影响肯尼亚卡卡梅加县Lurambi和Butere县母亲围产期死亡率的第二延迟因素

C. Simiyu, M. Kipmerewo, J. Arudo
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摘要

目的:研究肯尼亚Kakamega Lurambi和Butere县产妇延迟到达适当医疗设施与围产期死亡率之间的关系。方法:采用基于社区的回顾性横断面研究设计,采用混合方法收集数据。采用多阶段整群抽样的方法,从鲁伦比县和布特尔县830个村中随机抽取40个村520名调查对象。受访者的访谈时间为2017年11月至2018年3月。使用SPSS Version 25软件进行数据录入和分析。采用描述性和推断性统计分析。采用双变量和多变量logistic回归,并采用校正优势比确定关联强度。p值≤0.05认为有统计学意义。发现:了解适当卫生设施的母亲围产期死亡的可能性降低90% (AOR: 0.1;95% ci: 0.1 - 0.4;p< 0.0001),到适当的卫生机构就诊的母亲围产期死亡的可能性降低80% (AOR=0.2;95%置信区间:0.1—-0.6;p = 0.002)。对理论、实践和政策的独特贡献:独特的发现是,靠近卫生设施本身并不重要,但靠近能够提供所需孕产妇和新生儿护理的适当卫生设施对于降低围产期死亡率非常重要。此外,旨在提高人们对在产妇和新生儿并发症期间前往适当设施的认识的干预措施对于确保围产期生存至关重要。
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Second Delay Factors Influencing Perinatal Mortality among Mothers in Lurambi and Butere Sub-Counties, Kakamega County, Kenya
Purpose: To examine the association between maternal delay in reaching appropriate health facility and perinatal mortality in Lurambi and Butere sub-counties, Kakamega Kenya Methodology: A community based retrospective cross-sectional research design was adopted using mixed methods for data collection. A total of 520 respondents were randomly selected from 40 out 830 villages of Lurambi and Butere sub-counties using multistage cluster sampling. The respondents were interviewed from November 2017 to March 2018. Data entry and analysis was done using SPSS Version 25 software. Descriptive and inferential statistical analyses were used. Bivariate and multivariate logistic regressions were applied and adjusted odds ratio was used to determine the strength of association. A p-value of ≤ 0.05 was considered as statistically significant. Findings: Mothers who were aware of the appropriate health facility were 90% less likely to experience perinatal deaths (AOR: 0.1; 95% CI: 0.1 – 0.4; p< 0.0001), mothers who visited appropriate health facility were 80% less likely to experience perinatal deaths (AOR=0.2; 95%CI: 0.1-0.6; p=0.002). Unique Contribution to Theory, Practice, and Policy: Unique finding is that proximity to a health facility alone is not critical but proximity to the appropriate health facility that will be able to provide the needed maternal and newborn care is very important in reduction of perinatal mortality. In addition, interventions aimed at creating awareness on the appropriate facility to visit during maternal and newborn complication is critical to ensure perinatal survival.
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