دورية أكاديمية
أعرض في EDS

Barriers to using skilled birth attendants' services in mid- and far-western Nepal: a cross-sectional study.

التفاصيل البيبلوغرافية
العنوان: Barriers to using skilled birth attendants' services in mid- and far-western Nepal: a cross-sectional study.
المؤلفون: Choulagai B; Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden. bishnu.p.choulagai@gu.se., Onta S, Subedi N, Mehata S, Bhandari GP, Poudyal A, Shrestha B, Mathai M, Petzold M, Krettek A
المصدر: BMC international health and human rights [BMC Int Health Hum Rights] 2013 Dec 23; Vol. 13, pp. 49. Date of Electronic Publication: 2013 Dec 23.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101088678 Publication Model: Electronic Cited Medium: Print ISSN: 1472-698X (Print) Linking ISSN: 1472698X NLM ISO Abbreviation: BMC Int Health Hum Rights Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Health Services Accessibility/*standards , Maternal Health Services/*statistics & numerical data , Midwifery/*statistics & numerical data, Adolescent ; Adult ; Analysis of Variance ; Cross-Sectional Studies ; Educational Status ; Female ; Humans ; Nepal ; Pregnancy ; Rural Population/statistics & numerical data ; Socioeconomic Factors ; Young Adult
مستخلص: Background: Skilled birth attendants (SBAs) provide important interventions that improve maternal and neonatal health and reduce maternal and neonatal mortality. However, utilization and coverage of services by SBAs remain poor, especially in rural and remote areas of Nepal. This study examined the characteristics associated with utilization of SBA services in mid- and far-western Nepal.
Methods: This cross-sectional study examined three rural and remote districts of mid- and far-western Nepal (i.e., Kanchanpur, Dailekh and Bajhang), representing three ecological zones (southern plains [Tarai], hill and mountain, respectively) with low utilization of services by SBAs. Enumerators assisted a total of 2,481 women. All respondents had delivered a baby within the past 12 months. We used bivariate and multivariate analyses to assess the association between antenatal and delivery care visits and the women's background characteristics.
Results: Fifty-seven percent of study participants had completed at least four antenatal care visits and 48% delivered their babies with the assistance of SBAs. Knowing the danger signs of pregnancy and delivery (e.g., premature labor, prolonged labor, breech delivery, postpartum hemorrhage, severe headache) associated positively with four or more antenatal care visits (OR = 1.71; 95% CI: 1.41-2.07). Living less than 30 min from a health facility associated positively with increased use of both antenatal care (OR = 1.44; 95% CI: 1.18-1.77) and delivery services (OR = 1.25; CI: 1.03-1.52). Four or more antenatal care visits was a determining factor for the utilization of SBAs.
Conclusions: Less than half of the women in our study delivered babies with the aid of SBAs, indicating a need to increase utilization of such services in rural and remote areas of Nepal. Distance from health facilities and inadequate transportation pose major barriers to the utilization of SBAs. Providing women with transportation funds before they go to a facility for delivery and managing transportation options will increase service utilization. Moreover, SBA utilization associates positively with women's knowledge of pregnancy danger signs, wealth quintile, and completed antenatal care visits. Nepal's health system must develop strategies that generate demand for SBAs and also reduce financial, geographic and cultural barriers to such services.
References: Indian J Med Res. 2011 Jan;133:64-9. (PMID: 21321421)
PLoS One. 2011 Feb 28;6(2):e17155. (PMID: 21386886)
PLoS One. 2012;7(2):e31666. (PMID: 22355386)
Matern Child Health J. 2011 Nov;15(8):1356-62. (PMID: 20827503)
Am J Public Health. 2008 Oct;98(10):1849-56. (PMID: 18703445)
BMC Pregnancy Childbirth. 2009 Aug 11;9:34. (PMID: 19671156)
Reprod Health. 2012 Oct 10;9:25. (PMID: 23050689)
Ethiop J Health Sci. 2010 Jul;20(2):75-82. (PMID: 22434964)
BMC Pregnancy Childbirth. 2004 May 22;4(1):8. (PMID: 15154970)
J Biosoc Sci. 2007 Jan;39(1):109-20. (PMID: 16522226)
Midwifery. 2012 Oct;28(5):554-60. (PMID: 22884893)
J Adv Nurs. 2008 Feb;61(3):244-60. (PMID: 18197860)
Confl Health. 2010 Dec 01;4:20. (PMID: 21122098)
J Health Popul Nutr. 2011 Aug;29(4):371-8. (PMID: 21957676)
BMC Health Serv Res. 2009 Jun 09;9:97. (PMID: 19508710)
Kathmandu Univ Med J (KUMJ). 2010 Jul-Sep;8(31):325-32. (PMID: 22610739)
تواريخ الأحداث: Date Created: 20131225 Date Completed: 20140725 Latest Revision: 20220409
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC3878020
DOI: 10.1186/1472-698X-13-49
PMID: 24365039
قاعدة البيانات: MEDLINE
الوصف
تدمد:1472-698X
DOI:10.1186/1472-698X-13-49