.01, 2.62)] and [AOR = 2.04, CI 95: (1.31, 3.19)], in contrast, Somali and Afar regions have shown [AOR = 011, CI 95%: (0.05, 0.22)] and [AOR = 0.31, CI 95%: (0.18, 0.54)] times less likely to use contraceptive services than Tigray Region respectively. The spatial analysis of contraceptive usage discovered that the northern, central and southern parts of the country had higher utilization of contraceptives than the eastern and northeastern of the country.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The study revealed that contraceptive usage among married women is comparatively low, with wide regional variation. Raising awareness among mothers ab","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"4 ","pages":"1151031"},"PeriodicalIF":0.0,"publicationDate":"2023-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10556865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41175977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Frontiers in global women's health
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