Poverty, partner discord, and divergent accounts; a mixed methods account of births before arrival to health facilities in Morogoro Region, Tanzania.
Poverty, partner discord, and divergent accounts; a mixed methods account of births before arrival to health facilities in Morogoro Region, Tanzania.
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DOI：
10.1186/s12884-016-1058-x
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发表时间：
2016-09-27
影响因子：
3.1
通讯作者：
Kennedy CE
中科院分区：
文献类型：
--
作者：
McMahon SA;Chase RP;Winch PJ;Chebet JJ;Besana GVR;Mosha I;Sheweji Z;Kennedy CE
与设施分娩或计划在家中分娩相比，到达保健设施前分娩与围产期发病率和死亡率较高有关。在一些高收入国家已经对这种分娩进行了研究，但几乎没有对低收入环境进行研究，因为大多数孕产妇和新生儿死亡发生在低收入环境中。根据对妇女的家庭调查和对妇女及其伴侣的深入访谈，我们研究了坦桑尼亚莫罗戈罗地区农村地区的工商管理硕士经验。在调查的应答者中，59名新生儿（4%）被归类为BBA。其中大多数分娩是在家庭成员（47%）或传统助产士（24%）在场的情况下进行的。低社会经济地位是最强的预测BBA。在通过匹配控制财富后，高生育率和低产前护理（ANC）次数保持了统计学意义。虽然这些变量是有用的指标，妇女在BBA的风险更大，其预测能力是有限的，在许多妇女是穷人，多产，并进行多次ANC访问的背景下。在定性访谈中，BBAs的故事包括合作伙伴在何时离开设施和财务或后勤限制方面的分歧，这些限制导致了出发延误。妇女描述说，她们希望比伴侣更早地离开设施。随着继续努力促进设施分娩，我们强调与设施分娩相关的财务需求，以及这些需求使妇女面临更高风险的可能性。本文的在线版本（doi：10.1186/s12884-016-1058-x）包含补充材料，可供授权用户使用。
Births before arrival (BBA) to health care facilities are associated with higher rates of perinatal morbidity and mortality compared to facility deliveries or planned home births. Research on such births has been conducted in several high-income countries, but there are almost no studies from low-income settings where a majority of maternal and newborn deaths occur. Drawing on a household survey of women and in-depth interviews with women and their partners, we examined the experience of BBA in rural districts of Morogoro Region, Tanzania. Among survey respondents, 59 births (4 %) were classified as BBAs. Most of these births occurred in the presence of a family member (47 %) or traditional birth attendant (24 %). Low socioeconomic status was the strongest predictor of BBA. After controlling for wealth via matching, high parity and a low number of antenatal care (ANC) visits retained statistical significance. While these variables are useful indicators of which women are at greater risk of BBA, their predictive power is limited in a context where many women are poor, multiparous, and make multiple ANC visits. In qualitative interviews, stories of BBAs included themes of partner disagreement regarding when to depart for facilities and financial or logistical constraints that underpinned departure delays. Women described wanting to depart earlier to facilities than partners. As efforts continue to promote facility birth, we highlight the financial demands associated with facility delivery and the potential for these demands to place women at a heightened risk for BBAs. The online version of this article (doi:10.1186/s12884-016-1058-x) contains supplementary material, which is available to authorized users.
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DOI：
10.1111/j.1471-0528.1991.tb10312.x
发表时间：
1991-01-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
BHOOPALAM, PS;WATKINSON, M
通讯作者：
WATKINSON, M
影响因子：
1.6
作者：
BEERAM, M;SOLARIN, K;ABEDIN, M
通讯作者：
ABEDIN, M
DOI：
10.1001/archpedi.1994.02170020033005
发表时间：
1994-02-01
影响因子：
--
作者：
BATEMAN, DA;OBRYAN, L;HEAGARTY, MC
通讯作者：
HEAGARTY, MC
影响因子：
168.9
作者：
Campbell, Oona M. R.;Graham, Wendy J.
通讯作者：
Graham, Wendy J.
影响因子：
2.7
作者：
McLelland, Gayle;McKenna, Lisa;Archer, Frank
通讯作者：
Archer, Frank