Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets.
Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets.
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DOI：
10.1186/1471-2393-7-29
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发表时间：
2007-12-06
影响因子：
3.1
通讯作者：
Mwakipa H
中科院分区：
文献类型：
--
作者：
Mpembeni RN;Killewo JZ;Leshabari MT;Massawe SN;Jahn A;Mushi D;Mwakipa H
自安全孕产倡议启动以来近二十年，大多数发展中国家的孕产妇死亡率仍然居高不下。 2000 年，世界卫生组织估计，撒哈拉以南非洲地区孕产妇终生死亡风险为十六分之一，而发达国家这一数字仅为 2800 分之一。孕产妇死亡率的巨大差异是由于孕产妇保健服务的获取和使用方面的差异造成的。众所周知，每次分娩时都有熟练的护理人员可以显着降低孕产妇死亡率。因此，由熟练保健人员接生的比例是用于监测改善孕产妇健康的千年发展目标 5 进展情况的指标之一。采用定量研究方法的横断面研究。我们采访了 974 名在调查前一年内生育过的女性。尽管几乎所有人 (99.8%) 在上次怀孕期间至少参加过一次 ANC，但只有 46.7% 的人报告在医疗机构分娩，并且只有 44.5% 在分娩过程中得到了熟练护理人员的协助。与医疗机构的距离 (OR = 4.09 (2.72–6.16))、与男性伴侣讨论分娩地点 (OR = 2.37(1.75–3.22))、建议 ANC 期间在医疗机构分娩 (OR = 1.43 (1.25–2.63)) 以及对妊娠风险因素的了解 (OR 2.95 (1.65–5.25)) 显示与使用即使在控制了混杂因素后，分娩时仍能得到熟练的护理。该地区分娩过程中熟练护理人员的使用率低于国际人口与发展会议+设定的目标，即到 2005 年达到 80% 的熟练人员参与分娩的目标。为了加快实现千年发展目标的步伐，我们建议采取以下措施：提高卫生设施的覆盖率，提高男性和女性对怀孕/分娩期间危险迹象的认识，并加强对设施分娩和个人分娩准备的咨询。
Almost two decades since the initiation of the Safe motherhood Initiative, Maternal Mortality is still soaring high in most developing countries. In 2000 WHO estimated a life time risk of a maternal death of 1 in 16 in Sub- Saharan Africa while it was only 1 in 2800 in developed countries. This huge discrepancy in the rate of maternal deaths is due to differences in access and use of maternal health care services. It is known that having a skilled attendant at every delivery can lead to marked reductions in maternal mortality. For this reason, the proportion of births attended by skilled health personnel is one of the indicators used to monitor progress towards the achievement of the MDG-5 of improving maternal health. Cross sectional study which employed quantitative research methods. We interviewed 974 women who gave birth within one year prior to the survey. Although almost all (99.8%) attended ANC at least once during their last pregnancy, only 46.7% reported to deliver in a health facility and only 44.5% were assisted during delivery by a skilled attendant. Distance to the health facility (OR = 4.09 (2.72–6.16)), discussion with the male partner on place of delivery (OR = 2.37(1.75–3.22)), advise to deliver in a health facility during ANC (OR = 1.43 (1.25–2.63)) and knowledge of pregnancy risk factors (OR 2.95 (1.65–5.25)) showed significant association with use of skilled care at delivery even after controlling for confounding factors. Use of skilled care during delivery in this district is below the target set by ICPD + of attaining 80% of deliveries attended by skilled personnel by 2005. We recommend the following in order to increase the pace towards achieving the MDG targets: to improve coverage of health facilities, raising awareness for both men and women on danger signs during pregnancy/delivery and strengthening counseling on facility delivery and individual birth preparedness.