Use of antenatal services and delivery care among women in rural western Kenya: A community based survey

被引：159

作者：

Van Eijk A.M. ^{[1
,4
]}

Bles H.M. ^{[1
]}

Odhiambo F. ^{[2
]}

Ayisi J.G. ^{[2
]}

Blokland I.E. ^{[1
]}

Rosen D.H. ^{[3
]}

Adazu K. ^{[2
]}

Slutsker L. ^{[4
]}

Lindblade K.A. ^{[4
]}

机构：

[1] Kenya Medical Research Institute, Centre for Vector Biology and Control Research, Kisumu

[2] Global AIDS Program, Centers for Disease Control and Prevention, Atlanta, GA

[3] Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA

来源：

Reproductive Health | / 3卷 / 1期

关键词：

Malaria; Health Facility; Antenatal Care; Home Delivery; Intermittent Preventive Treatment;

D O I：

10.1186/1742-4755-3-2

中图分类号：

学科分类号：

摘要：

Background: Improving maternal health is one of the UN Millennium Development Goals. We assessed provision and use of antenatal services and delivery care among women in rural Kenya to determine whether women were receiving appropriate care. Methods: Population-based cross-sectional survey among women who had recently delivered. Results: Of 635 participants, 90% visited the antenatal clinic (ANC) at least once during their last pregnancy (median number of visits 4). Most women (64%) first visited the ANC in the third trimester; a perceived lack of quality in the ANC was associated with a late first ANC visit (Odds ratio [OR] 1.5, 95% confidence interval [CI] 1.0-2.4). Women who did not visit an ANC were more likely to have < 8 years of education (adjusted OR [AOR] 3.0, 95% CI 1.5-6.0), and a low socio-economic status (SES) (AOR 2.8, 95% CI 1.5-5.3). The ANC provision of abdominal palpation, tetanus vaccination and weight measurement were high (>90%), but provision of other services was low, e.g. malaria prevention (21%), iron (53%) and folate (44%) supplementation, syphilis testing (19.4%) and health talks (14.4%). Eighty percent of women delivered outside a health facility; among these, traditional birth attendants assisted 42%, laypersons assisted 36%, while 22% received no assistance. Factors significantly associated with giving birth outside a health facility included: age ≥ 30 years, parity ≥ 5, low SES, < 8 years of education, and > 1 hour walking distance from the health facility. Women who delivered unassisted were more likely to be of parity ≥ 5 (AOR 5.7, 95% CI 2.8-11.6). Conclusion: In this rural area, usage of the ANC was high, but this opportunity to deliver important health services was not fully utilized. Use of professional delivery services was low, and almost 1 out of 5 women delivered unassisted. There is an urgent need to improve this dangerous situation. © 2006van Eijk et al; licensee BioMed Central Ltd.

引用

共 39 条

[1]

Maternal Mortality in 2000: Estimates Developed by WHO, UNICEF and UNFPA, (2004)

[2]

The Safe Motherhood Action Agenda: Priorities for the next Decade. Report on the Safe Motherhood Technical Consultation 18-23 October 1997, (1997)

[3]

Khan M., Pillay T., Moodley J.M., Connolly C.A., Maternal mortality associated with tuberculosis-HIV-1 co-infection in Durban, South Africa, AIDS, 15, pp. 1857-1863, (2001)

[4]

Magadi M., Madise N., Diamond I., Factors associated with unfavourable birth outcomes in Kenya, J Biosoc Sci, 33, pp. 199-225, (2001)

[5]

Maternal Mortality Reduction Strategy, (2003)

[6]

Antenatal Care in Developing Countries. Promises, Achievements and Missed Opportunities. An Analysis of Trends, Levels and Differentials, 1990-2001, (2003)

[7]

Villar J., Bergsjo P., Scientific basis for the content of routine antenatal care. I. Philosophy, recent studies, and power to eliminate or alleviate adverse maternal outcomes, Acta Obstet Gynecol Scand, 76, pp. 1-14, (1997)

[8]

Bergsjo P., Villar J., Scientific basis for the content of routine antenatal care. II. Power to eliminate or alleviate adverse newborn outcomes

[9]

some special conditions and examinations, Acta Obstet Gynecol Scand, 76, pp. 15-25, (1997)

[10]

Lumbiganon P., Appropriate technology: Antenatal care, Int J Gynaecol Obstet, 63, 1 SUPPL., (1998)

← 1 2 3 4 →