背景:孕产妇健康持续护理(COCM)是解决孕产妇和围产期死亡率的可预防原因的关键策略。尽管全球在减少孕产妇和婴儿死亡方面取得了显著进展,问题依然存在,特别是在低资源环境中。此外,各大洲之间和同一大陆国家内部在提供持续护理方面存在巨大差异。这项研究旨在评估非洲产妇护理连续体的总体完成率,并调查相关因素。
方法:通过EMBASE访问了相关文章,CINAHL,科克伦图书馆,PubMed,Hinari,和谷歌学者数据库。漏斗图和Egger检验用于评估发表偏倚,而I平方检验用于评估研究异质性。纳入标准仅限于仅在非洲进行的观察性研究。使用JBI检查表评估这些研究的质量。使用MicrosoftExcel从所包括的研究中提取数据,然后使用Stata16软件进行分析。
结果:共有23项研究涉及74,880名母亲,符合纳入标准。成功完成COCM的女性总体患病率为20.9%[95%CI:16.9-25.0]。我们的分析揭示了与这一结果相关的几个因素,包括城市居住权[OR:2.3;95%CI:1.6-3.2],最高财富指数水平[OR:2.1;95%CI:1.4-3.0],初产状态[OR:1.3;95%CI:2.2-5.1],计划妊娠[OR:3.0;95%CI:2.3-3.7],和暴露于大众媒体[OR:2.7;95%CI:1.9-3.8]。
结论:研究显示,只有20.9%的女性完全完成了COCM。它还确定了与完成COCM相关的几个因素,例如居住在城市地区,拥有更高的财富指数,作为第一次做母亲,经历一次计划中的怀孕,并有机会接触大众媒体。根据研究结果,建议在农村地区实施有针对性的干预措施,向财富指数水平较低的妇女提供财政援助,通过大众媒体开展教育运动,促进早期产前保健,加强计划生育服务。
背景:PROSPERO国际系统评价前瞻性注册(ID:CRD42020205736)。
BACKGROUND: The continuum of care for maternal health (COCM) is a critical strategy for addressing preventable causes of maternal and perinatal mortality. Despite notable progress in reducing maternal and infant deaths globally, the problem persists, particularly in low-resource settings. Additionally, significant disparities in the provision of continuous care exist both between continents and within countries on the same continent. This study aimed to assess the pooled prevalence of completion across the maternity care continuum in Africa and investigate the associated factors.
METHODS: Relevant articles were accessed through the EMBASE, CINAHL, Cochrane Library, PubMed, HINARI, and Google Scholar databases. Funnel plots and Egger\'s test were employed to assess publication bias, while the I-squared test was used to evaluate study heterogeneity. The inclusion criteria were limited to observational studies conducted exclusively in Africa. The quality of these studies was assessed using the JBI checklist. Data extraction from the included studies was performed using Microsoft Excel and then analysed using Stata 16 software.
RESULTS: A total of 23 studies involving 74,880 mothers met the inclusion criteria. The overall prevalence of women who successfully completed the COCM was 20.9% [95% CI: 16.9-25.0]. Our analysis revealed several factors associated with this outcome, including urban residency [OR: 2.3; 95% CI: 1.6-3.2], the highest wealth index level [OR: 2.1; 95% CI: 1.4-3.0], primiparous status [OR: 1.3; 95% CI: 2.2-5.1], planned pregnancy [OR: 3.0; 95% CI: 2.3-3.7], and exposure to mass media [OR: 2.7; 95% CI: 1.9-3.8].
CONCLUSIONS: The study revealed that only 20.9% of women fully completed the COCM. It also identified several factors associated with completion of the COCM, such as residing in urban areas, possessing a higher wealth index, being a first-time mother, experiencing a planned pregnancy, and having access to mass media. Based on the study\'s findings, it is recommended that targeted interventions be implemented in rural areas, financial assistance be provided to women with lower wealth index levels, educational campaigns be conducted through mass media, early antenatal care be promoted, and family planning services be strengthened.
BACKGROUND: PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42020205736).