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Determinants of Birth Attendant Choice of Women in Rural Cambodia and Outcome Differences -Comparison between Skilled and Unskilled Attendants-

柬埔寨农村妇女接生员选择的决定因素和结果差异 - 熟练和非熟练助产士之间的比较 -

基本信息

批准号：
15390683
负责人：
YANAGISAWA Satoko
金额：
$ 5.25万
依托单位：
Shinshu University (2004-2005)Mie Prefectural College of Nursing (2003)
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2003
资助国家：
日本
起止时间：
2003 至 2005
项目状态：
已结题

项目摘要

Objectives : An increase in the utilization of skilled attendants at delivery is an effective intervention to reduce maternal mortality by the management of obstetric complications. The objectives of this study were 1) to describe the health seeking behavior of women during pregnancy and childbirth, 2) to identify the determinants of birth attendant choice, and 3) to compare perceived outcomes between skilled and unskilled attendants.Methods : The study was conducted in Memot District, Kompong Cham Province. The study population was women who gave birth to a baby during three months prior to the survey. We located a total of 1046 pregnant women, of whom 980 were included in the analysis. Information was collected by a household survey using a structured questionnaire. Semi-structured interviews of selected women with serious complications were also conducted to explore the barriers to health services. We used logistic regression to identify determinants of birth attendant choice accord … More ing to delivery place (facility vs. non-facility), birth attendant at home births (skilled vs. unskilled), and change of birth attendant during delivery (changed vs. unchanged). Semi-structured interviews were tape-recorded, then analyzed using content analysis.Results : Of 980 women included in the analyses, 19.8% had skilled attendant present during delivery. 78.5% had unskilled attendants, and 1.7% did not have any attendants. 10.9% took place at health facilities. Health seeking behavior analysis revealed that more than half of the women who perceived possible life-threatening conditions did not seek help from skilled personnel.The determinants of facility delivery choices differed from those of skilled attendant choice in home births. In facility delivery choice, the significant determinants were ; school attendance of 7 years and over, frequent antenatal care attendance and having prolonged labor. For home births, the choice of skilled and unskilled attendant in preceding deliveries were positively and negatively associated with skilled attendant choice in the following delivery, respectively.Incidences of neonatal deaths and severe bleeding during delivery and postpartum were more in facility deliveries than non-facility deliveries. However, negative incidences did not show a difference between the presence of skilled or unskilled attendant during home births.The semi-structured interview revealed barriers to health care in all three levels of health seeking, i.e. 1) recognizing risks or deciding to seek health care, 2) reaching health care, 3) acquiring quality health care once it was accessed. Less

目的：增加熟练接生员的使用是通过管理产科并发症来降低孕产妇死亡率的有效干预措施。本研究的目的是：1)描述孕产期妇女的求医行为；2)确定接生员选择的决定因素；3)比较熟练和非熟练接生员的感知结果。研究人群是在调查前三个月内生过孩子的妇女。我们总共找到了1046名孕妇，其中980人被纳入分析。信息是通过使用结构化问卷进行的家庭调查收集的。还对有严重并发症的选定妇女进行了半结构化访谈，以探索获得保健服务的障碍。我们使用Logistic回归来确定助产士选择符合…的决定因素更多地考虑到分娩地点(设施与非设施)、在家分娩的助产士(熟练与非熟练)，以及在分娩过程中更换助产员(更改与不变)。半结构化访谈被录制下来，然后使用内容分析进行分析。结果：在980名参与分析的妇女中，19.8%的人在分娩过程中有熟练的陪同人员。78.5%的人没有熟练的服务员，1.7%的人没有服务员。10.9%发生在卫生机构。求医行为分析显示，在感觉到可能危及生命的情况下，超过一半的女性没有寻求熟练人员的帮助。选择设施接生的决定因素与选择在家分娩的熟练接生员的决定因素不同。在设施分娩选择上，有意义的决定因素是：7年及以上的就学年限、频繁的产前检查次数和分娩时间过长。在居家分娩中，前一次分娩中选择熟练和非熟练助产士分别与第二次分娩中熟练助产员的选择呈正相关和负相关，设施分娩中新生儿死亡和产后大出血的发生率高于非设施分娩。然而，负面事件并没有显示在家庭分娩期间有熟练或非熟练保姆的存在。半结构化访谈揭示了在寻求健康的所有三个层面上的卫生保健障碍，即1)认识到风险或决定寻求卫生保健，2)获得卫生保健，3)一旦获得优质卫生保健。较少

项目成果

期刊论文数量（16）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

WHO systematic review of randomized controlled trials of Routine antenatal care.

世卫组织对常规产前保健随机对照试验的系统评价。

DOI：
发表时间：
2001
期刊：
The Lancet 357
影响因子：
0
作者：
Family and Community Health;Department of Reproductive Health and Research.;Hunt LM et al.;Carroli G et al.
通讯作者：
Carroli G et al.

Household characteristics affecting where mothers deliver in rural Kenya