Birth preparedness

出生准备
  • 文章类型: Journal Article
    背景:分娩准备和并发症准备是一种整体方法,赋予母亲和家庭以知识,态度,和资源来缓解分娩期间的潜在挑战。尽管有好处,丈夫参与孕产妇保健的国家和地区之间存在显著差异。以前的研究缺乏研究丈夫对分娩准备和并发症准备的反应。因此,这项研究的主要目标是找出有12个月以下婴儿的妻子的丈夫对分娩准备的感觉,为问题做好准备,及其相关因素。
    方法:2022年5月30日至7月29日进行了基于社区的横断面研究设计。采用简单随机抽样方法选择499名丈夫。一名面试官管理,结构化,并采用预测试问卷收集数据。分别使用Epi数据版本4.6和SPSS版本25进行数据输入和分析。我们使用多变量逻辑回归来寻找有统计学意义的因素。P值小于0.05,95%置信区间,和调整后的比值比用于声明统计显著性。调查结果如图所示,tables,和文本。
    结果:研究发现,55.9%(95%CI:51.4%至61.4%)的丈夫对分娩准备和并发症准备有反应。该反应与被雇用显着相关(AOR=3.7,95%CI:2.27-5.95),从事自营业务(AOR=5.3,95%CI:2.34-12.01),有在医疗机构分娩的妻子(AOR=7.1,95%CI:3.92-12.86),陪伴妻子进行产前护理(AOR=2.2,95%CI:1.39-3.56),在分娩期间(AOR=2.0,95%CI:1.08-3.74)和产后(AOR=7.1,95%CI:3.14-16.01)具有良好的危险体征知识。有趣的是,居住在医疗机构附近的居民(AOR=0.6,95%CI:0.39-0.97)反应的可能性较小.
    结论:本研究发现,近6/10的丈夫在分娩准备和并发症准备方面积极回应。虽然这项研究中的丈夫在分娩准备和并发症方面表现出一些参与,与在全国范围内进行的研究相比,这是很好的。为了改善这一点,建议通过关注危险信号及其在分娩中的作用来教育丈夫。
    BACKGROUND: Birth preparedness and complication readiness is a holistic approach that empowers mothers and families with the knowledge, attitude, and resources to alleviate potential challenges during childbirth. Despite its benefits, husbands\' participation in maternal care differs significantly between countries and regions. There is a lack of previous studies that look at husbands\' responses to birth preparedness and complication readiness in the research area. Thus, the primary goal of this study is to find out how husbands who have wives with infants under 12 months old feel about birth preparation, readiness for problems, and its associated factors.
    METHODS: A community-based cross-sectional study design was conducted from May 30 to July 29, 2022. Simple random sampling was employed to select 499 husbands. An interviewer-administered, structured, and pretested questionnaire was used to collect the data. Data entry and analysis were performed using Epi Data version 4.6 and SPSS version 25, respectively. We used multivariable logistic regression to find statistically significant factors. P-values less than 0.05, 95% confidence intervals, and adjusted odds ratios are used to declare statistical significance. The findings were shown in figures, tables, and text.
    RESULTS: The study found that 55.9% (95% CI: 51.4 to 61.4%) of husbands responded to birth preparedness and complication readiness. This response was significantly associated with being employed (AOR = 3.7, 95% CI: 2.27-5.95), engaging in self-business (AOR = 5.3, 95% CI: 2.34-12.01), having wives who delivered in health facilities (AOR = 7.1, 95% CI: 3.92-12.86), accompanying wives for antenatal care (AOR = 2.2, 95% CI: 1.39-3.56), possessing good knowledge of danger signs during labor (AOR = 2.0, 95% CI: 1.08-3.74) and the postnatal period (AOR = 7.1, 95% CI: 3.14-16.01). Interestingly, residents living near a health facility (AOR = 0.6, 95% CI: 0.39-0.97) were less likely to respond.
    CONCLUSIONS: The present study found that nearly 6 out of 10 husbands actively responded in terms of birth preparedness and complication readiness. While husbands in this study showed some involvement in birth preparedness and complications, it is good when compared to studies carried out nationally. To improve this, educating husbands by focusing on the danger signs and their role in childbirth is recommended.
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  • 文章类型: Journal Article
    评估和比较出生准备和并发症准备程度(BPCR),并确定社会人口因素对Ekiti州农村和城市社区夫妇的预测影响。
    一项基于社区的比较横断面研究。
    这项研究是在埃基蒂州的十二个农村和十二个城市社区进行的。
    来自农村和城市社区的夫妇。女性伴侣是在调查前12个月内分娩的育龄妇女(15-49岁)。
    为分娩和产科急诊做好充分准备的夫妇比例,及其社会人口决定因素。
    在城市社区(60.5%)中,为分娩及其并发症做好充分准备的夫妇比例明显高于农村(48.4%)。研究还显示,生活在贫困线以上(95%CI=1.01-3.79),在受访者中,产次和配偶年龄差异小于5岁(95%CI=1.09-2.40)是BPCR的阳性预测因子.
    城市居民比农村居民准备得更好。生活在贫困线以上,奇偶校验,配偶年龄差异小于5岁是BPCR的阳性预测因子。有必要强调对夫妇进行教育,以了解将献血者识别为BPCR的重要组成部分的重要性。
    没有声明。
    UNASSIGNED: To assess and compare the level of Birth Preparedness and Complications Readiness (BPCR) and determine the predicting effect of socio-demographic factors on it among couples in rural and urban communities of Ekiti State.
    UNASSIGNED: A community-based comparative cross-sectional study.
    UNASSIGNED: The study was conducted in twelve rural and twelve urban communities in Ekiti State.
    UNASSIGNED: Couples from rural and urban communities. Female partners were women of reproductive age group (15-49 years) who gave birth within twelve months before the survey.
    UNASSIGNED: Proportion of couples that were well prepared for birth and obstetric emergencies, and its socio-demographic determinants.
    UNASSIGNED: The proportion of couples that were well prepared for birth and its complications was significantly higher in urban (60.5%) than rural (48.4%) communities. The study also revealed that living above poverty line (95% CI=1.01-3.79), parity and spousal age difference less than five years (95% CI=1.09 - 2.40) were positive predictors of BPCR among respondents.
    UNASSIGNED: Urban residents were better prepared than their rural counterparts. Living above poverty line, parity, and spousal age difference less than five years were positive predictors of BPCR. There is a need to emphasize on educating couples on the importance of identifying blood donors as a vital component of BPCR.
    UNASSIGNED: None declared.
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  • 文章类型: Journal Article
    背景:男性伴侣参与分娩准备和并发症准备计划是改善母婴健康的关键策略。它帮助准妈妈在无法获得服务的情况下及时做出决定。尽管意义重大,在研究环境中,男性伴侣参与分娩准备和并发症准备计划的信息很少.
    目的:评估Dale区Sidama男性伴侣参与分娩准备和并发症准备计划的患病率和相关因素,2021年埃塞俄比亚。
    方法:从11月到12月进行了一项基于社区的调查,2021年。数据是使用结构化的,预先测试和访谈管理问卷。采用多阶段整群抽样方法招募634份样本。进行Logistic回归分析,以确定与男性伴侣参与分娩准备和并发症准备计划相关的因素。通过逐步向后似然比方法估计相关因素的调整比值比(AORs)和95%置信区间(95%CI)。
    结果:634名研究参与者中有622人完成了访谈,产生98.1%的应答率。男性伴侣参与分娩准备和并发症准备计划的患病率为47.6%(95CI:44.9%,48.9%)。调整共同变量后,诸如在产前检查期间陪伴妻子与伴侣的因素(AOR=2.3,95CI1.5,3.5),妻子有剖腹产史的男性伴侣(AOR=2.1,95CI1.1,3.8),男性伴侣对分娩准备和并发症准备计划的了解(AOR=3.5,95CI:3.1,6.6),产科并发症的存在(AOR=5.1,95CI:4.3,11.2),primi-gravida(AOR=2.7,95CI:1.6,4.7),男性伴侣对产科并发症的了解(AOR=3.5,95CI,2.2,5.7)与男性伴侣参与分娩准备和并发症准备计划显著相关。
    结论:这项研究表明,男性伴侣参与分娩准备和并发症准备的患病率较低。因此,应加强对男性参与分娩准备和并发症准备计划的认识。
    BACKGROUND: Male partners\' involvement in birth preparedness and complication readiness plans is a key strategy to improve maternal and child health. It assists an expectant mother to make timely decisions in receiving care where service is inaccessible. Despite its significance, information is scarce about male partner involvement in birth preparedness and complication readiness plan in the study setting.
    OBJECTIVE: To assess prevalence and factors associated with male partners\' involvement in birth preparedness and complication readiness plan in Dale district Sidama, Ethiopia in 2021.
    METHODS: A community-based survey was done from November to December, in 2021. Data were collected using a structured, pre-tested and interview administered questionnaire. A multi-stage cluster sampling was applied to recruit 634 samples. Logistic regression analysis was performed to identify factors associated with male partner involvement in birth preparedness and complication readiness plan. Adjusted odds ratios (AORs) and 95% confidence intervals (95% CI) of associated factors were estimated by stepwise backward likelihood ratio method.
    RESULTS: 622 out of the 634 study participants completed the interview, yielding a 98.1% response rate. Prevalence of male partners\' involvement in birth preparedness and complication readiness plan was 47.6% (95%CI: 44.9%, 48.9%). After adjusting the cofounding variables, factors like accompanying wives with their partners during their antenatal care visits (AOR = 2.3, 95%CI 1.5, 3.5), male partners whose wives had a history of caesarean birth (AOR = 2.1, 95%CI 1.1, 3.8), knowledge of male partners on birth preparedness and complication readiness plan (AOR = 3.5, 95%CI:3.1,6.6), presence of obstetric complications(AOR = 5.1,95%CI:4.3,11.2),primi-gravida (AOR = 2.7,95%CI:1.6,4.7), and male partners\' knowledge of obstetrics complications (AOR = 3.5,95%CI,2.2,5.7) were significantly associated with male partners\' involvement in birth preparedness and complication readiness plan.
    CONCLUSIONS: This study indicates that prevalence of male partners\' involvement in birth preparedness and complication readiness was low. Therefore, awareness creation should be strengthened on male involvement on birth preparedness and complication readiness plan.
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  • 文章类型: Journal Article
    劳动时间或紧急时间不是决定做什么的时间,相反,现在是时候向熟练的医疗保健提供者寻求治疗了。分娩准备和并发症准备是计划正常分娩并预测紧急情况下需要采取的行动的过程,这有助于减少产科并发症。尽管分娩准备和并发症准备降低了孕产妇和新生儿的发病率和死亡率,埃塞俄比亚的分娩准备和并发症准备率仍然很低。这项研究旨在评估在DebreTabor镇公共卫生设施中接受产前护理的孕妇的分娩准备和并发症准备情况及其相关因素,西北,埃塞俄比亚。从2022年8月1日至2022年9月15日,对397名孕妇进行了一项基于医疗机构的横断面研究。使用系统随机抽样技术收集研究,并使用SPSS版本25.0输入和分析收集的数据。采用双变量和多变量逻辑回归分析来估计粗和调整后的比值比,并在95%的置信区间和小于0.05的P值被认为是显着的。分娩准备和并发症准备实践的比例为32.2%。受过正规教育,primigravida,在怀孕的头三个月开始接触产前保健,了解劳动和分娩的危险迹象,分娩准备和并发症准备程度与准备和并发症准备程度显著相关。在这个研究领域,分娩准备和并发症准备程度较低。因此,重要的是要加强咨询,以尽早开始产前保健联系,并建立对分娩准备和并发症准备的认识。
    Time of labor or time of emergency is not the time to decide what to do, instead it is time to seek care from skilled health care providers. Birth preparedness and complication readiness is the process of planning for a normal birth and anticipating the action needed in case of an emergency, which helps to minimize obstetric complications. Even though birth preparedness and complication readiness reduce maternal and newborn morbidity and mortality, the practice of birth preparedness and complication readiness is still low in Ethiopia. This study aimed to assess the practice of birth preparedness and complication readiness and its associated factors among pregnant women who attended antenatal care in the public health facilities of Debre Tabor town, northwest, Ethiopia. A health facility-based cross-sectional study was conducted from August 1/2022 to September 15/2022 among 397 pregnant mothers. The study was collected using a systematic random sampling technique and the collected data were entered and analyzed using SPSS version 25.0. Bivariate and multivariate logistic regression analyses were employed to estimate the crude and adjusted odds ratio and considered significant at a confidence interval of 95% and a P-value of less than .05. The proportion of birth preparedness and complication readiness practice was found to be 32.2%. Having formal education, primigravida, starting antenatal care contact in the first trimester of pregnancy, having knowledge of danger signs of labor and delivery, and birth preparedness and complication readiness were significantly associated with the practice of preparedness and complication readiness. In this study area, the practice of birth preparedness and complication readiness was low. Therefore, it is important to strengthen counseling on the advantage of starting antenatal care contact early and creating awareness of birth preparedness and complication readiness.
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  • 文章类型: Meta-Analysis
    背景:分娩准备和并发症准备(BPCR)是安全孕产计划的重要组成部分。这项研究旨在系统地确定和综合印度孕妇和最近分娩妇女的分娩准备和并发症准备情况的现有证据。
    方法:本研究遵循了PRISMA指南,并使用了PubMed等数据库,科克伦图书馆,和ProQuest。乔安娜·布里格斯研究所[JBI]工具用于对研究进行批判性评估。使用综合Meta分析[CMA]工具和Rstudio软件进行Meta分析。使用目视检查森林地块来评估统计异质性,Cochran的Q测试,和I2统计结果。漏斗图和Egger检验用于探索研究中发表偏倚的可能性[PROSPERO:CRD42023396109]。
    结果:三十五项横断面研究报告了有关分娩准备[BP]的一个或多个组成部分的知识,在34项纳入研究中报告了有关并发症准备[CR]或危险体征的知识。利用随机效应模型,汇总结果显示,只有大约一半的女性[49%;95%CI:44%,53%]对BPCR组分有认识。此结果介于15%[95%CI:12%,19%]至79%[95%CI:72%,84%]分别在马哈拉施特拉邦和卡纳塔克邦[I2=94%,p=<0.01]。在所有组分中观察到高异质性[>90%][p<0.01]。亚组分析结果表明,孕妇的BPCR比例没有显着差异[50%;95%CI:45%,55%]和最近分娩的女性[54%;95%CI:46%,62%]。然而,印度南部地区显示相对更好[56%;95%CI:45%,67%]患病率。
    结论:我们的研究强调了印度BPCR的低患病率及其相关因素。扩大具有成本效益的干预措施,如BPCR,具有积极的整体效果是必要的。作者强烈建议,分娩准备和并发症准备应对降低孕产妇发病率和死亡率至关重要,以实现可持续发展目标。应考虑加强现有资源,例如一线工人和初级医疗保健,作为增强意识举措有效性的战略方法。
    BACKGROUND: Birth preparedness and complication readiness (BPCR) is an essential component of safe motherhood programs. This study aims to systematically identify and synthesize available evidence on birth preparedness and complication readiness among pregnant and recently delivered women in India.
    METHODS: The study followed PRISMA guidelines and used databases such as PubMed, Cochrane Library, and ProQuest. Joanna Briggs Institute [JBI] Tool was used for critical appraisal of studies. The meta-analysis was conducted using Comprehensive Meta-Analysis [CMA] tool and R studio software. Statistical heterogeneity was evaluated using visual inspection of the forest plot, Cochran\'s Q test, and the I2 statistic results. Funnel plot and Egger\'s tests were applied to explore the possibility of the publication bias in the studies [PROSPERO: CRD42023396109].
    RESULTS: Thirty-five cross-sectional studies reported knowledge on one or more components of birth preparedness [BP], whilst knowledge on complication readiness [CR] or danger signs was reported in 34 included studies. Utilizing the random effect model, the pooled result showed that only about half of the women [49%; 95% CI: 44%, 53%] were aware on BPCR components. This result ranged between 15% [95% CI: 12%, 19%] to 79% [95% CI: 72%, 84%] in Maharashtra and Karnataka respectively [I2 = 94%, p = < 0.01]. High heterogeneity [> 90%] is observed across all components [p < 0.01]. The result of subgroup analysis indicated no significant difference in the proportion on BPCR among pregnant women [50%; 95% CI: 45%, 55%] and recently delivered women [54%; 95% CI: 46%, 62%]. However, the southern region of India indicates relatively better [56%; 95% CI: 45%, 67%] prevalence.
    CONCLUSIONS: Our study highlights the low prevalence of BPCR in India and the factors associated with it. Scaling up cost-effective interventions like BPCR that have a positive overall effect is necessary. Authors strongly suggests that birth preparedness and complication readiness should be given utmost importance to reduce maternal morbidity and mortality to achieve the Sustainable Development Goals. Consideration should be given to fortifying existing resources, such as frontline workers and primary healthcare, as a strategic approach to augmenting the effectiveness of awareness initiatives.
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  • 文章类型: Journal Article
    在印度等低收入和中等收入国家,孕产妇保健仍然是一个具有挑战性的公共卫生问题。在印度农村地区,对与生育准备及其并发症有关的做法的理解和服务仍然很差,没有得到充分利用。鉴于此,我们进行了这项研究,以探讨居住在德里农村居民区的社区中孕妇的准备情况。
    这项基于社区的横断面研究是在德里农村地区通过按比例抽样选择的165名当前孕妇中进行的。使用了从出生准备和并发症准备(BPCR)工具包改编的半结构化问卷。应用二元和多元回归分析来确定BPCR的预测因子。
    在我们的研究中,BPCR指数为25.78%。只有17.6%的孕妇做好了充分的准备。Multigravida,识字,在双变量分析中,发现较高的社会经济地位是分娩准备和并发症准备准备的重要预测因素。在多变量逻辑回归中,研究发现,多重妊娠和识字是做好准备的预测因素。
    在怀孕和分娩的背景下,需要提高婆婆和其他妇女以及丈夫在家庭中的技能和知识水平。前线卫生工作者可以协助准妈妈及其家庭成员做出明智的决策,以获得更好的助产结果。
    UNASSIGNED: Maternal healthcare remains a challenging public health problem in low and middle-income countries like India. The comprehension and services regarding practices related to birth preparedness and its complications in rural areas of India remain poor and underused. In view of this, we conducted this study to explore the preparedness of the pregnant women in the community residing in rural settlements of Delhi.
    UNASSIGNED: This cross-sectional community-based study was carried out in 165 currently pregnant women selected through proportionate sampling from rural Delhi. A semi-structured questionnaire adapted from Birth Preparedness and Complication Readiness (BPCR) tool kit was used. Binary and multivariate regression analysis was applied to identify the predictors of BPCR.
    UNASSIGNED: In our study, BPCR index was found to be 25.78%. Only 17.6% pregnant women were well prepared. Multigravida, literacy, and higher socioeconomic status were found significant predictors for well preparedness for child birth and complication readiness in bivariate analysis. In multivariate logistic regression, multigravida and literacy were found to be predictors for well preparedness.
    UNASSIGNED: The skill and knowledge level of the mother-in-laws and other women along with husband in the family needs to be improved in context of pregnancy and child birth. Frontline health workers can assist the to-be mothers and their family members in informed decision-making for better feto-maternal outcomes.
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  • 文章类型: Randomized Controlled Trial
    背景:孕产妇医疗保健利用,特别是机构交付,在埃塞俄比亚农村地区不成比例的低。本研究旨在评估基于社区的综合干预措施对提高产科危险体征知识的有效性。临产准备,以及在加莫区农村地区利用机构提供服务,埃塞俄比亚南部。
    方法:我们于2019年至2021年在ArbaMinch健康和人口监测系统站点进行了集群随机对照试验(NCT05385380)。我们将10个kebele集群随机分配给干预和控制组。我们使用了一揽子干预措施,其中包括通过视频和/或音频以及孕妇的分娩准备卡提供有关安全孕产的信息,培训社区志愿者和健康推广工作者,并改善待产家庭服务。控制部门的妇女只接受常规服务。我们使用广义混合效应逻辑回归模型来评估干预对结果变量的有效性。
    结果:该研究在10个群体中招募了727名孕妇,617(84.9%)的成功随访率。干预组机构分娩的比例从基线时的36.4%(174/478)增加到终线时的52.5%(224/427),增加了16.1%(McNemar检验的调整比值比[AOR]=1.5;95%置信区间[CI]:1.1至2;p<0.001)。在控制臂中,然而,机构交付的比例下降了10.3%(从164/249降至105/190)。接受干预的孕妇在医疗机构分娩的可能性明显高于未接受干预的孕妇(AOR2.8;95%CI:1.2,6.4)。
    结论:该研究表明,基于社区的综合干预方案,包括基于视频的讲故事和升级产妇候诊室,提高了农村妇女对机构分娩护理的利用率。我们建议视听讲故事,在怀孕期间开始并继续产后,纳入常规孕产妇保健服务,以解决农村地区获得护理的不平等问题。
    背景:研究方案已在clinicaltrials.gov注册,注册号为NCT05385380。
    许多发展中国家的妇女,包括埃塞俄比亚,由于与怀孕和分娩有关的问题而死亡。预防孕产妇疾病和死亡的干预措施之一是促进和确保及时使用孕产妇保健服务。这项研究旨在评估基于社区的综合干预措施对改善埃塞俄比亚农村地区机构出生率的有效性。我们在ArbaMinchHDSS网站进行了试验。该软件包通过视频和录音带为孕妇提供了有关安全孕产的信息,妇女的生育准备卡,社区志愿者和推广工作者培训,和待产家庭服务升级。在控制臂中,妇女只接受常规服务。从10个ArbaMinchHDSSkebele集群中,6个kebele集群被随机分配到干预组,另外4个被分配到对照组.使用不同的统计技术来评估干预措施对机构出生率的有效性。在基线,727名孕妇在所有10个集群中注册,617(84.9%)的成功随访率。干预组的机构分娩比例(224/427[52.5%])高于基线(174/478[36.4%])。此外,研究表明干预状况与机构出生率之间存在显著关联.因此,刺激对现有服务的需求,以确保及时使用护理,可以提高孕产妇保健服务的利用率,特别是机构出生率。
    BACKGROUND: Maternal healthcare utilization, particularly the institutional delivery, is disproportionately low in rural Ethiopia. This study aimed to evaluate the effectiveness of an integrated package of community-based interventions on the improved knowledge of obstetric danger signs, birth preparedness, and institutional delivery services utilization in rural areas of Gamo zone, southern Ethiopia.
    METHODS: We conducted cluster-randomized controlled trial (NCT05385380) from 2019 to 2021 at the Arba Minch Health and Demographic Surveillance System site. We randomly assigned the 10 kebele clusters to intervention and control arm. We used a package of interventions, which included providing information on safe motherhood via video and/or audio with a birth preparedness card for pregnant women, training for community volunteers and health extension workers, and improving maternity waiting home services. Women in the control arm received routine services only. We used generalized mixed-effects logistic regression models to evaluate the effectiveness of the intervention on the outcome variables.
    RESULTS: The study enrolled 727 pregnant women across the 10 clusters, with a 617 (84.9%) successful follow-up rate. The proportion of institutional delivery in the intervention arm was increased by 16.1% from 36.4% (174/478) at the baseline to 52.5% (224/427) at the endline (Adjusted odds ratio [AOR] for McNemar\'s Test = 1.5; 95% confidence interval [CI]: 1.1 to 2; p < 0.001). In the control arm, however, there was a 10.3% fall in the proportion of institutional delivery (from 164/249 to 105/190). Pregnant women who received the intervention were significantly more likely to give birth in a health institution than those who did not (AOR 2.8; 95% CI: 1.2, 6.4).
    CONCLUSIONS: The study demonstrates that an integrated community-based intervention package that included video-based storytelling and upgrading maternity waiting homes increased institutional delivery care utilization among rural women. We recommend that audio-visual storytelling, starting during pregnancy and continuing postpartum, be incorporated into routine maternal healthcare services to address access to care inequalities in rural settings.
    BACKGROUND: The study protocol was registered in the clinicaltrials.gov with registry number NCT05385380.
    Many women in developing nations, including Ethiopia, are dying due to problems related to pregnancy and childbirth. One of the interventions to prevent maternal illness and deaths is promoting and ensuring the timely use of maternal health care services. This study aimed to evaluate the effectiveness of an integrated package of community-based interventions on the improved institutional birth rate in rural Ethiopia. We conducted a trial at the Arba Minch HDSS site. The package provided information on safe motherhood via videos and audiocassettes for pregnant women, a birth preparedness card for women, community volunteers and extension workers training, and maternity waiting home services upgrading. In the control arm, women received routine services only. From the 10 Arba Minch HDSS kebele clusters, six kebele clusters were randomly assigned to the intervention and an additional four were assigned to the control. Different statistical techniques were used to evaluate the effectiveness of the intervention on the institutional birth rate. At the baseline, 727 pregnant women had enrolled across all 10 clusters, with a 617 (84.9%) successful follow-up rate. The intervention arm had a higher proportion of institutional birth (224/427 [52.5%]) at the endline than the baseline (174/478 [36.4%). Furthermore, the study showed a significant association between intervention status and institutional birth rate. Therefore, stimulating demand for existing services to ensure the timely use of care can improve maternal health service utilization, particularly the institutional birth rate.
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  • 文章类型: Journal Article
    背景:基本上所有妇女和婴儿,无论其经济和社会地位如何,都应充分发挥其健康和福祉的潜力。该研究评估了加纳三个处境不利的农村地区的母亲的准备情况及其分娩准备情况。
    方法:2018年1月至12月采用多阶段抽样方法进行多中心定量调查。使用结构化问卷收集了来自加纳三个主要生态区的产前和产后诊所的母亲的数据。连续招募提供知情同意的妇女,直到达到样本量。对于分类数据,汇总表,比例和百分比。多变量逻辑回归分析确定了选定特征对出生准备的影响。伦理批准是从Navrongo健康研究中心获得的。
    结果:共纳入1058名母亲:33.6%,阿达西部分别为33.4%和33.0%,上登基拉西部和Builsa南部地区。大约94%的妇女事先了解分娩准备。约22.6%(95CI20.1,25。2)的母亲被评估为生育准备不足:南部的Builsa占8.0%,阿达西部为27.8%,上登基拉西部为31.7%。产前和产后数据显示,在不良准备方面没有统计学上的显着差异(21.9%vs23.3%;p值>0.05)。产妇年龄,就业状况,宗教信仰和产次与生育准备无关(p值>0.05).研究领域(P<0.001),受教育程度(P<0.016),婚姻状况(p<0.001)和产前接触者(<0.001)与分娩准备显著相关。
    结论:作为一项重要的安全孕产策略,妇女应做好妊娠和分娩计划,以降低孕产妇和新生儿死亡率。政策举措应考虑居住地,教育,妇女的婚姻状况和产前接触。
    BACKGROUND: Essentially all women and babies irrespective of their economic and social status should reach their full potential for health and well-being. The study assessed the readiness of mothers and their preparedness for birth across three disadvantaged rural districts in Ghana.
    METHODS: A multi-centre quantitative survey from January to December 2018 using a multistage sampling approach was employed. Using a structured questionnaire data from mothers attending antenatal and postnatal clinics in three main ecological zones of Ghana were collected. Women who provided informed consent were consecutively recruited until the sample size was achieved. For categorical data, summary tables, proportions and percentage are presented. Multivariate logistic regression analysis determined the effect of selected characteristics on birth preparedness. Ethics approval was obtained from the Navrongo Health Research Centre.
    RESULTS: A total of 1058 mothers were enrolled: 33.6%, 33.4% and 33.0% respectively from the Ada west, Upper Denkyira west and Builsa south districts. About 94% of the women had prior knowledge of birth preparedness. Approximately 22.6% (95%CI 20.1, 25. 2) of the mothers were assessed to have poor birth preparedness: 8.0% in Builsa south, 27.8% in Ada west and 31.7% in Upper Denkyira west. Prenatal and postnatal data showed no statistically significant difference in poor preparedness (21.9% vs 23.3%; p-value > 0.05). Maternal age, employment status, religious affiliation and parity were not associated with birth preparedness (p-value > 0.05). Area of study (P < 0.001), educational level (P < 0.016), marital status (p < 0.001) and antenatal contacts (< 0.001) were significantly associated with birth preparedness.
    CONCLUSIONS: As an important safe motherhood strategy woman should plan their pregnancy and birth well to reduce maternal and neonatal mortality. Policy initiatives should take into consideration area of residence, education, marital status and antenatal contacts of women.
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  • 文章类型: Journal Article
    背景:分娩准备和并发症准备是正常分娩和潜在紧急情况的准备策略,并且对怀孕期间母亲和新生儿的安全和健康很重要,分娩,和产后。
    目的:本研究旨在评估孕妇的分娩准备率和并发症准备率以及相关因素。
    方法:这是一个基于社区的,在2020年2月至4月随机选择的480名孕妇中进行了横断面研究。进行双变量逻辑回归以评估每个自变量与因变量的关联。将P值<2的所有变量输入多变量逻辑回归模型以确定相关因素。估计具有95%置信区间的调整后的优势比来衡量关联的强度。
    结果:在498名孕妇样本中,480人(96.4%)同意参与本研究;104人发现分娩准备和并发症准备情况令人满意(21.7%;95%置信区间,18.3-25.7)。有过产科并发症的经历(调整后的优势比,1.83;95%置信区间,1.07-3.14),产前护理就诊的早期开始时间(调整后的优势比,5.22;95%置信区间,2.26-12.06),关于生育准备的建议(调整后的赔率比,2.99;95%置信区间,1.21-7.39),以及对分娩和产后期间产科危险迹象的认识(调整后的优势比,2.23;95%置信区间,1.33-3.74)被发现与分娩准备和并发症准备显着相关。
    结论:分娩准备和并发症准备率较低。产科并发症的经验,产前护理就诊的开始时间,关于分娩准备和并发症准备的建议,分娩期间和产后期间对关键危险体征的认识与分娩准备和并发症准备程度显着相关。
    BACKGROUND: Birth preparedness and complication readiness is a preparation strategy for normal birth and potential emergency situations, and is important for the safety and health of mothers and newborns during pregnancy, childbirth, and the postpartum period.
    OBJECTIVE: This study aimed to assess the prevalence of birth preparedness and complication readiness and the associated factors among pregnant women.
    METHODS: This was a community-based, cross-sectional study conducted among randomly selected 480 pregnant women from February to April of 2020. Bivariable logistic regression was performed to assess the association of each independent variable with the dependent variable. All variables with a P value of <.2 were entered into a multivariable logistic regression model to identify associated factors. Adjusted odds ratios with 95% confidence intervals were estimated to measure the strength of the association.
    RESULTS: Out of the 498 sampled pregnant women, 480 (96.4%) agreed to participate in the study; 104 were found to have satisfactory birth preparedness and complication readiness (21.7%; 95% confidence interval, 18.3-25.7). Having had an experience of obstetrical complications (adjusted odds ratio, 1.83; 95% confidence interval, 1.07-3.14), early starting time for antenatal care visits (adjusted odds ratio, 5.22; 95% confidence interval, 2.26-12.06), advice about birth preparedness (adjusted odds ratio, 2.99; 95% confidence interval, 1.21-7.39), and awareness about obstetrical danger signs during childbirth and the postpartum period (adjusted odds ratio, 2.23; 95% confidence interval, 1.33-3.74) were found to be significantly associated with birth preparedness and complication readiness.
    CONCLUSIONS: The prevalence of birth preparedness and complication readiness was low. Experience of obstetrical complications, starting time for antenatal care visits, advice about birth preparedness and complication readiness, and awareness of key danger signs during childbirth and the postpartum period were significantly associated with birth preparedness and complication readiness.
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  • 文章类型: Journal Article
    这项研究旨在评估在加纳北部贫困农村地区,健康教育和社区一级的参与性干预措施以及社区孕产妇健康促进者对孕产妇保健服务利用的影响。
    从2019年6月至2020年7月,在加纳北部的两个农村地区进行了随机对照调查设计。采用多级整群抽样技术选择参与者。数据是从重复的横断面家庭调查中收集的。描述性分析,使用STATA16版统计软件进行双变量和协变量校正的简单逻辑回归分析.
    在干预后,两组在ANC方面有显著差异(p=0.001),熟练交付(SD)(p=0.003),和PNC(p<0.0001)。在研究结束时,接受产科危险迹象健康教育的妇女的知识水平提高了50%。在与ANC和熟练分娩相关的实践中接受健康教育干预(HEI)的女性使用ANC(AOR=4.18;95%CI=2.48-7.04)和SD(AOR=3.90;95%CI=1.83-8.29)服务的可能性增加。机构交付和PNC出勤率至少四次显着增加,从88.5%增加到97.5%(p<0.0001),干预后分别为77.3-96.7%(p<0.0001)。接受过HEI的女性更有可能对产科危险体征有良好的认识(AOR=10.17;95%CI=6.59-15.69)。和BPCR(AOR=2.10;95%CI=1.36-3.24)。受过高等教育的女性更有可能至少四次访问ANC(AOR=2.38;95%CI=0.09-1.67)。
    这项研究表明,使用健康教育和由社区促进者领导的参与性会议可能是一种潜在的有效干预措施,以提高妇女对产科危险迹象的认识,并鼓励在资源匮乏的地区采用产妇护理服务加纳。
    This study aimed to assess the effects of health education and community-level participatory interventions at the community level and the use of community maternal health promoters on the utilization of maternal health care services in poor rural settings of northern Ghana.
    A randomized controlled survey design was conducted from June 2019 to July 2020 in two rural districts of northern Ghana. A multistage cluster sampling technique was used to select the participants. Data were collected from a repeated cross-sectional household survey. Descriptive analysis, bivariate and covariates adjusted simple logistic regression analyses were performed using STATA version 16 statistical software.
    At post-intervention, the two groups differed significantly in terms of ANC (p = 0.001), skilled delivery (SD) (p = 0.003), and PNC (p < 0.0001). Women who received health education on obstetric danger signs had improved knowledge by 50% at the end of the study. Women who received the health education intervention (HEI) on practices related to ANC and skilled delivery had increased odds to utilize ANC (AOR = 4.18; 95% CI = 2.48-7.04) and SD (AOR = 3.90; 95% CI = 1.83-8.29) services. Institutional delivery and PNC attendance for at least four times significantly increased from 88.5 to 97.5% (p < 0.0001), and 77.3-96.7% (p < 0.0001) respectively at postintervention. Women who had received the HEI were significantly more likely to have good knowledge about obstetric danger signs (AOR = 10.17; 95% CI = 6.59-15.69), and BPCR (AOR = 2.10; 95% CI = 1.36-3.24). Women who had obtained tertiary education were significantly more likely to make at least four visits to ANC (AOR = 2.38; 95% CI = 0.09-1.67).
    This study suggests that the use of health education and participatory sessions led by community-based facilitators could be a potentially effective intervention to improve the knowledge of women about obstetric danger signs and encourage the uptake of maternity care services in resource-poor settings of Ghana.
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