ABSTRACT
<B>Objectives:</B> In developing countries, measuring household income is difficult. The Wealth Index is an alternative to household income; however, it contains too many items making its use in a healt-related study difficult. Thus, we developed a shorter version of the index appropriate for rural areas in Cambodia and analyzed the relationship between economic status and maternal health knowledge and behavior using the index.<BR><B>Methods:</B> We conducted the study in four health center areas in Kampong Cham Province. We administered structured questionnaires to 640 women who had delivered babies within a year prior to the study. The development of the Cambodian Wealth Index-Rural version (CWI-R) followed the procedures of the Demographic and Health Survey (DHS) Wealth Index. Out of 69 items in the Cambodian DHS, we selected 18 items by assessing the distribution and correlation between the items and then performed principal component analysis. Those items that had principal component scores (PCS) below 0.4 were removed. As a result, we created an 11-item wealth index weighted by PCS; Cronbach’s <I>α</I> was 0.81. We tabulated economic status using quintiles and calculated health behavior and the women’s healt-related knowledge for each quintile.<BR><B>Results:</B> The mean age (SD) of the women was 27.0 (6.4) years. The rate of antenatal and postnatal care and skilled birth attendant increased as economic status improved. Knowledge of risk factors during pregnancy and delivery varied according to item. For prolonged labor and edema, knowledge increased as economic status improved; however, we observed no significant differences for vaginal bleeding. More women who had a higher economic status knew the benefits of Vitamin A and the causes of intestinal parasitic infections.<BR><B>Conclusion:</B> The pattern of maternal knowledge and behavior analyzed with the CWI-R was parallel to the original wealth index, indicating its usefulness as an alternative to the original wealth index.
ABSTRACT
An assessment of the use of traditional birth (TBAs) was undertaken in Phu Wiang District, Khon Kaen Province in Northeast Thailand form February to March 1992. The study was cross – sectional using a cluster random sampling scheme with probabiliry proportionate to size. According to official accounts, the utilization of TBA services by mothers has declined, particularly in their role as birth attendants and advisers on family planning. This study set out to substantiate this as well as find out what their new role is now. By questionnaire and in – depth interview it was ascertained that 31% of mothers with children under one had been delivered by TBAs. We found that overall, the utilization of TBAs by women before, during and after delivery were the following :- for anternatal care, 11.4% of mothers and pregnant women (n – 248) received either services or advice from TBAs. - for postpartum care, 35% of mothers (n = 183) were visited by TBAs.Overall , the proportion of all mothers in the sampled villages who received any advice or services from TBAs at any time last year, i.e. before, during, or after delivery was 49%.The fact that one – third of all deliveries were attended by TBAs in this study provides evidence that the TBA’s influence and acceptability continues to exist amingst people in remote rural areas even when formal health services are made available.