Determinants of skilled birth attendant utilization in Afghanistan: A cross-sectional study
Determinants of skilled birth attendant utilization in Afghanistan: A cross-sectional study
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DOI：
10.2105/ajph.2007.123471
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发表时间：
2008-10-01
影响因子：
12.7
通讯作者：
Burnham, Gilbert
中科院分区：
文献类型：
--
作者：
Mayhew, Maureen;Hansen, Peter M.;Burnham, Gilbert
目标.我们试图找出与使用熟练的助产士的卫生服务存在于阿富汗的特点。2004年，我们在所有33个省进行了一项横断面研究，从617个卫生设施和9917名妇女谁住在附近产生的数据。在过去的2年里，这些设施和分娩。只有13%的受访者使用过熟练的助产士。来自最富有的五分之一的妇女（与最贫穷的五分之一相比）有更高的使用几率（比值比[OR]=6.3; 95%置信区间[CI]=4.4，8.9）。识字与使用密切相关（OR=2.5; 95% CI=2.0，3.2），居住距离设施不到60分钟（OR=1.5; 95% CI=1.1，2.0），居住在有女性助产士或医生的设施附近（OR=1.4; 95% CI=1.1，1.8）。居住在收取使用费（OR=0.8; 95%CI =0.6，1.0）和有男性社区卫生工作者（OR=0.6; 95%CI =0.5，0.9）的设施附近的妇女使用的几率较低。在阿富汗，必须提高安全分娩护理的使用率。应减少贫穷和未受教育妇女的经济障碍，必须考虑文化上可接受的替代办法。
Objectives. We sought to identify characteristics associated with use of skilled birth attendants where health services exist in Afghanistan.Methods. We conducted a cross-sectional study in all 33 provinces in 2004, yielding data from 617 health facilities and 9917 women who lived near. the facilities and had given birth in the past 2 years.Results. Only 13% of respondents had used skilled birth attendants. Women from the wealthiest quintile (vs the poorest quintile) had higher odds of use (odds ratio [OR]=6.3; 95% confidence interval [CI]=4.4, 8.9). Literacy was strongly associated with use (OR=2.5; 95% CI=2.0, 3.2), as was living less than 60 minutes from the facility (OR=1.5; 95% CI=1.1, 2.0) and residing near a facility with a female midwife or doctor (OR=1.4; 95% CI=1.1, 1.8). Women living near facilities that charged user fees (OR=0.8; 95% CI=0.6, 1.0) and that had male community health workers (OR=0.6; 95% CI=0.5, 0.9) had lower odds of use.Conclusions. In Afghanistan, the rate of use of safe delivery care must be improved. The financial barriers of poor and uneducated women should be reduced and culturally acceptable alternatives must be considered.