Predictors of person-centered maternity care: the role of socioeconomic status, empowerment, and facility type.
Predictors of person-centered maternity care: the role of socioeconomic status, empowerment, and facility type.
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DOI：
10.1186/s12913-018-3183-x
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发表时间：
2018-05-11
影响因子：
2.8
通讯作者：
Montagu D
中科院分区：
文献类型：
--
作者：
Afulani PA;Sayi TS;Montagu D
产妇保健服务使用率低以及护理质量差是撒哈拉以南非洲产妇死亡率高的原因之一。特别是，以人为本的孕产妇护理（PCMC），它抓住了用户体验，直接影响了妊娠结果，并通过减少对服务的需求间接地影响了妊娠结果。虽然许多研究考察了孕产妇保健服务使用方面的差异，但很少有研究考察了护理质量方面的差异，据我们所知，没有一个研究对SSA地区PCMC方面的差异进行了实证研究。本研究的目的是研究与PCMC相关的因素，特别是家庭财富、个人赋权和设施类型的作用。数据来自2016年在肯尼亚西部进行的一项调查，调查对象为15至49岁的妇女，她们在调查前9周分娩（N = 877）。PCMC是基于对PCMC量表中包含尊严和尊重、沟通和自主以及支持性护理的30个项目的回答而得出的总结性分数。我们发现了其他因素的影响；富裕、就业、识字和已婚妇女的PCMC分别高于贫穷、失业、文盲和未婚妇女。此外，经历过家庭暴力的妇女报告的PCMC低于从未经历过家庭暴力的妇女。此外，在保健中心和私人设施分娩的妇女报告的PCMC高于在公立医院分娩的妇女。就业和设施类型的影响取决于财富，对最贫穷妇女的影响最大。失业的贫困妇女和在高级设施分娩的贫困妇女获得的PCMC质量最低。研究结果表明，最弱势的妇女接受的PCMC质量最低，特别是当她们在更高级别的机构寻求治疗时。减少PCMC差异的干预措施对于改善弱势群体的孕产妇结局至关重要。本文的在线版本（10.1186/s12913-018-3183-x）包含补充材料，授权用户可以使用。
Low use of maternal health services, as well as poor quality care, contribute to the high maternal mortality in sub-Saharan Africa (SSA). In particular, poor person-centered maternity care (PCMC), which captures user experience, contributes both directly to pregnancy outcomes and indirectly through decreased demand for services. While many studies have examined disparities in use of maternal health services, few have examined disparities in quality of care, and none to our knowledge has empirically examined disparities in PCMC in SSA. The aim of this study is to examine factors associated with PCMC, particularly the role of household wealth, personal empowerment, and type of facility. Data are from a survey conducted in western Kenya in 2016, with women aged 15 to 49 years who delivered in the 9 weeks preceding the survey (N = 877). PCMC is operationalized as a summative score based on responses to 30 items in the PCMC scale capturing dignity and respect, communication and autonomy, and supportive care. We find that net of other factors; wealthier, employed, literate, and married women report higher PCMC than poorer, unemployed, illiterate, and unmarried women respectively. Also, women who have experienced domestic violence report lower PCMC than those who have never experienced domestic violence. In addition, women who delivered in health centers and private facilities reported higher PCMC than those who delivered in public hospitals. The effect of employment and facility type is conditional on wealth, and is strongest for the poorest women. Poor women who are unemployed and poor women who deliver in higher-level facilities receive the lowest quality PCMC. The findings imply the most disadvantaged women receive the lowest quality PCMC, especially when they seek care in higher-level facilities. Interventions to reduce disparities in PCMC are essential to improve maternal outcomes among disadvantaged groups. The online version of this article (10.1186/s12913-018-3183-x) contains supplementary material, which is available to authorized users.
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影响因子：
5.4
作者：
Andersen, HM
通讯作者：
Andersen, HM
影响因子：
3.1
作者：
Abuya, Timothy;Ndwiga, Charity;Warren, Charlotte E.
通讯作者：
Warren, Charlotte E.
影响因子：
3.7
作者：
Abuya T;Warren CE;Miller N;Njuki R;Ndwiga C;Maranga A;Mbehero F;Njeru A;Bellows B
通讯作者：
Bellows B
影响因子：
3.1
作者：
Afulani, Patience A.;Altman, Molly;Sudhinaraset, May
通讯作者：
Sudhinaraset, May
影响因子：
3.4
作者：
Afulani, Patience A.;Diamond-Smith, Nadia;Sudhinaraset, May
通讯作者：
Sudhinaraset, May