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Factors Associated with Not Using Antenatal Iron/Folic Acid Supplements in Indonesia: The 2002/2003 and 2007 Indonesia Demographic and Health Survey

在印度尼西亚产前未补充铁/叶酸的相关因素:2002、2003和2007印度尼西亚人口与健康普查

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摘要


背景:本研究分析了印度尼西亚产前未补充铁/叶酸的相关因素。方法:本研究使用了2002、2003和2007年印度尼西亚人口与健康普查(IDHS)数据,采集了每次普查前近5年26591位妇女生育资料,其中主要的相关变量就是没有补充铁/叶酸。我们使用Logistic回归分析,研究一些外部环境的作用、诱发、启用、需要因素,以及使用其他孕产妇保健服务对产前未补充铁/叶酸的人群的影响。结果:Java-巴厘地区以外以及农村地区有更多未补充铁/叶酸的母亲(OR=1.73, 95% CI: 1.48-2.03)。不服用这些补充剂的可能性随着家庭财富指数和父母受教育程度降低而增高。对于那些很少主动关注自身健康(OR=1.24, 95% CI: 1.04-1.49)、生产过多胎经产妇、对产科并发症知识低以及很少接触大众媒体的母亲,其不服用补充剂的几率升高。影响产前不补充铁/叶酸的主观因素主要有去做产前检查的费用(OR=1.28, 95% CI: 1.13-1.44)和与产前检查机构的距离(OR=1.20, 95% CI: 1.02-1.40)。我们的研究说明产前护理作为一个非常重要的补充剂的分配渠道。结论:提高社区意识,增加健康服务的覆盖率、在孕期护理期间加强宣传指导、组织社区参与健康计划,对提高铁/叶酸补充剂的摄入、增加印度尼西亚婴儿存活率将是非常必要的。

並列摘要


Background: This analysis examined factors associated with non-use of antenatal iron/folic acid supplements in Indonesia. Methods: Data from the 2002/2003 and 2007 Indonesia Demographic and Health Surveys (IDHS) were used, providing survival information for 26,591 most recent deliveries over the five-year period prior to each survey. The main outcome variable was non-use of iron/folic acid supplements. Using logistic regression, we examined the role of external environment, predisposing, enabling, need factors, and previous utilization of other maternal care services in non-use of antenatal iron/folic acid supplements. Results: Mothers from outer Java- Bali Region and rural areas (OR=1.73, 95% CI: 1.48-2.03) had increased odds for not using antenatal iron/folic acid supplements. The likelihood for not using the supplements increased with the reduction of household wealth index and parental education. The odds increased amongst mothers with low autonomy on her own health care (OR=1.24, 95% CI: 1.04-1.49), high birth-rank infants, mothers with low knowledge of obstetric complications and low exposure to mass media. Enabling factors associated with increased odds for non-use of iron/folic acid supplements included mothers reporting money to pay health services (OR=1.28, 95% CI: 1.13- 1.44) and distance to health services (OR=1.20, 95% CI: 1.02-1.40) were major problems. Our study demonstrated the importance of antenatal care as a distribution channel of the supplements. Conclusions: Increasing community awareness, coverage and access to health services along with strengthening counselling sessions during antenatal care and community participation in health programs are necessary to improve the uptake of iron/folic acid supplements, to increase infant survival in Indonesia.

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