Trends, determinants and inequities of 4(+) ANC utilisation in Bangladesh.
Trends, determinants and inequities of 4(+) ANC utilisation in Bangladesh.
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DOI：
10.1186/s41043-016-0078-5
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发表时间：
2017-01-13
期刊：
影响因子：
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通讯作者：
Anwar I
中科院分区：
文献类型：
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作者：
Rahman A;Nisha MK;Begum T;Ahmed S;Alam N;Anwar I
本研究的目的是记录过去22年期间使用四种或更多种（4+）产前护理（ANC）的趋势，并探讨最近两次孟加拉国人口与健康调查（BDHS）（2011年和2014年）报告的4+ ANC使用的决定因素和不公平性。与ANC有关的数据是从BDHS数据集中提取的，该数据集可作为开放源在线获取。使用STATA 13软件组织和分析数据。本研究考虑的结果变量是4+ ANC的利用率。4+ ANC的趋势以百分比测量，4+ ANC的预测因子通过双变量和多变量分析测量。估计集中指数是为了评估4+ ANC使用的不公平性。1994年至2014年间，4+ ANC的使用率增加了约26%。较高的教育水平，居住在城市地区和最富有的财富五分之一被认为是显着的预测。4+ ANC的使用率随着产次和产妇年龄的增加而下降。不公平指数显示，4+ ANC使用率存在持续的不公平现象，这种不公平现象在2011年至2014年期间有所增加。在孟加拉国，任何ANC的使用率在1994年至2014年期间稳步上升，但在4+ ANC使用率方面的进展要慢得多，因为预期到2016年实现国家设定的目标（50%：4+ ANC使用率）。在未能参加4+ ANC访问的群体中观察到社会经济不平等。政策制定者应特别注意增加4+ ANC的覆盖率，这项研究可以帮助确定需要优先干预的目标群体。
The objectives of this study are to document the trend on utilisation of four or more (4+) antenatal care (ANC) over the last 22 years period and to explore the determinants and inequity of 4+ ANC utilisation as reported by the last two Bangladesh Demographic and Health surveys (BDHS) (2011 and 2014). The data related to ANC have been extracted from the BDHS data set which is available online as an open source. STATA 13 software was used for organising and analysing the data. The outcome variable considered for this study was utilisation of 4+ ANC. Trends of 4+ ANC were measured in percentage and predictors for 4+ ANC were measured through bivariate and multivariable analysis. The concentration index was estimated for assessing inequity in 4+ ANC utilisation. Utilisation of 4+ ANC has increased by about 26% between the year 1994 and 2014. Higher level of education, residing in urban region and richest wealth quintile were found to be significant predictors. The utilisation of 4+ ANC has decreased with increasing parity and maternal age. The inequity indices showed consistent inequities in 4+ ANC utilisation, and such inequities were increased between 2011 and 2014. In Bangladesh, the utilisation of any ANC rose steadily between 1994 and 2014, but progress in terms of 4+ ANC utilisation was much slower as the expectation was to achieve the national set target (50%: 4+ ANC utilisation) by 2016. Socio-economic inequities were observed in groups that failed to attend a 4+ ANC visit. Policymakers should pay special attention to increase the 4+ ANC coverage where this study can facilitate to identify the target groups whom need to be intervened on priority basis.