Barriers to the utilization of maternal health care in rural Mali
Barriers to the utilization of maternal health care in rural Mali
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DOI：
10.1016/j.socscimed.2007.06.001
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发表时间：
2007-10-01
影响因子：
5.4
通讯作者：
Gage, Anastasia J.
中科院分区：
文献类型：
--
作者：
Gage, Anastasia J.
这项研究使用了2001年人口与健康调查的数据和多水平Logistic回归模型，以检查马里农村地区和个人对孕产妇保健服务利用的障碍。这项分析突出了地区一级对产妇保健服务使用的一系列影响。虽然在怀孕的前三个月缺乏卫生设施是获得产前护理的障碍，但对于四次或四次以上的产前检查来说，交通障碍更为重要，而距离障碍则阻碍了训练有素的医务人员的分娩协助和机构分娩。妇女利用产妇保健服务的几率很大程度上受到居住地区其他人的做法以及居住在受过中等教育或高等教育的人附近的影响。家庭贫困和个人问题与所审议的所有结果呈负相关。这些结果突出了产前护理和关于妊娠并发症的咨询对于增加适当分娩护理的可能性的重要性，特别是在距离保健机构15-29公里的妇女中。地区一级的因素解释了分娩护理方面的差异比产前护理方面的差异更大的比例，然而，孕产妇保健服务利用的地区差异仍然无法解释。(C)2007爱思唯尔有限公司。保留所有权利。
This study used data from the 2001 Demographic and Health Survey and multilevel logistic regression models to examine area- and individual-level barriers to the utilization of maternal health services in rural Mali. The analysis highlights a range of area-level influences on the use made of maternal health services. While the dearth of health facilities was a barrier to receipt of prenatal care in the first trimester, transportation barriers were more important for four or more prenatal visits, and distance barriers for delivery assistance by trained medical personnel and institutional delivery. Women's odds of utilizing maternal health services were strongly influenced by the practices of others in their areas of residence and by living in close proximity to people with secondary or higher education. Household poverty and personal problems were negatively related to all outcomes considered. The results highlight the importance of antenatal care and counseling about pregnancy complications for increasing the likelihood of appropriate delivery care, particularly among women living 15-29 km from a health facility. Area-level factors explained a greater proportion of the variation in delivery care than in prenatal care However, significant area variation in the utilization of maternal health services remained unexplained. (c) 2007 Elsevier Ltd. All rights reserved.