孟加拉农村的孕产妇医疗利用率:高灾区和低灾区之间的比较分析
Afroza Begum1, Syed Abdul Hamid2
1Department of Statistics, University of Chittagong, Chittagong, Bangladesh.
PLOS global public health
|July 31, 2023
概括
孟加拉国高灾难易发 (HDP) 和低灾难易发 (LDP) 地区的孕产妇健康结果,包括产前护理 (ANC) 访问和机构分娩,都很低. 易受灾害影响的地区的剖腹产和由毕业医生参加的分娩率明显较低.
科学领域:
- 孕产妇健康 孕产妇健康
- 公共卫生 公共卫生
- 灾害管理 灾害管理
背景情况:
- 在全球范围内,在获得和使用孕产妇医疗保健方面的差异仍然存在,特别是在易受灾害影响的地区.
- 了解影响产前护理 (ANC) 和机构分娩的因素对于改善母亲和儿童健康结果至关重要.
- 孟加拉国面临着独特的挑战,因为其对自然灾害的高度易感性,影响了医疗保健的获取.
研究的目的:
- 检查孟加拉国高灾难易发 (HDP) 和低灾难易发 (LDP) 地区在ANC访问和机构交付方面的差异.
- 用安德森的行为模型确定影响ANC利用和分娩地点选择的关键因素.
- 为改善受灾地区的孕产妇保健提供有针对性的干预信息.
主要方法:
- 一项横截面研究,利用了来自孟加拉国近期活产的345名母亲的数据.
- 应用层次的多项物流和二元物流模型来分析ANC联系和交付位置的决定因素.
- 基于安德森的行为模型进行分析,以评估倾向性,启用性和需要因素.
主要成果:
- 在HDP (20%) 和LDP (15%) 地区,利用4个以上的ANC访问率都很低,没有显著差异.
- 机构交付率总体较低 (21%),与LDP地区 (25.7%) 相比,HDP地区 (15.2%) 的交付率明显较低.
- 在HDP地区的剖腹产率 (HDP:42%与LDP:79%) 和研究生医生的出席率 (HDP:58%与LDP:88%) 中观察到显著的差异.
结论:
- 在HDP地区的母亲不太可能选择机构分娩,受教育程度,家庭规模,收入和设施附近等因素的影响.
- 建议采取需求侧干预措施 (例如,优惠券计划,产妇津贴) 和供应侧干预措施 (例如,培训传统助产士,移动医疗队伍).
- 长期解决方案需要设施准备,解决人员短缺和缺勤问题,并探索公私合作伙伴关系,特别是在HDP地区.
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