Determinants of the use of maternal health services in rural Bangladesh
Determinants of the use of maternal health services in rural Bangladesh
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DOI：
10.1093/heapro/dag414
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发表时间：
2003-12-01
影响因子：
2.7
通讯作者：
Akhter, HH
中科院分区：
文献类型：
--
作者：
Chakraborty, N;Islam, MA;Akhter, HH
利用卫生服务是一种复杂的行为现象。对预防和治疗服务的实证研究往往发现，保健服务的使用与服务的可得性、质量和费用以及使用者的社会结构、保健信念和个人特点有关。本文试图根据孟加拉国促进基本和生殖健康与技术研究所（BIRPERHT）开展的一项关于孟加拉国孕产妇发病率的调查数据，审查与孟加拉国使用孕产妇保健服务有关的因素。双变量和多变量分析的结果证实了母亲教育在解释卫生保健服务利用方面的重要性。女性教育对孕产妇保健服务的使用保持着净影响，与其他妇女的背景特征、家庭的社会经济地位和获得保健服务的机会无关。母亲的教育对保健服务的利用有很大影响，这与其他研究的结果一致。丈夫从事商业/服务业的妇女也对利用现代保健服务产生积极影响。然而，关于其他诱发因素和促成因素的影响，如妇女的年龄、以前怀孕的次数和获得保健设施的机会，研究结果尚无定论。多变量logistic回归估计未显示这些因素对孕产妇保健的使用有任何显著影响。疾病状况的严重程度在解释孕产妇保健利用方面的影响似乎是显著的。多变量分析表明，患有危及生命疾病的妇女向医生或护士寻求治疗其产妇疾病的可能性略高于两倍。
Utilization of health services is a complex behavioral phenomenon. Empirical studies of preventive and curative services have often found that use of health services is related to the availability, quality and cost of services, as well as to social structure, health beliefs and personal characteristics of the users. In this paper an attempt is made to examine the factors associated with the use of maternal health care services in Bangladesh on the basis of data from a survey of maternal morbidity in Bangladesh, conducted by the Bangladesh Institute of Research for Promotion of Essential and Reproductive Health and Technologies (BIRPERHT). The results from both the bivariate and multivariate analyses confirmed the importance of mother's education in explaining the utilization of health care services. Female education retains a net effect on maternal health service use, independent of other women's background characteristics, household's socioeconomic status and access to healthcare services. The strong influence of mother's education on the utilization of health care services is consistent with findings from other studies. Women whose husbands are involved in business/services also positively influenced the utilization of modern health care services. However, the study results are inconclusive with respect to the influence of other predisposing and enabling factors, such as women's age, number of previous pregnancies and access to health facilities. Multivariate logistic regression estimates do not show any significant impact of these factors on the use of maternal health care. The influence of severity of disease condition in explaining the utilization of maternal health care appears to be significant. Multivariate analysis indicate that women having had a life-threatening condition are little over two times more likely to seek care from a doctor or nurse to treat their maternal morbidities.