Adolescent and adult first time mothers' health seeking practices during pregnancy and early motherhood in Wakiso district, central Uganda.
Adolescent and adult first time mothers' health seeking practices during pregnancy and early motherhood in Wakiso district, central Uganda.
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DOI：
10.1186/1742-4755-5-13
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发表时间：
2008-12-30
影响因子：
3.4
通讯作者：
Faxelid E
中科院分区：
文献类型：
--
作者：
Atuyambe L;Mirembe F;Tumwesigye NM;Annika J;Kirumira EK;Faxelid E
产妇保健服务在改善生殖健康方面具有潜在的关键作用。为了更好地了解青少年母亲的需求，我们在乌干达瓦基索地区比较了第一次怀孕和早产的青少年母亲和成年母亲的求医行为。这是一项于2007年5月至8月在瓦基索地区进行的横断面研究。共有762名妇女(442名青少年和320名成年人)使用结构化问卷进行了访谈。我们用他们95%的可信区间计算了父母在比较青少年和成年第一次母亲时所经历的产前和产后寻求医疗保健、羞辱和暴力的优势比。数据分析采用STATA V.8统计软件。与成年母亲相比，青春期母亲在寻求生殖健康服务的保健方面处于更不利的地位，在怀孕和早产期间面临更多挑战。与成年母亲相比，青春期母亲更有可能因怀孕而辍学(OR=3.61，95%CI：2.40-5.44)，更不可能获得工资(OR=0.43，95%CI：0.24-0.76)，更有可能参加少于4次的产前检查(OR=1.52，95%CI：1.12-2.07)。青少年也更容易遭受来自父母的暴力(OR=2.07，95%CI：1.39~3.08)和被社区污名化(CI=1.58，95%CI：1.09~2.59)。与成年母亲相比，青春期母亲更不愿意为婴儿接种第二针和第三针[小儿麻痹症2(OR=0.73，95%CI：0.55~0.98)、小儿麻痹症3号(OR=0.70：95%CI：0.51~0.95)、小儿麻痹症2号(OR=0.71，95%CI：0.53~0.96)、小儿麻痹症3号(OR=0.68，95%CI：0.50~0.92)]。这些结果令人信服，需要以青少年为重点的紧急干预。青少年为自己和子女寻求保健的行为较差，并经历了更多的社区污名化和暴力，这表明青少年母亲在社会支持方面面临更大的挑战。需要采用和实施有利于青少年的干预措施，例如以怀孕小组为目标的干预措施，以增强怀孕青少年的能力，提供有关怀孕、分娩和幼儿护理的信息。
Maternal health services have a potentially critical role in the improvement of reproductive health. In order to get a better understanding of adolescent mothers'needs we compared health seeking practices of first time adolescent and adult mothers during pregnancy and early motherhood in Wakiso district, Uganda. This was a cross-sectional study conducted between May and August, 2007 in Wakiso district. A total of 762 women (442 adolescents and 320 adult) were interviewed using a structured questionnaire. We calculated odds ratios with their 95% CI for antenatal and postnatal health care seeking, stigmatisation and violence experienced from parents comparing adolescents to adult first time mothers. STATA V.8 was used for data analysis. Adolescent mothers were significantly more disadvantaged in terms of health care seeking for reproductive health services and faced more challenges during pregnancy and early motherhood compared to adult mothers. Adolescent mothers were more likely to have dropped out of school due to pregnancy (OR = 3.61, 95% CI: 2.40–5.44), less likely to earn a salary (OR = 0.43, 95%CI: 0.24–0.76), and more likely to attend antenatal care visits less than four times compared to adult mothers (OR = 1.52, 95%CI: 1.12–2.07). Adolescents were also more likely to experience violence from parents (OR = 2.07, 95%CI: 1.39–3.08) and to be stigmatized by the community (CI = 1.58, 95%CI: 1.09–2.59). In early motherhood, adolescent mothers were less likely to seek for second and third vaccine doses for their infants [Polio2 (OR = 0.73, 95% CI: 0.55–0.98), Polio3 (OR = 0.70: 95% CI: 0.51–0.95), DPT2 (OR = 0.71, 95% CI: 0.53–0.96), DPT3 (OR = 0.68, 95% CI: 0.50–0.92)] compared to adult mothers. These results are compelling and call for urgent adolescent focused interventions. Adolescents showed poorer health care seeking behaviour for themselves and their children, and experienced increased community stigmatization and violence, suggesting bigger challenges to the adolescent mothers in terms of social support. Adolescent friendly interventions such as pregnancy groups targeting to empower pregnant adolescents providing information on pregnancy, delivery and early childhood care need to be introduced and implemented.