背景:青少年和年轻母亲的分娩与各种并发症有关,包括围产期死亡率,早产,低出生体重,和感染,这共同导致了新生儿和产妇死亡率的高负担。尽管取得了一些进展,熟练接生的患病率,证明可以改善孕产妇和新生儿的健康状况,尼日利亚北部一直很低。这项研究评估了尼日利亚北部15-24岁年轻女性中熟练分娩(SBA)的患病率和决定因素。
方法:这项汇总的横断面研究包括2011年,2016年和2021年在尼日利亚进行的6,461名15-24岁的年轻女性多指标聚类调查。我们使用二元逻辑回归模型以95%置信区间(CI)和计算的调整比值比(aOR)评估与熟练分娩相关的因素。
结果:尼日利亚北部年轻女性熟练分娩率从2011年的25.6%上升到2021年的33.1%。在控制了混杂因素后,与初婚年龄小于18岁的女性相比,初婚年龄至少18岁的女性SBA的几率高2.48(aOR2.48,95%CI=1.54-4.00)。与来自贫穷家庭财富五分之一的年轻女性相比,来自富裕家庭财富五分之一的年轻女性更有可能利用SBA(aOR1.84,95%CI=1.11-3.14)。在教育方面,与未受过教育的女性相比,受过中学教育(aOR=2.52,95%CI=1.77-3.56)和受过高等教育(aOR=10.01,95%CI=2.21-49.31)的女性患SBA的几率更高.个别女性媒体暴露的可能性高59%(aOR=1.59,95%CI=1.16-2.19),在最后一次怀孕期间进行4次或更多次产前检查的女性显示出2.28倍的几率(aOR=2.28,95%CI=1.67-3.09),而那些报告不打算最后一次怀孕的人使用SBA的可能性降低了37%(aOR=0.63,95%CI=0.42-0.96)。
结论:在10年期间,观察到熟练助产率略有增加。尼日利亚北部年轻女性的熟练接生率显著提高,需要特别注意女童儿童教育,延迟婚姻,年轻女性的经济赋权,和利用训练有素的社区卫生工作者(CHIP)使生殖保健接近生活在农村地区的年轻妇女的战略方法。
BACKGROUND: Childbirth among adolescents and young mothers has been linked to various complications, including perinatal mortality, preterm births, low birth weight, and infections, which collectively contribute to the high burden of neonatal and maternal mortality. Despite some progress, the prevalence of skilled birth attendance, proven to improve maternal and newborn health outcomes, remains consistently low in Northern Nigeria. This study assessed the prevalence and determinants of Skilled Birth Attendance (SBA) among young women ages 15-24 years in Northern Nigeria.
METHODS: This pooled cross-sectional study included 6,461 young women aged 15-24 years from 2011, 2016 and 2021 multiple indicator cluster surveys in Nigeria. We used a binary logistic regression model to assess the factors associated with skilled birth attendance at 95% confidence intervals (CIs) with computed adjusted odds ratios (aORs).
RESULTS: The prevalence of skilled birth attendance among young women in Northern Nigeria increased from 25.6% in 2011 to 33.1% in 2021. Women who were atleast 18 years of age at first marriage had 2.48 higher odds of SBA (aOR 2.48, 95% CI = 1.54-4.00) compared those less than 18 years of age at first marriage after controlling for confounders. Young women from rich household wealth quintile were more likely to utilize SBA (aOR 1.84, 95% CI = 1.11-3.14) compared to young women from poor household wealth quintile. In terms of education, those women who had secondary (aOR = 2.52, 95% CI = 1.77-3.56) and higher education (aOR = 10.01, 95% CI = 2.21-49.31) had higher odds of SBA compared to those with no education. Individual women with media exposure had 59% higher likelihood (aOR = 1.59, 95% CI = 1.16-2.19), women who attended 4 or more antenatal care visits during their last pregnancy demonstrated 2.28 times higher odds (aOR = 2.28, 95% CI = 1.67-3.09), while those who reported no intention for their last pregnancy were 37% less likely (aOR = 0.63, 95% CI = 0.42-0.96) to utilize SBA.
CONCLUSIONS: A slight increase in the prevalence of skilled birth attendance was observed over the 10-year period. For a significant boost in skilled birth attendance among young women in Northern Nigeria, particular attention needs to be paid to girls\' child education, delay in marriage, economic empowerment of young women, and strategic ways of leveraging trained community health workers (CHIPs) to bring reproductive healthcare close to young women living in rural areas.