Tale of 22 cities: utilisation patterns and content of maternal care in large African cities.
Tale of 22 cities: utilisation patterns and content of maternal care in large African cities.
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DOI：
10.1136/bmjgh-2021-007803
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发表时间：
2022-03
影响因子：
8.1
通讯作者：
Beňová L
中科院分区：
文献类型：
--
作者：
Wong KL;Banke-Thomas A;Sholkamy H;Dennis ML;Pembe AB;Birabwa C;Asefa A;Delamou A;Sidze EM;Dossou JP;Waiswa P;Beňová L
在全球范围内，大多数出生发生在城市地区。在大城市，如何确保妇女及其新生儿在怀孕、分娩和产后期间获得一整套高质量的护理，是一项特殊的挑战。我们研究卫生服务的利用和内容的照顾沿着孕产妇连续保健（CoC）在22个大的非洲城市。我们分析了自2013年以来最新的人口与健康调查（DHS）的数据，这些数据来自2015年至少有一个人口≥ 100万的城市的任何非洲国家。确定了每个国家人口最多城市调查组中的活产妇女。我们分析了17个指标，这些指标反映了卫生设施的利用率、部门和水平以及三种孕产妇保健服务的内容：产前保健（ANC）、分娩保健和产后保健（PNC），还有一个综合指标反映了孕产妇CoC的完成情况。我们根据母体CoC中的利用率和内容物的表现对城市进行了分类。研究样本包括19217名妇女报告的25326例活产。城市之间以及城市内部的三种服务之间都观察到三种服务的绩效存在差异。产前护理的使用率很高（>85%）;设施分娩和PNC的范围很广，分别为77%-99%和29%-94%。大多数城市在母体CoC中的利用和含量水平不一致，科托努和阿克拉表现相对最好，内罗毕和恩贾梅纳表现最差。这一探索性分析表明，可以在非洲大城市一级对许多人口与健康调查进行分析，以提供关于三种产妇保健服务的利用情况和内容的可采取行动的信息。我们对22个城市的比较分析以及提出的表现最好和最差城市的类型学可以为提取经验教训和解决快速城市化背景下孕产妇健康的关键差距提供一个起点。
Globally, the majority of births happen in urban areas. Ensuring that women and their newborns benefit from a complete package of high-quality care during pregnancy, childbirth and the postnatal period present specific challenges in large cities. We examine health service utilisation and content of care along the maternal continuum of care (CoC) in 22 large African cities. We analysed data from the most recent Demographic and Health Survey (DHS) since 2013 in any African country with at least one city of ≥1 million inhabitants in 2015. Women with live births from survey clusters in the most populous city per country were identified. We analysed 17 indicators capturing utilisation, sector and level of health facilities and content of three maternal care services: antenatal care (ANC), childbirth care and postnatal care (PNC), and a composite indicator capturing completion of the maternal CoC. We developed a categorisation of cities according to performance on utilisation and content within maternal CoC. The study sample included 25 326 live births reported by 19 217 women. Heterogeneity in the performance in the three services was observed across cities and across the three services within cities. ANC utilisation was high (>85%); facility-based childbirth and PNC ranged widely, 77%–99% and 29%–94%, respectively. Most cities showed inconsistent levels of utilisation and content across the maternal CoC, Cotonou and Accra showed relatively best and Nairobi and Ndjamena worst performance. This exploratory analysis showed that many DHS can be analysed on the level of large African cities to provide actionable information about the utilisation and content of the three maternal health services. Our comparative analysis of 22 cities and proposed typology of best and worst-performing cities can provide a starting point for extracting lessons learnt and addressing critical gaps in maternal health in rapidly urbanising contexts.
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影响因子：
34.3
作者：
Delamou, Alexandre;El Ayadi, Alison M.;De Brouwere, Vincent
通讯作者：
De Brouwere, Vincent
影响因子：
2.9
作者：
Bakibinga, Pauline;Ettarh, Remare;Osindo, Jane
通讯作者：
Osindo, Jane
影响因子：
3.2
作者：
Banke-Thomas A;Wong KLM;Collins L;Olaniran A;Balogun M;Wright O;Babajide O;Ajayi B;Afolabi BB;Abayomi A;Benova L
通讯作者：
Benova L
影响因子：
8.1
作者：
Banke-Thomas A;Wong KLM;Ayomoh FI;Giwa-Ayedun RO;Benova L
通讯作者：
Benova L
影响因子：
3.7
作者：
Ahmed, Shakil;Adams, Alayne M.;Panciera, Rocco
通讯作者：
Panciera, Rocco