Inequities in postnatal care in low- and middle-income countries: a systematic review and meta-analysis.
Inequities in postnatal care in low- and middle-income countries: a systematic review and meta-analysis.
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低收入国家和中等收入国家的产后护理的不平等：系统评价和荟萃分析。
DOI：
10.2471/blt.14.140996
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发表时间：
2015-04-01
影响因子：
11.1
通讯作者：
Karp I
中科院分区：
文献类型：
--
作者：
Langlois ÉV;Miszkurka M;Zunzunegui MV;Ghaffar A;Ziegler D;Karp I
评估低收入和中等收入国家在利用产后保健服务方面的社会经济、地理和人口不平等现象。我们检索了Medline、Embase和科克伦中心数据库以及灰色文献，以寻找在低收入和中等收入国家进行的实验性、准实验性和观察性研究。我们定性总结了相关研究，并根据选定的社会经济地位和居住在城市或农村环境的指标，对产后护理服务的使用进行了荟萃分析。共纳入36项研究，其中10项用于荟萃分析。与社会经济地位最低的五分之一妇女相比，第二、第三、第四和第五分之一妇女使用产后护理的合并优势比为：1.14（95%可信区间，CI：0.96-1.34）、1.32（95% CI：1.12-1.55）、1.60（95% CI：1.30-1.98）和2.27（95% CI：1.75-2.93）。与生活在农村环境中的妇女相比，生活在城市环境中的妇女使用产后护理的合并优势比为1.36（95%CI：1.01-1.81）。对相关公布数据的定性评估还表明，产后护理服务的使用随着教育水平的提高而增加。在低收入和中等收入国家，产后护理服务的使用仍然非常不公平，而且因社会经济地位不同以及城乡居民之间的差异而明显不同。
To assess the socioeconomic, geographical and demographic inequities in the use of postnatal health-care services in low- and middle-income countries. We searched Medline, Embase and Cochrane Central databases and grey literature for experimental, quasi-experimental and observational studies that had been conducted in low- and middle-income countries. We summarized the relevant studies qualitatively and performed meta-analyses of the use of postnatal care services according to selected indicators of socioeconomic status and residence in an urban or rural setting. A total of 36 studies were included in the narrative synthesis and 10 of them were used for the meta-analyses. Compared with women in the lowest quintile of socioeconomic status, the pooled odds ratios for use of postnatal care by women in the second, third, fourth and fifth quintiles were: 1.14 (95% confidence interval, CI : 0.96–1.34), 1.32 (95% CI: 1.12–1.55), 1.60 (95% CI: 1.30–1.98) and 2.27 (95% CI: 1.75–2.93) respectively. Compared to women living in rural settings, the pooled odds ratio for the use of postnatal care by women living in urban settings was 1.36 (95% CI: 1.01–1.81). A qualitative assessment of the relevant published data also indicated that use of postnatal care services increased with increasing level of education. In low- and middle-income countries, use of postnatal care services remains highly inequitable and varies markedly with socioeconomic status and between urban and rural residents.