广西农村地区孕产妇住院分娩状况及影响因素研究

Study on the status of institutional delivery and its determinants in rural Guangxi autonomous region

目的了解1998—2003年广西农村地区孕产妇住院分娩服务的状况，并探讨影响住院分娩服务利用的因素。方法以安德森卫生服务利用行为模型为分析框架，资料来源于第三次国家卫生服务调查的广西数据库。以其中1998—2003年有活产史的广西农村地区妇女为研究对象，描述住院分娩服务的状况，进行单因素分析并拟合多因素logistic回归模型，考察农村妇女住院分娩的影响因素。结果在全部407名有活产史的妇女中，39．80％的妇女是住院分娩；1998—2003年的住院分娩率呈逐年升高（P〈0．0001），在乡镇卫生院分娩的产妇呈逐年上升趋势，在家分娩的产妇比例则逐年减少（P〈0．0001）。经综合考虑单因素分析和多因素logistic回归分析结果，孕产妇的分娩史、教育状况、家庭的饮水类型、以最快方式去最近医院的时间、产前检查情况，以及是否被动员住院分娩等因素是影响广西农村地区孕产妇住院分娩服务利用的重要因素，其OR值分别为：经产妇1．749、以最快方式去最近医院的时间少于10min者1．995、家庭饮用自来水者3．011、高中及以上文化程度者5．435、接受5次及以上产前检查者29．149与被动员过住院分娩者37．822。结论社会经济发展水平、孕期保健状况、分娩史等是影响广西农村妇女选择住院分娩，接受专业人员助产服务的主要因素。

Objective To understand the situation of institutional delivery of rural pregnant women in Guangxi Autonomous Region in the period of 1998 - 2003 and to identify the determinants on institutional delivery utilization. Methods Using Andersen＇s behavioral model as analytical framework and Guangxi databank of the 3^rd National Health Service Survey as data source, we described the status of institutional delivery with the rural women having had live birth history in the period of 1998- 2003 as subjects, while and the univariate analysis and multivariate logistic analysis were done to identify determinants of institutional delivery utilization. Results Among a total number of 407 women with live birth history,39.80 percent of them delivered at the health-care facilities. The rate of institutional delivery increased annually in 1998- 2003 （P〈 0. 0001）. The proportion of delivery in township health centers increased and the proportion of home delivery decreased by year （P〈 0.0001 ）. Results from both univariate and multivariate analysis showed that parity, education background of women, type of drinking water, time needed to get to the nearest healthcare facilities by the most convenient traffic, frequency of prenatal checkup, together with whether or not being advocated on institutional delivery etc. were determinants of delivery utilization. The OR value were 1. 749 for multipara, 1. 995 for those going to the nearest healthcare facilities by the most convenient traffic in less than 10 minutes,3. 011 for those drinking tap water,5. 435 for those with the education of high school,29. 149 for those with over 5 times in terms of frequency of prenatal checkup and 37. 822 for those being advocated on institutional delivery. Conclusion Socio-economic situation,status of maternal health care and parity made main contribution to institutional delivery and skilled birth attendance for women in rural Guangxi.