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overty/access to healthcare

Poverty/access to healthcare 医疗设施落后

The risk for maternal death (during pregnancy or childbirth) in sub-Saharan Africa is 175 times higher than in developed countries, and risk for pregnancy-related illnesses and negative consequences after birth is even higher. Poverty, maternal health, and outcomes for the child are all interconnected. Neonatal deaths in developing countries account for 98% of worldwide yearly neonatal deaths.[2] That being said, poverty is detrimental to the health of both mother and child. 孕妇死亡风险（在怀孕期间或者产子期间）在撒哈拉以南的非洲比其他发达国家的高175倍，孕妇感染孕期相关疾病和得产后后遗症的几率更高。贫穷，孕妇健康和婴健康三者相互影响。发展中国家的新生儿死亡人数占每年世界新生儿死亡总人数的98%。根据相关资料，贫困程度对母亲健康和新生儿健康有着决定性影响。

Women living in poverty-stricken areas are more likely to be obese and engage in unhealthy behaviors such as cigarette smoking and drug use, are less likely to engage in or even have access to legitimate prenatal care, and are at a significantly higher risk for adverse outcomes for both the mother and child.[3] A study conducted in Kenya observed that common maternal health problems in poverty-stricken areas include hemorrhaging, anemia, hypertension, malaria, placenta retention, premature labor, prolonged/complicated labor, and pre-eclampsia.[4] 发展中国家的女性肥胖比例更高，更有可能沾染吸烟吸毒等恶习。她们很难得到正规的产前保健，母亲和婴儿出现产后不良后果的风险很高。根据在肯尼亚的调查显示在发展中国家最常见的孕产妇疾病包括：大出血，贫血，高血压，疟疾，胎盘滞留，早产，难产和子痫前症。

Generally, adequate prenatal care encompasses medical care and educational, social, and nutritional services during pregnancy.[5] Although there are a variety of reasons women choose not to engage in proper prenatal care, 71% of low-income women in a US national study had difficulties getting access to prenatal care when they sought it out.[5] Additionally, immigrants and Hispanic women are at higher risk than white or black women for receiving little to no prenatal care, where level of education is also an indicator (since education and race are correlated). Adolescents are least likely to receive any prenatal care at all. Throughout several studies, women and adolescents ranked inadequate finances and lack of transportation as the most common barriers to receiving proper prenatal care.[6] 总体来说，全面的产前保健包含孕期医疗保健，教育，社科，营养服务。由于各种原因，女性不愿意进行全面的产前保健，但是美国国内研究表明70%的低收入女性在寻求产前保健时，遇到困难。除此之外，移民女性群体和拉美裔女性比白人和黑人女性更难获得产前保健，教育程度也是其中原因之一（因为教育程度和人种相互关联）。青少年基本无法获得产前保健。一些研究表明，阻碍青少年和中年女性获得产前保健主要因素是收入不足，交通不便。

Income is strongly correlated with quality of prenatal care.[6] Sometimes, proximity to healthcare facilities and access to transportation have significant effects on whether or not women have access to prenatal care. An analysis conducted on maternal healthcare services in Mali found that women who lived in rural areas, far away from healthcare facilities were less likely to receive prenatal care than those who lived in urban areas. Furthermore, researchers found an even stronger relationship between lack of transportation and prenatal and delivery care.[7] In addition to proximity being a predictor of prenatal care access, Materia and colleagues found similar results for proximity and antenatal care in rural Ethiopa.[8] 收入对产前保健质量的影响最大。是否邻近医疗设施，交通是否便利都对女性能否获得产前保健有重要影响。根据马里的孕产妇医疗中心调查显示居住在郊区，远离医疗设施比居住在市中心的女性更难获得产前保健。除此之外，研究员还发现交通不便对产前保健的获得有深远影响。