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Alem AZ, Tegegne BA, Aragaw FM, Teklu RE, Baykeda TA. Multilevel negative binomial analysis of factors associated with numbers of antenatal care contacts in low and middle income countries: Findings from 59 nationally representative datasets. PLoS One 2024; 19:e0301542. [PMID: 38635815 PMCID: PMC11025891 DOI: 10.1371/journal.pone.0301542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Antenatal care (ANC) is one of the recommended interventions to reduce stillbirth, maternal, neonatal, and child mortality through early identification and management of pregnancy complications or pre-existing conditions. Although increasing number of ANC is a key priority of the 2016 WHO recommendations, ANC uptake in Low and Middle Income Countries (LMICs) is insufficient. Therefore, this study aimed to investigate factors associated with the number of ANC contacts in LMICs. METHODS Data for the study were drawn from 59 recent Demographic and Health Surveys (DHS) conducted in LMICS. We included a total sample of 520,377 mothers who gave birth in the five years preceding the survey. A multilevel negative binomial regression model was applied to identify factors that may affect number of ANC. Adjusted incidence rate ratios (AIRR) with 95% Confidence Interval (CI) were reported to show association. RESULTS This study found that mothers and their partner with higher educational attainment, mothers aged >35 years, mothers who had decision making autonomy, mothers from female headed household, mothers from richer and richest household, mothers exposed to media, and residing in urban areas had significantly more ANC contacts. However, number of ANC contacts were significantly lower among mothers who initiated ANC after 12 weeks of gestation and perceived healthcare access to be a big problem. CONCLUSION Our results suggest that individual, household, and community-level factors were associated with number of ANC contacts among pregnant mothers in LMICs. Hence, local and international policymakers, and programmers should focus on improving community awareness about maternal health care services through mass media and outreach programs with especial emphasis on women's and their partners educational attainment, rural mothers, women's empowerment, and household socioeconomic status.
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Affiliation(s)
- Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, Australia
| | - Biresaw Ayen Tegegne
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Rediet Eristu Teklu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaw Amare Baykeda
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- School of Public Health, The University of Queensland, Brisbane, Australia
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Lateef MA, Kuupiel D, Mchunu GG, Pillay JD. Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:440. [PMID: 38673351 PMCID: PMC11050659 DOI: 10.3390/ijerph21040440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Daily, the number of women who die around the world reaches an average of 800; these deaths are a result of obstetric complications in pregnancy and childbirth, and 99% of these deaths occur in low- and middle-income countries. This review probes the use of antenatal care (ANC) and skilled birth delivery (SBD) services in sub-Saharan Africa (SSA) and highlights research gaps using Arksey and O'Malley's methodological approach. The screening of abstracts and full text was carried out by two independent authors who ensured the eligibility of data extraction from the included articles. An exploration of the data was undertaken with descriptive analyses. In total, 350 potentially eligible articles were screened, and 137 studies were included for data extraction and analysis. From the 137 included studies, the majority were from Ethiopia (n = 40, 29.2%), followed by Nigeria (n = 30, 21.9%). Most of the studies were published between 2019 and 2023 (n = 84, 61%). Significant trends and challenges with ANC and SBD services emerged from the studies. It is revealed that there are wide gaps in the utilization of ANC and SBD services. Policy attention, intervention strategies to improve access, resources, rural-urban disparity, and women's literacy are recommended to improve the utilization of ANC and SBD services in SSA countries.
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Affiliation(s)
- Monsurat A. Lateef
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
| | - Desmond Kuupiel
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
- Discipline of Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban 4001, South Africa
| | - Gugu G. Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
| | - Julian D. Pillay
- Faculty of Health Sciences, Durban University of Technology, Durban 4001, South Africa; (D.K.); (G.G.M.); (J.D.P.)
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Islam MA, Nahar MT, Siddiquee T, Toma AS, Hoque F, Hossain MZ. Prevalence and determinants of utilizing skilled birth attendance during home delivery of pregnant women in India: Evidence from the Indian Demographic and Health Survey 2015-16. PLoS One 2024; 19:e0295389. [PMID: 38452023 PMCID: PMC10919655 DOI: 10.1371/journal.pone.0295389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 11/21/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Utilization of skilled birth attendance during home delivery of pregnant women is proven to reduce complications during and after childbirth. Though the utilization of skilled birth attendance (SBA) during home delivery has increased significantly in recent times, the rate of utilizing skilled birth attendance is still low in several regions across India. The objective of this study is to analyze the prevalence and to identify the determinants of the utilization of skilled birth attendance during home delivery of pregnant women in India. METHODS To conduct this study, data and information from the Indian Demographic and Health Survey 2015-16 have been utilized. The sample size for this study is a weighted sample of 41,171 women. The sample consisted of women who had given a live birth in the three years preceding the survey. For women with more than one child, only the first live birth was considered. The binary logistic regression model and the log-binary logistic regression analysis have been applied as the adjusted odds ratios (AORs) with 95% confidence intervals for identifying the determinants of home-based skilled birth attendance during delivery. That allows us to select the most appropriate model for our study objective by ensuring that the determinants of skilled birth attendance for home delivery are accurately assessed based on the characteristics of the data. RESULTS The analyses show that only 18.8% of women had utilized skilled birth attendance during delivery. Women residing in urban areas are more likely to utilize skilled birth attendance during home delivery (AOR: 1.14; 95% CI: 1.08-1.20). Women having higher education levels are associated with increased use of SBA during home delivery (AOR: 1.15; 95% CI: 1.04-1.28). Exposure to media is associated with increased utilization of SBA (AOR: 1.17; 95% CI: 1.11-1.23). Overweight women are also more likely to avail the SBA during home delivery (AOR: 1.11; 95% CI: 1.03-1.19). Women belonging to affluent households have higher odds of utilizing skilled birth attendance (AOR: 1.41; 95% CI: 1.33-1.49). Having 3+ tetanus injections is associated with the utilization of SBA (AOR: 1.56; 95% CI: 1.43-1.69). Women having 4+ antenatal care visits were more likely to utilize SBA (AOR: 1.81; 95% CI: 1.71-1.92). Women belonging to the Hindu religion were 1.12 times more likely to utilize SBA (AOR: 1.12; 95% CI: 1.07-1.18). Women with 1 to 3 birth orders were 1.40 times more likely to utilize skilled birth attendance during home delivery (AOR: 1.40; 95% CI: 1.30-1.51). CONCLUSION The percentage of women utilizing skilled birth attendance during home delivery is still very low which is a matter of serious concern. Several factors have been found to be associated with the utilization of SBA during home delivery in India. As skilled birth attendance has significant positive health outcomes for pregnant women and newborns, efforts to increase the rate of SBA utilization during home delivery should be undertaken.
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Affiliation(s)
- Md. Akhtarul Islam
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Mst. Tanmin Nahar
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Tanjim Siddiquee
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Afrina Sultana Toma
- Statistics Discipline, Science, Engineering & Technology School, Khulna University, Khulna, Bangladesh
| | - Farhana Hoque
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
| | - Md. Zobayer Hossain
- Development Studies Discipline, Social Science School, Khulna University, Khulna, Bangladesh
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Saito A, Kondo M. Continuum of care for maternal and child health and child undernutrition in Angola. BMC Public Health 2024; 24:680. [PMID: 38439029 PMCID: PMC10910721 DOI: 10.1186/s12889-024-18144-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 02/17/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Continuum of care (CoC) for maternal and child health provides opportunities for mothers and children to improve their nutritional status, but many children remain undernourished in Angola. This study aimed to assess the achievement level of CoC and examine the association between the CoC achievement level and child nutritional status. METHODS We used nationally representative data from the Angola 2015-2016 Multiple Indicator and Health Survey. Completion of CoC was defined as achieving at least four antenatal care visits (4 + ANC), delivery with a skilled birth attendant (SBA), child vaccination at birth, child postnatal check within 2 months (PNC), and a series of child vaccinations at 2, 4, 6, 9 and 15 months of child age. We included under 5 years old children who were eligible for child vaccination questionnaires and their mothers. The difference in CoC achievement level among different nutritional status were presented using the Kaplan-Meier method and examined using the Log-Lank test. Additionally, the multivariable logistic regression analysis examined the associations between child nutritional status and CoC achievement levels. RESULTS The prevalence of child stunting, underweight and wasting was 48.3%, 23.2% and 5.9% respectively. The overall CoC completion level was 1.2%. The level of achieving CoC of mother-child pairs was 62.8% for 4 + ANC, 42.2% for SBA, 23.0% for child vaccination at birth, and 6.7% for PNC, and it continued to decline over 15 months. The Log-Lank test showed that there were significant differences in the CoC achievement level between children with no stunting and those with stunting (p < 0.001), those with no underweight and those with underweight (p < 0.001), those with no wasting and those with wasting (p = 0.003), and those with malnutrition and those with a normal nutritional status (p < 0.001). Achieving 4 + ANC (CoC1), 4 + ANC and SBA (CoC 2), and 4 + ANC, SBA, and child vaccination at birth (CoC 3) were associated with reduction in child stunting and underweight. CONCLUSIONS The completion of CoC is low in Angola and many children miss their opportunity of nutritional intervention. According to our result, improving care utilization and its continuity could improve child nutritional status.
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Affiliation(s)
- Akiko Saito
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058577, Japan.
| | - Masahide Kondo
- Department of Health Care Policy and Health Economics, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058577, Japan
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Armah-Ansah EK, Bawa B, Dindas J, Budu E, Ahinkorah BO, Ameyaw EK. A multilevel analysis of social determinants of skilled birth attendant utilisation among married and cohabiting women of Madagascar. Int Health 2023:ihad108. [PMID: 38011796 DOI: 10.1093/inthealth/ihad108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/30/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Maternal mortality ratio (MMR) in Madagascar is 392 deaths per 100 000 live births, and this is a major public health concern. One of the strategies for reducing MMR and achieving target 3.1 of the Sustainable Development Goals (i.e. reducing the global MMR below 70 per 100 000 live births) is the utilisation of skilled birth attendants (SBAs). This analysis examined the prevalence and social determinants of SBA utilisation among married and cohabiting women of Madagascar. METHODS Data from the 2021 Madagascar Demographic and Health Surveys was analysed on a weighted sample of 6997 married and cohabiting women. A multilevel regression was carried out to determine the social determinants of utilising SBAs. The results are presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and a p-value <0.05 to determine the significant associations. RESULTS The prevalence of SBAs among married and cohabiting women of Madagascar was 64.4% (95% CI 0.62 to 0.68). In model 3 of the multilevel regression, women 35-39 y of age (adjusted OR [aOR] 1.86 [95% CI 1.30 to 2.60]), women with secondary/higher education (aOR 1.67 [95% CI 1.32 to 2.10]), women whose partners had secondary/higher education (aOR 1.58 [95% CI 1.25 to 1.99]), cohabiting women (aOR 1.33 [95% CI 1.07 to 1.65]), women who had four or more antenatal care visits (aOR 2.05 [95% CI 1.79 to 2.35]), female household head (aOR 1.44 [95% CI 1.06 to 1.95]), Muslims (aOR 1.58 [95% CI 0.71 to 3.53]), those of the richest wealth index (aOR 4.32 [95% CI 2.93 to 6.36]) and women who lived in communities with high literacy levels (aOR 2.17 [95% CI 1.57 to 3.00]) had higher odds of utilisation of SBA. CONCLUSION This current analysis revealed low SBA utilisation among married and cohabiting women in Madagascar. The analysis points to the fact that understaffing and inaccessibility of health facilities remain major contributors to the low utilisation of SBAs. The findings call on the government and stakeholders in Madagascar to consider implementing programs that will empower women and focus on disadvantaged groups. These programs could include providing free maternal healthcare services to all pregnant women and intensifying health education programs that target women and their partners with no formal education.
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Affiliation(s)
- Ebenezer Kwesi Armah-Ansah
- Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Population and Development, National Research University, Higher School of Economics, Moscow, Russia
| | | | - John Dindas
- Department of Public Health and Healthcare, I.M. Scehenov First Moscow State Medical University, Moscow, Russia
| | - Eugene Budu
- Korle Bu Teaching Hospital, P.O. Box, 77, Accra, Ghana
| | - Bright Opoku Ahinkorah
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
- L & E Research Consult Limited, Wa, Upper West Region, Ghana
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Moreno-Ávila IDM, Martínez-Linares JM, Mimun-Navarro K, Pozo-Muñoz C. Muslim and Christian Women's Perceptions of the Influence of Spirituality and Religious Beliefs on Motherhood and Child-Rearing: A Phenomenological Study. Healthcare (Basel) 2023; 11:2932. [PMID: 37998424 PMCID: PMC10671127 DOI: 10.3390/healthcare11222932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
(1) Background: Spirituality is a factor that plays a role in decisions related to health and illness. When a woman becomes a mother, she undergoes physical, psychological, and social changes for which healthcare professionals must provide the necessary care. However, women may feel misunderstood and stigmatized when they carry out their religious practices and express their spirituality related to motherhood. The aim of this study was to describe the experiences of women with Muslim and Christian religious ideologies on the influence of spirituality and religious beliefs in motherhood and child-rearing. (2) Methods: A descriptive phenomenological qualitative study with two groups of women of Islamic and Christian ideology, respectively. Three focus groups and in-depth interviews were conducted, recorded, transcribed, and analyzed with ATLAS.ti 7.0. An inductive analysis was carried out according to the Moustakas model. (3) Results: Three themes were identified: religious and cultural aspects that determine child-rearing, the influence of spirituality and family on the mother's role, and the support received from healthcare personnel. (4) Conclusions: Spirituality and religious beliefs are manifested during motherhood and child-rearing in the form of infant feeding, the need for their protection, or the need for support from mothers. Healthcare personnel must be able to offer culturally competent and spiritually respectful care. Patients should not be judged based on their spirituality.
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Affiliation(s)
| | | | - Karim Mimun-Navarro
- Servicio Andaluz de Salud, Hospital Universitario Torrecárdenas, 04009 Almería, Spain;
| | - Carmen Pozo-Muñoz
- Departamento de Psicología, Universidad de Almería, 04120 Almería, Spain;
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Tesfay N, Kebede M, Asamene N, Tadesse M, Begna D, Woldeyohannes F. Factors determining antenatal care utilization among mothers of deceased perinates in Ethiopia. Front Med (Lausanne) 2023; 10:1203758. [PMID: 38020089 PMCID: PMC10663362 DOI: 10.3389/fmed.2023.1203758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Receiving adequate antenatal care (ANC) had an integral role in improving maternal and child health outcomes. However, several factors influence the utilization of ANC from the individual level up to the community level factors. Thus, this study aims to investigate factors that determine ANC service utilization among mothers of deceased perinate using the proper count regression model. Method Secondary data analysis was performed on perinatal death surveillance data. A total of 3,814 mothers of deceased perinates were included in this study. Hurdle Poisson regression with a random intercept at both count-and zero-part (MHPR.ERE) model was selected as a best-fitted model. The result of the model was presented in two ways, the first part of the count segment of the model was presented using the incidence rate ratio (IRR), while the zero parts of the model utilized the adjusted odds ratio (AOR). Result This study revealed that 33.0% of mothers of deceased perinates had four ANC visits. Being in advanced maternal age [IRR = 1.03; 95CI: (1.01-1.09)], attending primary level education [IRR = 1.08; 95 CI: (1.02-1.15)], having an advanced education (secondary and above) [IRR = 1.14; 95 CI: (1.07-1.21)] and being resident of a city administration [IRR = 1.17; 95 CI: (1.05-1.31)] were associated with a significantly higher frequency of ANC visits. On the other hand, women with secondary and above education [AOR = 0.37; 95CI: (0.26-0.53)] and women who live in urban areas [AOR = 0.42; 95 CI: (0.33-0.54)] were less likely to have unbooked ANC visit, while women who resided in pastoralist regions [AOR = 2.63; 95 CI: (1.02-6.81)] were more likely to have no ANC visit. Conclusion The uptake of ANC service among mothers having a deceased perinate was determined by both individual (maternal age and educational status) and community (residence and type of region) level factors. Thus, a concerted effort is needed to improve community awareness through various means of communication by targeting younger women. Furthermore, efforts should be intensified to narrow down inequalities observed in ANC service provision due to the residence of the mothers by availing necessary personnel and improving the accessibility of service in rural areas.
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Affiliation(s)
- Neamin Tesfay
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mandefro Kebede
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Negga Asamene
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Muse Tadesse
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dumesa Begna
- Center of Public Emergency Management, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Fitsum Woldeyohannes
- Health Financing Program, Clinton Health Access Initiative, Addis Ababa, Ethiopia
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Mussa I, Makhubela-Nkondo O, Maruta MB, Debella A. Missed Opportunity of Antenatal Care Services Utilization and Associated Factors among Reproductive Age Women in Eastern Hararghe Zone, Eastern Ethiopia: Mixed Methods Study. J Pregnancy 2023; 2023:8465463. [PMID: 37811139 PMCID: PMC10555490 DOI: 10.1155/2023/8465463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 08/30/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Abstract
Background Despite the enormous advantages of early pregnancy-related problem diagnosis and therapy during prenatal care visits, not all pregnant women begin antenatal care at the proper time. Thus, this study aims to identify factors associated with missed opportunities for antenatal care service utilization among reproductive-age women in Eastern Ethiopia. Methods A mixed methods study design (quantitative and qualitative) was conducted in Grawa, Meta, and Haramaya woredas from September 5 to December 5, 2019. The quantitative data were analyzed using SPSS version 25. A multivariable logistic regression analysis model was used to identify the predictors. Statistical software programs based on ATLAS.ti version 8.2 was were used to conduct the thematic analysis of the qualitative data. Results Overall, missed opportunities for antenatal care were 15.4% of 95% (12.1, 19.1%). Factors such as maternal age being 15-24 (AOR = 6.9, 95% CI: 2.89-8.81); having a college education (AOR = 0.02, 95% CI: 0.001, 0.42), elementary (AOR = 0.05, 95% CI: 0.002, 0.98), and secondary education (AOR = 0.04, 95% CI: 0.001, 0.88); having five and more parity (AOR = 0.08, 95% CI: 0.01, 0.75); three visits (AOR = 0.10, 95% CI: 0.02, 0.71); those in the first trimester (AOR = 0.02, 95% CI: 0.001, 0.35) and the second trimester (AOR = 0.01, 95% CI: 0.001, 0.26); and get information from a health facility (AOR =0.09, 95% CI: 0.01, 0.67) and traditional birth attendance (AOR = 0.02, 95% CI: 0.001, 0.74) were factors statistically associated with outcome variables. Conclusions According to this report, relatively high proportions of pregnant women experienced missed opportunities in antenatal care follow-up. Factors such as maternal age, education, parity, frequency, timing, and media access were statistically significantly correlated with missed antenatal care follow-up. Therefore, all stakeholders should emphasize advocating for and enhancing the benefits of antenatal care; this in turn plays a crucial role in increasing the follow-up of clients for these crucial services. Moreover, health policy implementers need to coordinate their tracking of pregnant women who missed their antenatal care session.
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Affiliation(s)
- Ibsa Mussa
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - On Makhubela-Nkondo
- Department of Health Studies, College of Human Sciences, School of Social Sciences, University of South Africa, South Africa
| | - Melat B. Maruta
- Department of Obstetrics and Gynecology, Menelik Specialized Comprehensive Hospital, Addis Ababa, Ethiopia
| | - Adera Debella
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Ayalew HG, Assefa KT, Desalegn SY, Mesele TT, Anteneh TA, Tibebu NS, Liyew AM. Individual and community-level determinants of skilled birth attendant delivery in Ethiopia; multilevel analysis. PLoS One 2023; 18:e0289145. [PMID: 37527239 PMCID: PMC10393148 DOI: 10.1371/journal.pone.0289145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
INTRODUCTION Skilled birth attendant (SBA) delivery is defined as assisting birth by a trained healthcare provider, which is vital for the health of mothers and newborns. Improving maternal health is one of the world health organization's (WHO) key priorities and skilled birth attendant delivery is one of the four pillars of the initiative for safe motherhood to reduce maternal mortality. Therefore, this study aimed to assess the individual and community-level factors associated with SBA delivery in Ethiopia. METHOD A secondary data analysis was conducted using the 2019 Mini Ethiopian demographic and health survey. A total of 5,527 (weighted) live births were included in the analysis. A multi-level logistic regression model was fitted using Stata 14.0 to identify individual and community-level factors associated with SBA delivery. Finally, AOR with 95% CI and random effects were reported. RESULT In this study after fitting a multilevel model, women with poor (AOR = 0.44 95%CI 0.32-0.61) and middle wealth index (AOR = 0.64;95% CI 0.46-0.87), multipara (AOR = 0.39;95% CI 0.28-0.55) and grand multipara (AOR = 0.46;95% CI 0.29-0.72), women from rural areas (AOR = 0.34;95% CI 0.16-0.72) and high community poverty level (AOR = 0.40;95% CI 0.21-0.76) had decreased odds of having SBA delivery. Whereas those who initiated Antenatal care (ANC) visits in the first trimester (AOR = 2.65; 95% CI 1.52-4.65) and second trimester (AOR = 1.87:95%CI 1.09-3.20) had increased odds of having SBA delivery in Ethiopia. CONCLUSION In this study socioeconomic factors like wealth index, parity, the timing of ANC visits, place of residency, and community poverty level were significantly associated with SBA delivery. Therefore, it is better to increase timely ANC initiation particularly for women with low levels of income to improve skilled birth attendant delivery.
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Affiliation(s)
- Hiwotie Getaneh Ayalew
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Kibir Temesgen Assefa
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Selam Yibeltal Desalegn
- Department of Midwifery, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Tiruye Tilahun Mesele
- Department of Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tazeb Alemu Anteneh
- Department of Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nebiyu Solomon Tibebu
- Department of Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Mamuk R, Akbulut Ş, Erdoğan A. Evaluation of the association between fear of COVID-19 and pregnancy distress. Afr Health Sci 2023; 23:59-71. [PMID: 37545897 PMCID: PMC10398489 DOI: 10.4314/ahs.v23i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023] Open
Abstract
Background Mental health problems experienced during pregnancy negatively affect both maternal and fetal wellbeing. Objective This study aimed to investigate the relationship between fear of COVID-19 and pregnancy distress in healthy pregnant women living in Turkey. Methods A descriptive, relational/cross-sectional study was conducted by interviewing 363 pregnant women in person. Data were collected using a personal information form, the Fear of COVID-19 Scale (FCV-19S), and the Tilburg Pregnancy Distress Scale (TPDS). Results The mean FCV-19S score was 19.03±5.65 and the mean TPDS score was 19.97±7.97. According to the TPDS cut-off score, 19.0% of the participants were at risk of pregnancy distress. There was a significant positive correlation between FCV-19S and TPDS scores (r = 0.263, p<0.05). According to the regression analysis, age (β= -0.217), years of education (β= -0.272), and number of births (β= 0.502) were associated with fear of COVID-19, and fear of COVID-19 was associated with TPDS scores (β= 0.369) (p<0.05). Conclusion The pregnant women in this study had moderate fear of COVID-19. Compared to the literature data, the prevalence of pregnancy distress was slightly higher than pre-COVID-19 reports but quite low compared to other studies conducted during the pandemic.
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Affiliation(s)
- Rojjin Mamuk
- Nursing Department, Faculty of Health Sciences, Eastern Mediterranean University. Famagusta, North Cyprus
| | - Şahide Akbulut
- Nursing Department, Faculty of Health Sciences, Batman University, Batman, Turkey
| | - Ayfer Erdoğan
- Nursing Department, Sabahattin Zaim University, Istanbul, Turkey
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Amu H, Aboagye RG, Dowou RK, Kongnyuy EJ, Adoma PO, Memiah P, Tarkang EE, Bain LE. Towards achievement of Sustainable Development Goal 3: multilevel analyses of demographic and health survey data on health insurance coverage and maternal healthcare utilisation in sub-Saharan Africa. Int Health 2023; 15:134-149. [PMID: 35439814 PMCID: PMC9977256 DOI: 10.1093/inthealth/ihac017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 12/28/2021] [Accepted: 03/19/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Improving maternal health and achieving universal health coverage (UHC) are important expectations in the global Sustainable Development Goals (SDGs) agenda. While health insurance has been shown as effective in the utilisation of maternal healthcare, there is a paucity of literature on this relationship in sub-Saharan Africa (SSA). We examined the relationship between health insurance coverage and maternal healthcare utilisation using demographic and health survey data. METHODS This was a cross-sectional study of 195 651 women aged 15-49 y from 28 countries in SSA. We adopted bivariable and multivariable analyses comprising χ2 test and multilevel binary logistic regression in analysing the data. RESULTS The prevalence of maternal healthcare utilisation was 58, 70.6 and 40.7% for antenatal care (ANC), skilled birth attendance (SBA) and postnatal care (PNC), respectively. The prevalence of health insurance coverage was 6.4%. Women covered by health insurance were more likely to utilise ANC (adjusted OR [aOR]=1.48, 95% CI 1.41 to 1.54), SBA (aOR=1.37, 95% CI 1.30 to 1.45) and PNC (aOR=1.42, 95% CI 1.37 to 1.48). CONCLUSION Health insurance coverage was an important predictor of maternal healthcare utilisation in our study. To accelerate progress towards the achievement of SDG 3 targets related to the reduction of maternal mortality and achievement of UHC, countries should adopt interventions to increase maternal insurance coverage, which may lead to higher maternal healthcare access and utilisation during pregnancy.
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Affiliation(s)
- Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Prince Owusu Adoma
- Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, Ghana
| | - Peter Memiah
- Division of Epidemiology and Prevention: Institute of Human Virology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Elvis Enowbeyang Tarkang
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Luchuo Engelbert Bain
- Lincoln International Institute for Rural Health (LIIRH), College of Social Science, University of Lincoln, Lincoln, UK
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Spatial distribution and predictive factors of antenatal care in Burundi: A spatial and multilevel baseline analysis for the third burundian demographic and health survey. PLoS One 2023; 18:e0272897. [PMID: 36649240 PMCID: PMC9844929 DOI: 10.1371/journal.pone.0272897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION The use of antenatal care by pregnant women enables them to receive good pregnancy monitoring. This monitoring includes counseling, health instructions, examinations and tests to avoid pregnancy-related complications or death during childbirth. To avoid these complications, the World Health Organization (WHO) recommends at least four antenatal visits. Therefore, this study was conducted to identify predictive factors of antenatal care (ANC) among women aged 15 to 49 years and its spatial distribution in Burundi. METHODS We used data from the Second Burundi Demographic and Health Survey (DHS). A Spatial analysis of ANC prevalence and Mulitlevel logistic regressions of determinants factors of ANC with a medical doctor were done. The ANC prevalence was mapped by region and by province. In unsampled data points, a cluster based interpolation of ANC prevalence was done using the kernel method with an adaptive window. Predictive factors of ANC were assessed using Mulitlevel logistic regressions. The dependent variable was antenatal care with a medical doctor and the explanatory variables were place of residence, age, education level, religion, marital status of the woman, household wealth index and delivery place of the woman. Data processing and data analysis were done using using Quantum Geographic Information System (QGIS) and R software, version 3. 5. 0. RESULTS The ANC prevalence varied from 0. 0 to 16. 2% with a median of 0. 5%. A highest predicted ANC prevalence was observed at Muyinga and Kirundo provinces' junction. Low prevalence was observed in several locations in all regions and provinces. The woman's education level and delivery place were significantly associated with antenatal care with a medical doctor. CONCLUSION Globally, the ANC prevalence is low in Burundi. It varies across the country. There is an intra-regional or intra-provincial heterogeneity in term of ANC prevalence. Woman's education level and delivery place are significantly associated antenatal care. There is a need to consider these ANC disparities and factors in the design and strengthening of existing interventions aimed at increasing ANC visits.
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Aboagye RG, Seidu AA, Ahinkorah BO, Cadri A, Frimpong JB, Hagan JE, Kassaw NA, Yaya S. Association between frequency of mass media exposure and maternal health care service utilization among women in sub-Saharan Africa: Implications for tailored health communication and education. PLoS One 2022; 17:e0275202. [PMID: 36174071 PMCID: PMC9522280 DOI: 10.1371/journal.pone.0275202] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 09/12/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Awareness creation through mass media has the potential to promoted positive behaviors and discourage negative health-related behaviors through direct and indirect pathways. In this study, we examined the association between exposure to mass media and maternal health care services utilization among women in sub-Saharan Africa. METHODS We used data from the recent Demographic and Health Surveys (DHS) conducted between 2010 and 2020. A total of 28 countries with a survey dataset within 2010-2020 were included in our study. We included 199,146 women who had ever had a pregnancy in the last five years preceding the survey. Weighting was applied. Multilevel mixed-effect models were considered to account for cluster-level variations and correct inferences. Fixed and random effects estimates were reported. Adjusted odds ratio (aOR) with their 95% confidence intervals (CIs) were used to present the results. Also, we presented the random intercept variations, intraclass correlation coefficient, and model fitness. RESULTS Women who listened to radio at least once every week (aOR = 1.11, 95% CI = 1.07,1.15) were more likely to attend ANC as against those who did not listen to radio at all. Also, women who watched television at least once a week (aOR = 1.39, 95% CI = 1.33,1.46) were more likely to attend ANC compared to those who did not watch television at all. Women who read newspaper/magazine at least once a week (aOR = 1.27, 95% CI = 1.14,1.41); listened to radio at least once a week (aOR = 1.12, 95% CI = 1.07,1.17); and watched television at least once a week (aOR = 1.32, 95% CI = 1.24,1.40), were more likely to utilize SBA than those who did not read newspaper/magazine; listen to radio; and watch television at all. Women who read newspaper/magazine at least once a week (aOR = 1.35, 95% CI = 1.27,1.45); listened to radio at least once a week (aOR = 1.37, 95% CI = 1.32,1.42); and watched television at least once a week (aOR = 1.39, 95% CI = 1.32,1.47) were more likely to utilize PNC compared to those who did not. CONCLUSIONS The study identified a strong positive relationship between mass media exposure and maternal health care services utilization. Specifically, exposure to radio and television were positively associated with ANC visitations. Moreover, exposure to mass media (newspaper/magazine, radio and television) were positively associated with SBA and PNC utilization. Policymakers and other non-governmental organizations should continuously invest resources in the design and implementation of maternal health service utilization educational programs through all the mass media channels to scale up women's maternal health service services utilization uptake in sub-Saharan Africa.
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Affiliation(s)
- Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Abdul-Aziz Seidu
- Department of Estate Management, Takoradi Technical University, Takoradi, Ghana
- Centre for Gender and Advocacy, Takoradi Technical University, Takoradi, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul Cadri
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Social and Behavioural Science, School of Public Health, University of Ghana, Legon, Accra, Ghana
| | - James Boadu Frimpong
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Faculty of Psychology and Sport Sciences, Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
| | | | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada
- The George Institute for Global Health, Imperial College London, London, United Kingdom
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Ohaja M, Senkyire EK, Ewetan O, Asiedua E, Azuh D. A narrative literature review on media and maternal health in Africa. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Magdalena Ohaja
- School of Nursing and Midwifery National University of Ireland Galway Ireland
| | | | - Olabanji Ewetan
- Department of Economics and Development Studies Covenant University Ota Ogun State Nigeria
| | | | - Dominic Azuh
- Department of Demography and Social Statistics Covenant University Ota Ogun State Nigeria
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Bain LE, Aboagye RG, Dowou RK, Kongnyuy EJ, Memiah P, Amu H. Prevalence and determinants of maternal healthcare utilisation among young women in sub-Saharan Africa: cross-sectional analyses of demographic and health survey data. BMC Public Health 2022; 22:647. [PMID: 35379198 PMCID: PMC8981812 DOI: 10.1186/s12889-022-13037-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 03/21/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Maternal health constitutes high priority agenda for governments across the world. Despite efforts by various governments in sub-Saharan Africa (SSA), the sub-region still records very high maternal mortality cases. Meanwhile, adequate utilization of maternal healthcare (antenatal care [ANC], skilled birth attendance [SBA], and Postnatal care [PNC]) plays a vital role in achieving improved maternal health outcomes. We examined the prevalence and determinants of maternal healthcare utilization among young women in 28 sub-Saharan African countries using data from demographic and health surveys. METHODS This was a cross-sectional study of 43,786 young women aged 15-24 years from the most recent demographic and health surveys of 28 sub-Saharan African countries. We adopted a multilevel logistic regression analysis in examining the determinats of ANC, SBA, and PNC respectively. The results are presented as adjusted Odds Ratios (aOR) for the logistic regression analysis. Statistical significance was set at p < 0.05. RESULTS The prevalence of maternal healthcare utilisation among young women in SSA was 55.2%, 78.8%, and 40% for ANC, SBA, and PNC respectively with inter-country variations. The probability of utilising maternal healthcare increased with wealth status. Young women who were in the richest wealth quintile were, for instance, 2.03, 5.80, and 1.24 times respectively more likely to utilise ANC (95% CI = 1.80-2.29), SBA (95% CI = 4.67-7.20), and PNC (95% CI = 1.08-1.43) than young women in the poorest wealth quintile. Young women who indicated having a barrier to healthcare utilisation were, however, less likely to utilise maternal healthcare (ANC: aOR = 0.83, 95% CI = 0.78-0.88; SBA: aOR = 0.82, 95% CI = 0.75-0.88; PNC: aOR = 0.88, 95% CI = 0.83-0.94). CONCLUSION While SBA utilisation was high, we found ANC and PNC utilisation to be quite low among young women in SSA with inter-country variations. To accelerate progress towards the attainment of the Sustainable Development Goal (SDG) targets on reducing maternal mortality and achieving universal health coverage, our study recommends the adoption of interventions which have proven effective in some countries, by countries which recorded low maternal healthcare utilisation. The interventions include the implementation of free delivery services, training and integration of TBAs into orthodox maternal healthcare, improved accessibility of facilities, and consistent public health education. These interventions could particularly focus on young women in the lowest wealth quintile, those who experience barriers to maternal healthcare utilisation, uneducated women, and young women from rural areas.
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Affiliation(s)
- Luchuo Engelbert Bain
- College of Social Science, Lincoln International Institute for Rural Health (LIIRH), University of Lincoln, Lincoln, UK
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kokou Dowou
- Department of Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Peter Memiah
- Division of Epidemiology and Prevention: Institute of Human Virology, University of Maryland School of Medicine, Baltimore Maryland, USA
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Sserwanja Q, Mufumba I, Kamara K, Musaba MW. Rural-urban correlates of skilled birth attendance utilisation in Sierra Leone: evidence from the 2019 Sierra Leone Demographic Health Survey. BMJ Open 2022; 12:e056825. [PMID: 35351721 PMCID: PMC8961150 DOI: 10.1136/bmjopen-2021-056825] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Understanding the rural-urban context-specific correlates of skilled birth attendance (SBA) is important to designing relevant strategies and programmes. This analysis aimed to assess for the rural-urban correlates of SBA in Sierra Leone. SETTING The latest nationally representative Sierra Leone Demographic and Health Survey of 2019. PARTICIPANTS The study included a weighted sample of 7326 women aged 15-49 years. Each of them had a live birth within 5 years prior to the survey (4531 in rural areas and 2795 women in urban areas). PRIMARY AND SECONDARY OUTCOME MEASURE SBA (primary) and predictors of SBA (secondary). RESULTS SBA was higher in urban areas at 94.9% (95% CI 94.1% to 95.7%) compared with 84.2% (95% CI 83.8% to 85.9%) in rural areas. Rural women resident in the Southern, Northern and Eastern regions, with postprimary education (adjusted OR (aOR) 1.8; 95% CI 1.3 to 2.5), exposure to mass media (aOR 1.5; 95% CI 1.1 to 1.9), not having difficulties with distance to the nearest health facility (aOR 2.3; 95% CI 1.7 to 3.0) were associated with higher odds of SBA. Urban women resident in the Southern, Eastern region, with households having less than seven members (aOR 1.5; 95% CI 1.1 to 2.3), exposure to mass media (aOR 1.8; 95% CI 1.1 to 2.9) and not having difficulties with distance to the nearest health facility (aOR 1.6; 95% CI 1.1 to 2.5) were associated with higher odds of SBA. CONCLUSION Given the observed differences, improving SBA requires programmes and strategies that are context-specific.
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Affiliation(s)
| | - Ivan Mufumba
- Clinical Epidemiology Unit, Makerere University, Kampala, Uganda
- CHILD Research Laboratory, Global Health Uganda, Kampala, Uganda
| | - Kassim Kamara
- National Disease Surveillance Programme, Sierra Leone Ministry of Health and Sanitation, Freetown, Western Area, Sierra Leone
| | - Milton W Musaba
- Obstetrics and Gynaecology, Busitema University, Mbale, Uganda
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Bain LE, Aboagye RG, Malunga G, Amu H, Dowou RK, Saah FI, Kongnyuy EJ. Individual and contextual factors associated with maternal healthcare utilisation in Mali: a cross-sectional study using Demographic and Health Survey data. BMJ Open 2022; 12:e057681. [PMID: 35193922 PMCID: PMC8867328 DOI: 10.1136/bmjopen-2021-057681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We examined the national prevalence as well as the individual and contextual factors associated with maternal healthcare utilisation in Mali. SETTING The study was conducted in Mali. PARTICIPANTS We analysed data on 6335 women aged 15-49 years from Mali's 2018 Demographic and Health Survey. OUTCOME VARIABLE Maternal healthcare utilisation comprising antenatal care (ANC) attendant, skilled birth attendant (SBA), and postnatal care (PNC) attendant, was our outcome variable. RESULTS Prevalence of maternal healthcare utilisation was 45.6% for ANC4+, 74.7% for SBA and 25.5% for PNC. At the individual level, ANC4 + and SBA utilisation increased with increasing maternal age, level of formal education and wealth status. Higher odds of ANC4 + was found among women who are cohabiting (adjusted OR (aOR)=2.25, 95% CI 1.16 to 4.37) and delivered by caesarean section (aOR=2.53, 95% CI 1.72 to 3.73), while women who considered getting money for treatment (aOR=0.72, 95% CI 0.60 to 0.88) and distance to health facility (aOR=0.73, 95% CI 0.59 to 0.90) as a big problem had lower odds. Odds to use PNC was higher for those who were working (aOR=1.22, 95% CI 1.01 to 1.48) and those covered by health insurance (aOR=1.87, 95% CI 1.36 to 2.57). Lower odds of SBA use were associated with having two (aOR=0.48, 95% CI 0.33 to 0.71), three (aOR=0.37, 95% CI 0.24 to 0.58), and four or more (aOR=0.38, 95% CI 0.24 to 0.59) children, and residing in a rural area (aOR=0.35, 95% CI 0.17 to 1.69). Listening to the radio and watching TV were associated with increased maternal healthcare utilisation. CONCLUSION The government should increase availability, affordability and accessibility to healthcare facilities by investing in health infrastructure and workforce to achieve Sustainable Development Goal 3.4 of reducing maternal morality to less than 70 deaths per 100 000 live births by 2030. It is important to ascertain empirically why PNC levels are astonishingly lower relative to ANC and SBA.
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Affiliation(s)
- Luchuo Engelbert Bain
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, Lincolnshire, UK
- Global South Health Research and Services, Amsterdam, The Netherlands
| | - Richard Gyan Aboagye
- Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Hubert Amu
- Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kokou Dowou
- Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Farrukh Ishaque Saah
- Global South Health Research and Services, Amsterdam, The Netherlands
- Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Imo CK. Influence of women's decision-making autonomy on antenatal care utilisation and institutional delivery services in Nigeria: evidence from the Nigeria Demographic and Health Survey 2018. BMC Pregnancy Childbirth 2022; 22:141. [PMID: 35193504 PMCID: PMC8861477 DOI: 10.1186/s12884-022-04478-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 02/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In the context of global health priority, understanding the role of power dynamics among women as an important intervention required towards achieving optimum maternal and child health outcomes is crucial. This study examined the influence of women's decision-making autonomy on antenatal care utilisation and institutional delivery services in Nigeria. METHODS The data for the study were derived from the 2018 Nigeria Demographic and Health Survey and comprised a weighted sample of 20,100 births in the last five years that preceded the survey among married/cohabiting childbearing women. Descriptive and analytical analyses were carried out, including frequency tables and multivariate using the binary logistic regression model. RESULTS The study revealed that despite a large number of women initiating antenatal care visits before 12 weeks of pregnancy (75.9%), far fewer numbers had at least eight antenatal care visits (24.2%) and delivered in a health facility (58.2%). It was established that the likelihood of having at least eight antenatal care visits was significantly increased among women who enjoyed decision-making autonomy on their healthcare (aOR: 1.24, CI: 1.02-1.51) and how their earnings are spent (aOR: 2.02, CI: 1.64-2.48). Surprisingly, women's decision-making autonomy on how their earnings are spent significantly reduced the odds of initiating antenatal care visits early (aOR: 0.75, CI: 0.63-0.89). Some socio-economic and demographic factors were observed to have a positive influence on quality antenatal care utilisation and delivery in a health facility. CONCLUSION In conclusion, women's decision-making autonomy on their healthcare and how their earnings are spent was significantly found to be protective factors to having eight antenatal care visits during pregnancy. Conversely, women's autonomy on how their earnings are spent significantly hindered their initiation of early antenatal care visits. There is a need for more pragmatic efforts through enlightenment and empowerment programmes of women to achieve universal access to quality maternal healthcare services in Nigeria.
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Affiliation(s)
- Chukwuechefulam Kingsley Imo
- Department of Sociology, Faculty of the Social Sciences, Adekunle Ajasin University, P. M. B. 001, Akoko-Akungba, Ondo State, Nigeria.
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Seidu AA, Aboagye RG, Sakyi B, Adu C, Ameyaw EK, Affum JB, Ahinkorah BO. Female genital mutilation and skilled birth attendance among women in sub-Saharan Africa. BMC Womens Health 2022; 22:26. [PMID: 35094712 PMCID: PMC8802442 DOI: 10.1186/s12905-021-01578-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 12/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background There is evidence that women who have had their genitals cut suffer substantial difficulties during and/or after childbirth, including the need for a caesarean section, an episiotomy, an extended hospital stay, post-partum bleeding, and maternal fatalities. Whether or not women in sub-Saharan Africa who have undergone female genital mutilation utilize the services of skilled birth attendants during childbirth is unknown. Hence, we examined the association between female genital mutilation and skilled birth attendance in sub-Saharan Africa. Methods The data for this study were compiled from 10 sub-Saharan African countries’ most recent Demographic and Health Surveys. In the end, we looked at 57,994 women between the ages of 15 and 49. The association between female genital mutilation and skilled birth attendance was investigated using both fixed and random effects models. Results Female genital mutilation and skilled birth attendance were found to be prevalent in 68.8% and 58.5% of women in sub-Saharan Africa, respectively. Women with a history of female genital mutilation had reduced odds of using skilled birth attendance (aOR = 0.91, 95% CI = 0.86–0.96) than those who had not been circumcised. In Ethiopia, Guinea, Liberia, Kenya, Nigeria, Senegal, and Togo, women with female genital mutilation had reduced odds of having a trained delivery attendant compared to women in Burkina Faso. Conclusion This study shed light on the link between female genital mutilation and skilled birth attendance among sub-Saharan African women. The study's findings provide relevant information to government agencies dealing with gender, children, and social protection, allowing them to design specific interventions to prevent female genital mutilation, which is linked to non-use of skilled birth attendance. Also, health education which focuses on childbearing women and their partners are necessary in enhancing awareness about the significance of skilled birth attendance and the health consequences of female genital mutilation.
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Affiliation(s)
- Abdul-Aziz Seidu
- Centre for Gender and Advocacy, Takoradi Technical University, P.O. Box 256, Takoradi, Ghana. .,Department of Estate Management, Takoradi Technical University, P.O. Box 256, Takoradi, Ghana. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD, 4811, Australia.
| | - Richard Gyan Aboagye
- Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Barbara Sakyi
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | | | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Duodu PA, Bayuo J, Mensah JA, Aduse-Poku L, Arthur-Holmes F, Dzomeku VM, Dey NEY, Agbadi P, Nutor JJ. Trends in antenatal care visits and associated factors in Ghana from 2006 to 2018. BMC Pregnancy Childbirth 2022; 22:59. [PMID: 35062909 PMCID: PMC8783507 DOI: 10.1186/s12884-022-04404-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 01/12/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction Given that maternal mortality is a major global health concern, multiple measures including antenatal care visits have been promoted by the global community. However, most pregnant women in Ghana and other sub-Saharan African countries do not attain the recommended timelines, in addition to a slower progress towards meeting the required minimum of eight visits stipulated by the World Health Organization. Therefore, this study explored the trends in antenatal care visits and the associated factors in Ghana from 2006 to 2018 using the Multiple Indicator Cluster Surveys. Methods The study used women datasets (N = 7795) aged 15 to 49 years from three waves (2006, 2011, and 2017-2018) of the Ghana Multiple Indicator Cluster Surveys (GMICS). STATA version 14 was used for data analyses. Univariable analyses, bivariable analyses with chi-square test of independence, and multivariable analyses with robust multinomial logistic regression models were fitted. Results The study found a consistent increase in the proportion of women having adequate and optimal antenatal attendance from 2006 to 2018 across the women’s sociodemographic segments. For instance, the proportion of mothers achieving adequate antenatal care (4 to 7 antenatal care visits) increased from 49.3% in 2006 to 49.98% in 2011 to 58.61% in 2017-2018. In the multivariable model, women with upward attainment of formal education, health insurance coverage, increasing household wealth, and residing in the Upper East Region were consistently associated with a higher likelihood of adequate and/or optimal antenatal care attendance from 2006 to 2018. Conclusion Women who are less likely to achieve optimal antenatal care visits should be targeted by policies towards reducing maternal mortalities and other birth complications. Poverty-reduction policies, promoting maternal and girl-child education, improving general livelihood in rural settings, expanding health insurance coverage and infrastructural access, harnessing community-level structures, and innovative measures such as telehealth and telemedicine are required to increase antenatal care utilization. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04404-9.
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Samuel O, Zewotir T, North D. Decomposing the urban-rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa. Reprod Health 2021; 18:216. [PMID: 34717668 PMCID: PMC8557532 DOI: 10.1186/s12978-021-01268-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/19/2021] [Indexed: 11/25/2022] Open
Abstract
Background There has been a substantial improvement in reducing maternal mortality in the Sub-Saharan African region. The vast rural-urban gap in maternal health outcomes, however, is obscured by this average achievement. This study attempts to measure the contribution of identified risk factors to describe the average rural-urban difference in the use of antenatal care, health facilities for delivery, and health professional assistance at delivery. Method To achieve this objective, we used descriptive analysis and Fairlie non-linear decomposition method to quantify covariates’ contribution in explaining the urban–rural difference in maternal healthcare services utilisation. Result The study’s finding shows much difference between urban and rural areas in the use of maternal healthcare services. Socio-economic factors such as household wealth index, exposure to media, and educational level of women and their husbands/partners contributed the most in explaining the gap between urban and rural areas in healthcare services utilisation. Conclusions Interventions to bridge the gap between urban and rural areas in maternal healthcare services utilisation in Sub-Saharan Africa should be centred towards socio-economic empowerment. Government can enforce targeted awareness campaigns to encourage women in rural communities in Sub-Sharan Africa to take the opportunity and use the available maternal health care services to be at par with their counterparts in urban areas. Maternal health refers to the health of women throughout pregnancy, delivery, and the postnatal period. Each step should be a good experience that ensures mothers, and their infants realize their maximum health and well-being potential. In this study, we used individual, demographic, and socio-economic characteristics to measure the urban–rural discrepancies in maternal health care services in Sub-Saharan Africa. We used Information of 220 164 women of child-bearing age (15–49) gathered from National Demographic Health Surveys from 27 countries in the Sub-Sahara African region. We found 46.1% of women in rural areas had no education, 39.7% of the women in rural areas have husbands/partners with no education, and 60.1% of the women in rural areas are from households with poor wealth indexes. The use of maternal health care services found to be predominant in the urban areas than rural areas, and the measure of this difference can inform policymakers on the level of effort that needed to be put in place to balance the discrepancies and improve maternal health in general.
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Affiliation(s)
- Oduse Samuel
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, 4001, South Africa.
| | - Temesgen Zewotir
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, 4001, South Africa
| | - Delia North
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, 4001, South Africa
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Budu E, Seidu AA, Agbaglo E, Armah-Ansah EK, Dickson KS, Hormenu T, Hagan JE, Adu C, Ahinkorah BO. Maternal healthcare utilization and full immunization coverage among 12-23 months children in Benin: a cross sectional study using population-based data. ACTA ACUST UNITED AC 2021; 79:34. [PMID: 33726859 PMCID: PMC7962345 DOI: 10.1186/s13690-021-00554-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/01/2021] [Indexed: 01/24/2023]
Abstract
Background Maternal and child health are important issues for global health policy, and the past three decades have seen a significant progress in maternal and child healthcare worldwide. Immunization is a critical, efficient, and cost-effective public health intervention for newborns. However, studies on these health-promoting indicators in low-income and middle-income countries, especially in sub-Sahara Africa are sparse. We investigated the association between maternal healthcare utilization and complete vaccination in the Republic of Benin. Methods We analysed data from the 2018 Benin Demographic and Health Survey (BDHS). Specifically, the children’s recode file was used for the study. The outcome variable used was complete vaccination. Number of antenatal care visits, assistance during delivery, and postnatal check-up visits were the key explanatory variables. Bivariate and multilevel logistic regression analyses were carried out. The results were presented as unadjusted odds ratios (uOR) and adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CIs) signifying their level of precision. Statistical significance was declared at p < 0.05. Results The prevalence of full immunization coverage in Benin was 85.4%. The likelihood of full immunization was lower among children whose mothers had no antenatal care visits, compared to those whose mothers had 1–3 visits [aOR = 0.11, 95% CI: 0.08–0.15], those who got assistance from Traditional Birth Attendants/other during delivery, compared to those who had assistance from Skilled Birth Attendants/health professionals [aOR = 0.55, 95% CI: 0.40–0.77], and mothers who had no postnatal care check-up visit, compared to those who had postnatal care check-up < 24 h after delivery [aOR = 0.49, 95% CI: 0.36–0.67]. With the covariates, religion, partner’s level of education, parity, wealth quintile, and place of residence also showed significant associations with full immunization. Conclusion The study has demonstrated strong association between full immunization and antenatal care, skilled attendance at birth, and postnatal care check-up visit. We found that full immunization decreases among women with no antenatal care visits, those who receive assistance from Traditional Birth Attendants during delivery, and those who do not go for postnatal care visits. To help achieve full immunization, it is prudent that the government of Benin collaborates with international organisations such as WHO and UNICEF to provide education to pregnant women on the importance of immunization after delivery. Such education can be embedded in the antenatal care, delivery and postnatal care services offered to pregnant women during pregnancy, delivery, and after delivery. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00554-y.
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Affiliation(s)
- Eugene Budu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana. .,College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia.
| | - Ebenezer Agbaglo
- Department of English, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer Kwesi Armah-Ansah
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Kwamena Sekyi Dickson
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Thomas Hormenu
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana.,Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany
| | - Collins Adu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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