Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context
Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context
复制标题
DOI：
10.1016/j.socscimed.2016.05.019
复制
发表时间：
2016-07-01
影响因子：
5.4
通讯作者：
Nyenswah, Tolbert
中科院分区：
文献类型：
--
作者：
Luginaah, Isaac N.;Kangmennaang, Joseph;Nyenswah, Tolbert
在利比里亚，死于2014年埃博拉疫情的人中有75%是妇女，孕妇对这种令人精疲力竭的流行病的影响更为严重。这立即引起了人们对这一流行病对孕产妇和儿童健康的长期影响的担忧。作为一个更大的研究的一部分，本文使用安德森的卫生保健利用的行为模型和戈夫曼的耻辱理论来解释的时间和利用孕产妇保健服务的埃博拉疫情爆发前的背景，对孕产妇健康的潜在长期影响。我们使用2007年（N = 3524）和2013年（N = 5127）利比里亚人口与健康调查（LDHS）数据进行了生存和多元回归分析。我们的样本包括在调查年前的最后五年内生育过的育龄妇女（15-49岁）。调查结果显示，从2007年到2013年，首次产前护理（ANC）访问的时间（TR = 0.92，p < 0.001），ANC访问的数量和熟练助产士的分娩都有了整体改善。结果还显示，在利用ANC服务方面存在县和地区差异，东南A地区成为一个相对脆弱的地方。此外，获得产前护理服务的定义距离保健设施强烈预测利用。我们认为，埃博拉疫情可能侵蚀了孕产妇保健的许多成果，并可能对孕产妇保健服务的获取和利用产生长期的负面影响。研究提出了相关政策建议。(C)2016爱思唯尔有限公司版权所有。
In Liberia, 75% of those who died from 2014 Ebola epidemic were women and the effects of this gruelling epidemic were more severely felt by pregnant women. This immediately raised fears about the long-term impacts of the epidemic on maternal and child health. As part of a larger study, this paper uses Andersen's behavioural model of health care utilization and Goffman's stigma theory to explain the timing and utilization of maternal health services before the outbreak of the Ebola epidemic as a background to the potential long-term effects on maternal health. We conducted survival and multiple regression analysis using the 2007 (N = 3524) and 2013 (N = 5127) Liberia's Demographic and Health Survey (LDHS) data. Our sample consisted of women of reproductive age (15-49 years) that had given birth in the last five years preceding the survey year. The findings show that from 2007 to 2013, there was an overall improvement in the timing of first antenatal care (ANC) visits (TR = 0.92, p < 0.001), number of ANC visits and delivery with skilled birth attendants. The results also show county and regional disparities in the utilization of ANC services with South Eastern A region emerging as a relatively vulnerable place. Also, access to ANC services defined by distance to a health facility strongly predicted utilization. We argue that the Ebola epidemic likely eroded many of the previous gains in maternal health care, and may have left a lingering negative effect on the access and utilization of maternal health services in the long-term. The study makes relevant policy recommendations. (C) 2016 Elsevier Ltd. All rights reserved.