{"title":"撒哈拉以南非洲与适当利用产前护理服务有关的个人和社区因素。","authors":"Setegn Muche Fenta, Haile Mekonnen Fenta, Seyifemickael Amare Yilema, Ding-Geng Chen, Amsalu Worku Mekonnin","doi":"10.1186/s41182-024-00631-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Sub-Saharan Africa (sSA) continues to rank among the regions in the world with the highest rates of maternal mortality and the lowest rates of utilization of maternal health care. The risk of death for women in sSA is 268 times higher than that of women in high-income nations. Adequate antenatal care (ANC) services utilization is essential to the mother's and the baby's survival and well-being. This study aimed to identify both individual and community-level factors associated with adequate antenatal care services utilization in sSA.</p><p><strong>Method: </strong>We used data from the most recent Health and Demographic Surveys (DHS), which were carried out between 2012 and 2022 in 33 sSA countries. A total of 240,792 women were included in this study. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with the use of adequate ANC service.</p><p><strong>Results: </strong>The pooled prevalence of adequate ANC service utilization in sSA was 55.48% (95% CI: 55.28-55.68). The study showed that secondary and above-educated women (AOR = 2.13, 95% CI 2.07-2.19, secondary and above-educated husbands (AOR = 1.55, 95% CI 1.51-1.60), rich women AOR = 1.26, 95% CI 1.24-1.29), women 35-49 years of age (AOR = 1.36, 95% CI 1.32-1.41) and distance to a health facility is not a big problem (AOR = 1.13; 95% CI 1.11-1.16) was significantly and positively correlated with the use of adequate ANC services. However, rural women (AOR = 0.80; 95% CI 0.78-0.82), not having mass media access (AOR = 0.74, 95% CI 0.72-0.75), 5 and above birth order (AOR = 0.73, 95% CI 0.68-0.78) were significantly and negatively correlated with the use of adequate ANC services. Additionally, the random effects model showed that variables at the community and individual levels were responsible for approximately 62.60% of the variation in the use of adequate ANC services.</p><p><strong>Conclusion: </strong>The sSA countries had a low prevalence of adequate utilization of ANC with a significant variation among countries. Moreover, public health initiatives should focus on rural women, poor women, and uneducated women to enhance maternal health services utilization. Furthermore, policies and programs that address cluster variations in the utilization of adequate ANC services must be developed, and their implementation must be vigorously pursued.</p>","PeriodicalId":23311,"journal":{"name":"Tropical Medicine and Health","volume":"52 1","pages":"70"},"PeriodicalIF":3.6000,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476180/pdf/","citationCount":"0","resultStr":"{\"title\":\"Individual and community-level factors associated with adequate antenatal care service utilization in sub-Saharan Africa.\",\"authors\":\"Setegn Muche Fenta, Haile Mekonnen Fenta, Seyifemickael Amare Yilema, Ding-Geng Chen, Amsalu Worku Mekonnin\",\"doi\":\"10.1186/s41182-024-00631-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Sub-Saharan Africa (sSA) continues to rank among the regions in the world with the highest rates of maternal mortality and the lowest rates of utilization of maternal health care. The risk of death for women in sSA is 268 times higher than that of women in high-income nations. Adequate antenatal care (ANC) services utilization is essential to the mother's and the baby's survival and well-being. This study aimed to identify both individual and community-level factors associated with adequate antenatal care services utilization in sSA.</p><p><strong>Method: </strong>We used data from the most recent Health and Demographic Surveys (DHS), which were carried out between 2012 and 2022 in 33 sSA countries. A total of 240,792 women were included in this study. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with the use of adequate ANC service.</p><p><strong>Results: </strong>The pooled prevalence of adequate ANC service utilization in sSA was 55.48% (95% CI: 55.28-55.68). The study showed that secondary and above-educated women (AOR = 2.13, 95% CI 2.07-2.19, secondary and above-educated husbands (AOR = 1.55, 95% CI 1.51-1.60), rich women AOR = 1.26, 95% CI 1.24-1.29), women 35-49 years of age (AOR = 1.36, 95% CI 1.32-1.41) and distance to a health facility is not a big problem (AOR = 1.13; 95% CI 1.11-1.16) was significantly and positively correlated with the use of adequate ANC services. However, rural women (AOR = 0.80; 95% CI 0.78-0.82), not having mass media access (AOR = 0.74, 95% CI 0.72-0.75), 5 and above birth order (AOR = 0.73, 95% CI 0.68-0.78) were significantly and negatively correlated with the use of adequate ANC services. Additionally, the random effects model showed that variables at the community and individual levels were responsible for approximately 62.60% of the variation in the use of adequate ANC services.</p><p><strong>Conclusion: </strong>The sSA countries had a low prevalence of adequate utilization of ANC with a significant variation among countries. Moreover, public health initiatives should focus on rural women, poor women, and uneducated women to enhance maternal health services utilization. Furthermore, policies and programs that address cluster variations in the utilization of adequate ANC services must be developed, and their implementation must be vigorously pursued.</p>\",\"PeriodicalId\":23311,\"journal\":{\"name\":\"Tropical Medicine and Health\",\"volume\":\"52 1\",\"pages\":\"70\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-10-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11476180/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Tropical Medicine and Health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s41182-024-00631-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"TROPICAL MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Tropical Medicine and Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s41182-024-00631-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"TROPICAL MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
背景:撒哈拉以南非洲地区仍然是世界上孕产妇死亡率最高、孕产妇保健利用率最低的地区之一。撒哈拉以南非洲地区妇女的死亡风险是高收入国家妇女的 268 倍。充分使用产前保健(ANC)服务对母婴的存活和福祉至关重要。本研究旨在确定与南部非洲充分使用产前保健服务相关的个人和社区因素:我们使用了最新的健康与人口调查(DHS)数据,该调查于 2012 年至 2022 年间在 33 个南部非洲国家进行。本研究共纳入 240,792 名妇女。研究采用两级混合效应逻辑回归模型来确定与使用适当产前保健服务相关的个人和社区因素:结果:在南部非洲,充足的产前保健服务使用率为 55.48%(95% CI:55.28-55.68)。29)、35-49 岁的妇女(AOR = 1.36,95% CI 1.32-1.41)以及与医疗机构的距离问题不大(AOR = 1.13;95% CI 1.11-1.16)与使用适当的产前保健服务呈显著正相关。然而,农村妇女(AOR = 0.80;95% CI 0.78-0.82)、无法接触大众媒体(AOR = 0.74,95% CI 0.72-0.75)、5 胎及 5 胎以上(AOR = 0.73,95% CI 0.68-0.78)与使用适当的产前护理服务呈显著负相关。此外,随机效应模型显示,社区和个人层面的变量约占适当产前保健服务使用率差异的 62.60%:结论:南部非洲国家充分使用产前保健服务的普及率较低,各国之间差异显著。此外,公共卫生措施应重点关注农村妇女、贫困妇女和未受过教育的妇女,以提高孕产妇保健服务的利用率。此外,还必须制定政策和计划,以解决在充分利用产前护理服务方面存在的群组差异,并大力实施这些政策和计划。
Individual and community-level factors associated with adequate antenatal care service utilization in sub-Saharan Africa.
Background: Sub-Saharan Africa (sSA) continues to rank among the regions in the world with the highest rates of maternal mortality and the lowest rates of utilization of maternal health care. The risk of death for women in sSA is 268 times higher than that of women in high-income nations. Adequate antenatal care (ANC) services utilization is essential to the mother's and the baby's survival and well-being. This study aimed to identify both individual and community-level factors associated with adequate antenatal care services utilization in sSA.
Method: We used data from the most recent Health and Demographic Surveys (DHS), which were carried out between 2012 and 2022 in 33 sSA countries. A total of 240,792 women were included in this study. The two-level mixed-effects logistic regression model was used to identify the individual and community-level factors associated with the use of adequate ANC service.
Results: The pooled prevalence of adequate ANC service utilization in sSA was 55.48% (95% CI: 55.28-55.68). The study showed that secondary and above-educated women (AOR = 2.13, 95% CI 2.07-2.19, secondary and above-educated husbands (AOR = 1.55, 95% CI 1.51-1.60), rich women AOR = 1.26, 95% CI 1.24-1.29), women 35-49 years of age (AOR = 1.36, 95% CI 1.32-1.41) and distance to a health facility is not a big problem (AOR = 1.13; 95% CI 1.11-1.16) was significantly and positively correlated with the use of adequate ANC services. However, rural women (AOR = 0.80; 95% CI 0.78-0.82), not having mass media access (AOR = 0.74, 95% CI 0.72-0.75), 5 and above birth order (AOR = 0.73, 95% CI 0.68-0.78) were significantly and negatively correlated with the use of adequate ANC services. Additionally, the random effects model showed that variables at the community and individual levels were responsible for approximately 62.60% of the variation in the use of adequate ANC services.
Conclusion: The sSA countries had a low prevalence of adequate utilization of ANC with a significant variation among countries. Moreover, public health initiatives should focus on rural women, poor women, and uneducated women to enhance maternal health services utilization. Furthermore, policies and programs that address cluster variations in the utilization of adequate ANC services must be developed, and their implementation must be vigorously pursued.