Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 - 2008.
Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 - 2008.
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DOI：
10.1186/1471-2393-14-295
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发表时间：
2014-08-29
影响因子：
3.1
通讯作者：
Östergren PO
中科院分区：
文献类型：
--
作者：
Asamoah BO;Agardh A;Pettersson KO;Östergren PO
在大多数低收入国家，特别是在撒哈拉以南非洲，改善孕产妇和生殖健康仍然是一项重大挑战。在获得孕产妇保健干预措施方面日益不平等是一个令人极为关切的问题。在加纳，妇女在获得怀孕期间的产前保健和分娩时的熟练护理方面存在的不平等差距没有得到足够的重视。因此，本研究旨在调查在获得产前保健和熟练助产方面与收入、教育、居住和产次有关的不平等的程度和趋势。利用1988年、1993年、1998年、2003年和2008年加纳人口和健康调查的数据建立了一个数据库。这些调查采用了标准的人口与健康调查问卷和数据收集技术。我们采用基于回归的总归因分数（TAF）作为衡量产前保健和熟练助产服务利用的社会经济不平等的指标。随着时间的推移，在利用产前护理和熟练助产士方面的城乡差距和与教育有关的不平等似乎正在缩小，而在利用产前护理方面与收入和产次有关的不平等正在急剧上升。1988年至1998年期间，在利用熟练助产护理方面的收入不平等程度相当低且稳定，1998年至2003年期间急剧增加，达到峰值，2003年后趋于平稳。应通过适当战略解决在使用产前护理和熟练助产护理方面与收入有关的不平等现象增加的问题。通过媒体和挨家挨户宣传活动加强社区卫生教育，可进一步减少上述与教育和均等有关的不平等现象。应大力鼓励和激励妇女上学，直至中学或更高级别。关于使用产妇保健服务的教育应纳入基础学校，以便最低一级的妇女能够接种适当的保健信息。
Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth. This study therefore aimed at investigating the magnitude and trends in income-, education-, residence-, and parity-related inequalities in access to antenatal care and skilled attendance at birth. A database was constructed using data from the Ghana Demographic and Health Surveys (DHS) 1988, 1993, 1998, 2003, and 2008. The surveys employed standard DHS questionnaires and techniques for data collection. We applied regression-based Total Attributable Fraction (TAF) as an index for measuring socioeconomic inequalities in antenatal care and skilled birth attendance utilization. The rural–urban gap and education-related inequalities in the utilization of antenatal care and skilled birth attendants seem to be closing over time, while income- and parity-related inequalities in the use of antenatal care are on a sharp rise. Income inequality regarding the utilization of skilled birth attendance was rather low and stable from 1988 to 1998, increased sharply to a peak between 1998 and 2003, and then leveled-off after 2003. The increased income-related inequalities seen in the use of antenatal care and skilled birth attendance should be addressed through appropriate strategies. Intensifying community-based health education through media and door-to-door campaigns could further reduce the mentioned education- and parity-related inequalities. Women should be highly motivated and incentivized to attend school up to secondary level or higher. Education on the use of maternal health services should be integrated into basic schools so that women at the lowest level would be inoculated with the appropriate health messages.
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影响因子：
3.3
作者：
Agyepong, Irene Akua;Nagai, Richard A.
通讯作者：
Nagai, Richard A.
影响因子：
5.4
作者：
Andersen, HM
通讯作者：
Andersen, HM
影响因子：
2.1
作者：
Awoonor-Williams, JK;Feinglass, ES;Jones, TC
通讯作者：
Jones, TC
影响因子：
1.4
作者：
Barimah, Kofi Bobi;Mensah, Joseph
通讯作者：
Mensah, Joseph
影响因子：
3.4
作者：
Adongo, Philip Baba;Tapsoba, Placide;Akweongo, Patricia
通讯作者：
Akweongo, Patricia