在孟加拉农村地区使用家庭或机构技术产科护理的公平性:一项观察性研究
Mahbub Elahi Chowdhury1, Carine Ronsmans, Japhet Killewo
1ICDDR, B: Centre for Health and Population Research, Bangladesh.
Lancet (London, England)
|January 31, 2006
概括
在孟加拉国,以设施为基础的产科护理增加了富人与穷人之间的不平等,扩大了熟练分娩人员的差距. 需要进一步的研究来比较家庭和设施分娩,以获得平等的孕产妇医疗保健.
科学领域:
- 全球健康 全球健康
- 孕产妇健康 孕产妇健康
- 卫生经济学 卫生经济学
背景情况:
- 对于发展中国家最贫困人口的设施分娩的好处,研究有限.
- 在孟加拉国农村地区,研究了在家庭获得专业助产服务与在设施中的社会经济差异.
- 在研究区域提供免费的产科护理服务.
研究的目的:
- 分析专业助产士在家庭和机构分娩中的社会经济地位差异.
- 评估从家庭医疗转向机构医疗产科护理对医疗保健不平等的影响.
主要方法:
- 利用来自孟加拉国Matlab的例行收集数据,涵盖1987年至2001年.
- 采用多项逻辑和双项日志链接回归模型来比较家庭和设施化产科护理.
- 控制多个混因素以确保可靠的分析.
主要成果:
- 基于财富的显著差异被观察到在家庭和设施的助产士利用.
- 在1996年引入基于设施的护理后,最富裕和最贫穷的五分之一之间熟练分娩的差距大大扩大.
- 在最富裕和最贫困人群中,熟练分娩的风险比率从1.91增加到2.71,随着转向以设施为基础的护理.
结论:
- 过渡到以设施为基础的基本产科护理在该地区是可行的,但可能会加剧现有的医疗保健不平等.
- 在家庭分娩方面,获得熟练护理人员的实质性不平等也很明显.
- 对于发展中国家来说,对家庭与医疗机构分娩的可行性,成本,有效性,可接受性和公平性等方面的比较研究至关重要.
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