Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens.
Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens.
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肯尼亚，乌干达和坦桑尼亚大陆的产前护理覆盖范围的空间变化和不平等使用基于模型的地统计学：社会经济和地理可及性镜头。
DOI：
10.1186/s12884-022-05238-1
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发表时间：
2022-12-06
影响因子：
3.1
通讯作者：
中科院分区：
文献类型：
--
作者：
撒哈拉以南非洲（SSA）的孕妇因主要可避免的原因，面临着最高水平的孕产妇死亡率和死产率。产前护理（ANC）可以预防、发现、缓解或处理这些原因。虽然现在建议进行8次产前护理接触，但在撒哈拉以南非洲，之前最低要求的4次产检（ANC4 +）的覆盖率仍然很低且不均衡。
我们根据肯尼亚（2020年）、乌干达（2018/19年）和坦桑尼亚（2017年）的疟疾指标调查数据，对三个公平分层因素（家庭财富、母亲教育程度以及到最近卫生设施的出行时间）下的ANC4 +覆盖率以及达到地区层面70%目标覆盖率的可能性进行了建模。采用地统计模型来预测ANC4 +覆盖率并计算超过目标覆盖率的概率。计算了未进行ANC4 +产检的孕妇数量。预测的空间分辨率为3千米，并在国家和地区层面进行汇总，以便进行国家以下层面的规划。
大约十分之六的女性报告进行了ANC4 +产检，这意味着这三个国家中约有300万女性产检次数少于4次。这三个国家的366个地区中，大多数地区的ANC4 +覆盖率在50% - 70%之间。在肯尼亚，13%的地区覆盖率低于70%，而乌干达和坦桑尼亚大陆分别有10%和27%的地区覆盖率低于70%。肯尼亚只有1个地区，坦桑尼亚大陆只有10个地区可能达到了目标覆盖率。在肯尼亚、乌干达和坦桑尼亚大陆，分别有6%、38%和50%的地区最多只有5000名女性产检次数少于4次，而有超过20000名女性产检次数少于4次的地区分别为38%、1%和1%。在许多地区，贫困、未受过教育以及在地理上处于医疗保健边缘的人群中，ANC4 +覆盖率以及达到目标覆盖率的可能性更低。
这些发现对于政策制定者进行年度资源分配具有极其重要的价值，这是减少孕产妇死亡和死产努力的一部分。
网络版包含补充材料，可在10.1186/s12884 - 022 - 05238 - 1获取。
Pregnant women in sub-Saharan Africa (SSA) experience the highest levels of maternal mortality and stillbirths due to predominantly avoidable causes. Antenatal care (ANC) can prevent, detect, alleviate, or manage these causes. While eight ANC contacts are now recommended, coverage of the previous minimum of four visits (ANC4+) remains low and inequitable in SSA. We modelled ANC4+ coverage and likelihood of attaining district-level target coverage of 70% across three equity stratifiers (household wealth, maternal education, and travel time to the nearest health facility) based on data from malaria indicator surveys in Kenya (2020), Uganda (2018/19) and Tanzania (2017). Geostatistical models were fitted to predict ANC4+ coverage and compute exceedance probability for target coverage. The number of pregnant women without ANC4+ were computed. Prediction was at 3 km spatial resolution and aggregated at national and district -level for sub-national planning. About six in ten women reported ANC4+ visits, meaning that approximately 3 million women in the three countries had <ANC4+ visits. The majority of the 366 districts in the three countries had ANC4+ coverage of 50–70%. In Kenya, 13% of districts had < 70% coverage, compared to 10% and 27% of the districts in Uganda and mainland Tanzania, respectively. Only one district in Kenya and ten districts in mainland Tanzania were likely met the target coverage. Six percent, 38%, and 50% of the districts had at most 5000 women with <ANC4+ visits in Kenya, Uganda, and mainland Tanzania, respectively, while districts with > 20,000 women having <ANC4+ visits were 38%, 1% and 1%, respectively. In many districts, ANC4+ coverage and likelihood of attaining the target coverage was lower among the poor, uneducated and those geographically marginalized from healthcare. These findings will be invaluable to policymakers for annual appropriations of resources as part of efforts to reduce maternal deaths and stillbirths. The online version contains supplementary material available at 10.1186/s12884-022-05238-1.
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影响因子：
5
作者：
Elvidge, Christopher D.;Zhizhin, Mikhail;Taneja, Jay
通讯作者：
Taneja, Jay
影响因子：
16.6
作者：
Alegana VA;Maina J;Ouma PO;Macharia PM;Wright J;Atkinson PM;Okiro EA;Snow RW;Tatem AJ
通讯作者：
Tatem AJ
影响因子：
4.8
作者：
Dowhaniuk N
通讯作者：
Dowhaniuk N
影响因子：
8.1
作者：
Banke-Thomas A;Semaan A;Amongin D;Babah O;Dioubate N;Kikula A;Nakubulwa S;Ogein O;Adroma M;Anzo Adiga W;Diallo A;Diallo L;Cellou Diallo M;Maomou C;Mtinangi N;Sy T;Delvaux T;Afolabi BB;Delamou A;Nakimuli A;Pembe AB;Benova L
通讯作者：
Benova L
影响因子：
2.9
作者：
Arunda MO;Agardh A;Asamoah BO
通讯作者：
Asamoah BO