中低收入国家的妇女在医疗机构接受产前护理,但未在医疗机构分娩:对 2016-2021 年人口与健康调查数据的多层次分析。

IF 3.6 Q1 TROPICAL MEDICINE Tropical Medicine and Health Pub Date : 2024-01-02 DOI:10.1186/s41182-023-00561-5
Mehari Woldemariam Merid, Dagmawi Chilot, Zeamanuel Anteneh Yigzaw, Alemakef Wagnew Melesse, Menberesibhat Getie Ferede, Fantu Mamo Aragaw, Desalegn Anmut Bitew
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引用次数: 0

摘要

背景:住院分娩辍学(IDD)是一个严重影响中低收入国家(LMICs)的主要问题。它与孕妇不良分娩结局风险的增加有关。因此,本研究评估了低收入和中等收入国家妇女产前检查(ANC)后IDD的综合估计值和决定因素:本研究采用了 29 个低收入和中等收入国家的人口与健康调查(DHS)数据。数据分析采用 STATA 14 版本。森林图用于估算IDD的总体患病率。多层次二元逻辑回归用于确定 IDD 的决定因素。结果与自变量之间的统计学显著性水平是通过调整后的几率比(AOR)(95% CI)和小于 0.05 的 p 值来确定的:在低收入和中等收入国家,育龄妇女在产前检查预约后的 IDD 患病率为 22.25%(95%CI:18.25, 26.25)。此外,南欧、中欧和加勒比海国家妇女的 IDD 患病率最高(29.83%),中亚/西亚和大洋洲妇女的 IDD 患病率最低(13.72%)。在多层次分析中,未受过教育(AOR = 2.92;95% CI:2.72, 3.13)、最贫穷指数(AOR = 3.46;95% CI:3.28, 3.66)、产前检查次数不足(AOR = 1.73;95% CI:1.39,1.77)、无媒体接触(AOR = 1.27;95% CI:1.23,1.30)、农村(AOR = 1.50;95% CI:1.43,1.54)、距离是个大问题(AOR = 1.28;95% CI:1.在低收入和中等收入国家的妇女中,农村妇女(AOR = 1.50;95% CI:1.43,1.54)、距离是个大问题(AOR = 1.28;95% CI:1.25,1.31)、南欧/东欧和加勒比海地区妇女 6.67(AOR = 6.67;95% CI:6.20,7.20)、低收入国家妇女 7.05(AOR = 7.05;95% CI:6.57,7.56)、中低收入国家妇女 5.34(AOR = 5.57;95% CI:4.93,5.78)在产前检查后患 IDD 的几率增加。然而,曾经生育过一个孩子的妇女(AOR = 0.29;95% CI:0.28,0.31)以及来自中亚、西亚和大洋洲的妇女(AOR = 0.78;95%CI:0.74,0.82)患 IDD 的几率有所下降:结论:在低收入和中等收入国家的妇女中,IDD 的发生率很高,在未受过教育、来自最贫困家庭、产前检查次数不足、未接触过媒体、农村、距离是个大问题的妇女中,IDD 的发生率明显增加。因此,减少IDD的干预措施应重点解决低收入和中等收入国家妇女在孕产妇教育、接触媒体和产前检查次数方面的差距。
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Women in low- and middle-income countries receive antenatal care at health institutions, yet not delivered there: a multilevel analysis of 2016-2021 DHS data.

Background: The institutional delivery dropout (IDD) is a major problem that disproportionately affects low- and middle-income countries (LMICs). It is associated with increased risks of adverse birth outcomes among pregnant women. Hence, this study assessed the pooled estimate and determinants of IDD after antenatal care (ANC) visit among women in LMICs.

Method: The Demographic and Health Survey (DHS) data from 29 LMICs were used for this study. Data analysis was performed with STATA version 14. The forest plot was used to estimate the pooled prevalence of IDD. Multilevel binary logistic regression was fitted to identify determinants of IDD. The statistical significance level between the outcome and independent variables was determined through the adjusted odds ratio (AOR) with 95% CI and p-value less than 0.05.

Result: The pooled prevalence of IDD after ANC booking among reproductive age women in LMICs was 22.25% (95%CI: 18.25, 26.25). Additionally, the prevalence of IDD was highest (29.83%) among women from the South and Central Europe and the Caribbean countries and lowest (13.72%) in Central/Western Asia and the Oceania. In the multilevel analysis; no education (AOR = 2.92; 95% CI: 2.72, 3.13), poorest wealth index (AOR = 3.46; 95% CI: 3.28, 3.66), inadequate ANC visits (AOR = 1.73; 95% CI: 1.39, 1.77), no media exposure (AOR = 1.27; 95% CI: 1.23, 1.30), rural (AOR = 1.50; 95% CI: 1.43, 1.54), distance a big problem (AOR = 1.28; 95% CI: 1.25, 1.31), and women located in the South/Eastern Europe and Caribbean region 6.67 (AOR = 6.67; 95% CI: 6.20, 7.20), women lived in low-income countries 7.05 (AOR = 7.05; 95% CI: 6.57, 7.56), and women from lower middle-income countries 5.34 (AOR = 5.57; 95% CI: 4.93, 5.78), had increased odds of IDD after ANC among women in LMICs. However, women who had ever born one child (AOR = 0.29; 95% CI: 0.28, 0.31), and women from Central and Western Asia and the Oceania (AOR = 0.78; 95%CI: 0.74, 0.82) had decreased odds of IDD.

Conclusion: The IDD was high among women in LMICs and significantly increased among women with no education, from poorest household, had inadequate ANC visit, no media exposure, rural, distance a big problem. Hence, interventions to reduce IDD should focus on addressing the gaps related to maternal education, access to media, and number of ANC visits among women in LMICs.

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来源期刊
Tropical Medicine and Health
Tropical Medicine and Health TROPICAL MEDICINE-
CiteScore
7.00
自引率
2.20%
发文量
90
审稿时长
11 weeks
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