Determinants of skilled birth attendance in rural Cambodia
Determinants of skilled birth attendance in rural Cambodia
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DOI：
10.1111/j.1365-3156.2005.01547.x
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发表时间：
2006-02-01
影响因子：
3.3
通讯作者：
Wakai, S
中科院分区：
文献类型：
--
作者：
Yanagisawa, S;Oum, S;Wakai, S
为了确定熟练和非熟练助产的决定因素，在柬埔寨农村地区对15-49岁在前3个月内分娩的妇女进行了基于人口的调查。一个基于安德森行为模型的分析框架用于根据分娩地点(设施与非设施)、在家分娩的助产士(熟练与非熟练)以及分娩期间助产士的变化(改变与不变)来确定决定因素。我们使用Logistic回归对数据进行分析。在980名参与分析的妇女中，19.8%的人在分娩过程中有熟练的助产士在场。设施交付的决定因素不同于有熟练的服务人员协助在家分娩的决定因素。在设施分娩的情况下，以前通过产前护理与熟练的服务人员接触是一个重要的决定因素。在家庭分娩的情况下，前一次分娩的助产士类型(即熟练或非熟练)是一个重要的决定因素。以社区为基础的方案需要惠及初级产妇，因为一旦妇女在非熟练助产员的帮助下分娩，她寻求熟练帮助的可能性比初级产妇低5至7倍。
To identify the determinants of skilled and unskilled birth attendance.Population-based survey in a rural area in Cambodia, of women aged 15-49 years who had delivered during the previous 3-month period. An analytical framework based on Andersen's behavioural model served to identify determinants according to delivery place (facility vs. non-facility), birth attendant at home births (skilled vs. unskilled), and change of birth attendant during delivery (changed vs. unchanged). We used logistic regression to analyse the data.Of 980 women included in the analyses, 19.8% had skilled attendants present during delivery. The determinants of facility delivery were different from those for having skilled attendants assisting in home births. In case of facility deliveries, previous contact with a skilled attendant through antenatal care was a significant determinant. In case of home births, the type of birth attendant (i.e. skilled or unskilled) at the preceding delivery was a significant determinant.Community-based programmes need to reach primiparas, because once a woman has delivered with the aid of an unskilled attendant, she is five to seven times less likely to seek skilled help than a primipara.