Access and utilization of maternal healthcare in a rural district in the forest belt of Ghana
Access and utilization of maternal healthcare in a rural district in the forest belt of Ghana
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DOI：
10.1186/s12884-018-2159-5
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发表时间：
2019-01-07
影响因子：
3.1
通讯作者：
Addai-Donkor, Kwasi
中科院分区：
文献类型：
--
作者：
Nuamah, Gladys Buruwaa;Agyei-Baffour, Peter;Addai-Donkor, Kwasi
背景在发展中国家，产妇保健接生不佳导致50多万产妇在怀孕、分娩或分娩后几周内死亡。这在一定程度上是由于在资源有限的情况下，产妇保健服务得不到提供和利用率低。本研究的目的是调查加纳阿散蒂地区阿曼西-西区孕产妇保健服务的获取和利用情况。方法于2015年2月至5月在阿曼西-西区的5个分区的产前诊所系统抽取720名孕妇进行横断面分析。研究对象的社会经济特征、知识水平以及获得和利用孕产妇保健服务的情况采用结构化问卷进行收集。结果68.5%、83.6%和33.6%的孕妇有过3次产前护理服务，分别利用过熟练分娩和产后护理服务。母亲对妊娠急症和新生儿危险体征的知晓率较低。社会经济特征和医疗保健机会影响了产妇保健的利用。与财富最低的五分之一相比，财富最高的五分之一与接受产后护理的几率更高相关(调整后的优势比[AOR]；95%CI：2.84；1.63，4.94)。将卫生设施作为主要的保健来源也与产前护理和熟练分娩的几率较高有关。结论本研究表明加纳农村地区孕产妇保健的获取和利用不是最优的，这受到怀孕母亲的社会经济特征的影响。这表明有必要采取有针对性的干预措施，以改善这种情况和其他类似情况下母亲的孕产妇保健利用情况。
BackgroundPoor maternal health delivery in developing countries results in more than half a million maternal deaths during pregnancy, childbirth or within a few weeks of delivery. This is partly due to unavailability and low utilization of maternal healthcare services in limited-resource settings. The aim of this study was to investigate the access and utilization of maternal healthcare in Amansie-West district in the Ashanti Region of Ghana.MethodsAn analytical cross-sectional study, involving 720 pregnant women systematically sampled from antenatal clinics in five sub-districts was conducted from February to May 2015 in the Amansie-West district. Data on participants' socio-economic characteristics, knowledge level and access and utilization of maternal health care services were collected with a structured questionnaire. Odds ratios were estimated to describe the association between explanatory variables and maternal healthcare using generalized estimating equations (GEE).Results68.5, 83.6 and 33.6% of the women had >3 antenatal care visits, utilized skilled delivery and postnatal care services respectively. The mothers' knowledge level of pregnancy emergencies and newborn danger signs was low. Socio-economic characteristics and healthcare access influenced the utilization of maternal healthcare. Compared to the lowest wealth quintile, being in the highest wealth quintile was associated with higher odds of receiving postnatal care (adjusted odds ratio [aOR]; 95%CI: 2.84; 1.63, 4.94). Use of health facility as a main source of healthcare was also associated with higher odds of antenatal care and skilled delivery.ConclusionThis study demonstrates suboptimal access and utilization of maternal healthcare in rural districts of Ghana, which are influenced by socio-economic characteristics of pregnant mothers. This suggests the need for tailored intervention to improve maternal healthcare utilization for mothers in this and other similar settings.