Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016.
Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016.
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DOI：
10.1186/s12913-021-07179-5
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发表时间：
2021-10-26
影响因子：
2.8
通讯作者：
Kitutu FE
中科院分区：
文献类型：
--
作者：
Sserwanja Q;Mukunya D;Musaba MW;Kawuki J;Kitutu FE
几乎所有孕产妇死亡和相关发病率都发生在低收入国家。在保健设施中由熟练的提供者监督分娩是预防孕产妇和围产期发病率和死亡率的关键干预措施。我们的研究旨在确定乌干达分娩期间卫生设施利用率的相关因素。我们使用了2016年乌干达人口与健康调查的10，152名年龄在15至49岁之间的女性数据。这项研究的重点是他们最近的活产在调查前5年。我们采用多阶段分层抽样选择研究参与者，我们进行了多变量logistic回归，以建立与分娩期间的卫生设施利用相关的因素，使用SPSS（版本25）。在卫生机构分娩的妇女比例为76.6%（7 780/10 152：（95%置信区间，CI，75.8-77.5）。15-19岁妇女在卫生机构分娩的几率是40 - 49岁妇女的两倍（调整后的比值比，AOR = 2.29; 95%CI：1.71-3.07）。居住在城市地区和参加产前保健（ANC）与卫生设施的使用。乌干达北方地区妇女使用卫生设施的几率是中部地区妇女的三倍（AOR = 3.13; 95% CI：2.15-4.56）。受过高等教育的妇女（AOR = 4.96; 95% CI：2.71-9.11）和最富有的五分之一人口（AOR = 4.55; 95% CI：3.27-6.32）在分娩期间使用卫生设施的几率分别高于未受过教育的妇女和最贫穷的五分之一人口。与天主教、非巴干达族、不接触大众媒体的妇女以及距离医疗保健有困难的妇女相比，穆斯林、巴干达族、接触大众媒体且距离医疗保健没有问题的妇女在分娩期间利用医疗保健设施的几率更高。分娩期间的卫生设施利用率较高，与年龄降低、教育水平和财富指数提高、城市居住、乌干达北方地区、ANC出勤率、接触大众媒体、部落、宗教和与附近卫生设施的距离有关。我们建议，在乌干达，促进卫生设施分娩的干预措施应针对贫困、受教育程度低和老年妇女，特别是那些居住在农村地区、接触大众媒体较少的妇女。
Almost all maternal deaths and related morbidities occur in low-income countries. Childbirth supervised by a skilled provider in a health facility is a key intervention to prevent maternal and perinatal morbidity and mortality. Our study aimed to establish the factors associated with health facility utilization during childbirth in Uganda. We used the Uganda Demographic and Health Survey 2016 data of 10,152 women aged 15 to 49 years. The study focused on their most recent live birth in 5 years preceding the survey. We applied multistage stratified sampling to select study participants and we conducted multivariable logistic regression to establish the factors associated with health facility utilization during childbirth, using SPSS (version 25). The proportion of women who gave birth at a health facility was 76.6% (7780/10,152: (95% confidence interval, CI, 75.8–77.5). The odds of women aged 15–19 years giving birth at health facilities were twice as those of women aged 40 to 49 years (adjusted odds ratio, AOR = 2.29; 95% CI: 1.71–3.07). Residing in urban areas and attending antenatal care (ANC) were associated with health facility use. The odds of women in the northern region of Uganda using health facilities were three times of those of women in the central region (AOR = 3.13; 95% CI: 2.15–4.56). Women with tertiary education (AOR = 4.96; 95% CI: 2.71–9.11) and those in the richest wealth quintile (AOR = 4.55; 95% CI: 3.27–6.32) had higher odds of using a health facility during child birth as compared to those with no education and those in the poorest wealth quintile, respectively. Muslims, Baganda, women exposed to mass media and having no problem with distance to health facility had higher odds of utilizing health facilities during childbirth as compared to Catholic, non Baganda, women not exposed to mass media and those having challenges with distance to access healthcare. Health facility utilization during childbirth was high and it was associated with decreasing age, increasing level of education and wealth index, urban residence, Northern region of Uganda, ANC attendance, exposure to mass media, tribe, religion and distance to the nearby health facility. We recommend that interventions to promote health facility childbirths in Uganda target the poor, less educated, and older women especially those residing in rural areas with less exposure to mass media.