Developing A Community Based Referral And Counter Referral System As A Strategy For Improving Antenatal, Postnatal Care Visits And Health Facility Delivery, Case Of Kisii County, Rural Kenya

Abstract Background Cambodia is a Southeast Asian country and has one the highest rates of maternal and child mortality with inadequate use of maternal healthcare services in the region. The present study aimed to analyse the progress made in terms of using maternal healthcare services since 2000.Methods Two rounds of Demographic and Health Surveys (DHS 2000 and DHS 2014) were used in the study. Sample population consisted 11,961 women aged between 15-49 years. The outcome measures were: Timing of first ANC attendance, adequacy of ANC attendance, place of delivery and postnatal checkup. WHO guidelines were used to set the cut-off/define these measures.Results Findings indicated that the overall prevalence of making the first ANC visit in the first trimester was 64.19% [95%CI=62.22,66.11], and that of having at least four ANC visits was 43.80% [95%CI=41.89,45.73]. Prevalence of health facility delivery was 48.76% [46.62,50.90] and that of postnatal checkup was 71.14% [95%CI=69.21,73.01]. Between 2000 and 2014, the percentage of timely and adequate use of ANC increased by respectively 61.8% and 65.3%, while that of health facility delivery and postnatal care increased by respectively 74.5% and 43.9%. Important demographic, socioeconomic and geographic disparities were observed in the utilization of ANC, health facility delivery and postnatal care services. Urban residency, having better educational status, white collar job, access to electronic media showed positive association, whereas higher parity (having >2 children) and unwanted pregnancy showed negative association with the use of maternal healthcare services. Having at least four ANC visits was associated with significantly increased higher odds of using health facility delivery and postnatal care.Conclusion There has a been a remarkable increase in the prevalence of women who are using the maternal healthcare services since 2000. Although the data are cross-sectional that precludes assuming any causal relationship, the current findings provide important insights regarding the pattern of sociodemographic inequalities in the use of maternal healthcare services in Cambodia.

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Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

10.21203/rs.3.rs-228056/v1 ◽

2021 ◽

Author(s):

Ruth Atuhaire ◽

Robert Wamala ◽

Leonard K Atuhaire

Keyword(s):

Community Health ◽

Health Facility ◽

Postnatal Care ◽

Maternal Education ◽

Health Workers ◽

Media Exposure ◽

Facility Delivery ◽

Health Facility Delivery ◽

Maternal Healthcare ◽

Care Health

Abstract BackgroundMaternal health equality is an ultimate goal for a better world. Early maternal healthcare service utilization is hindered by numerous social and economical barriers, along with widespread inequalities in utilization of existing services. To better understand variations existing in Uganda, we assessed differences in early antenatal care, health facility delivery and early postnatal care among women in selected sub regions. The differences were decomposed into components attributed to variation in women's characteristics and the effects of coefficients.MethodsWe used a sample of 1,521 women of reproductive ages (15-49), who delivered a child five years prior to the 2016 Uganda Demographic and Health Survey. Non-linear Oaxaca’ Blinder Multivariate Decomposition method and STATA 13.0 software were used.ResultsSignificant differences in early ANC, health facility delivery and EPNC among women in Eastern and Western sub regions were attributed to both variation in women’s characteristics and effects of coefficients. Overall gap in early ANC (57.39%), health facility delivery (63.88%) and EPNC (59.06%) was attributed to differences in women's characteristics, whereas differences in effects of coefficients attributed 42.61% variations in early ANC, 36.12% in health facility delivery, and 40.94% in EPNC.Specifically, overall gap in early ANC would reduce if differences in availability of community health workers (31.6%) and media exposure (34.7%) were to disappear. Furthermore, the gap would increase by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth differences respectively. Overall gap in health facility delivery would reduce if differences in community health worker availability (24.6%) and media exposure (37.2%) were to disappear, and increase by 54.9% in the absence of variations in effects of maternal education. The overall gap in EPNC would reduce if differences in maternal education (18.5%) and community health worker availability (17.17%) were to disappear and increase by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth quintile respectively.ConclusionProgress towards equitable maternal health should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.

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Interrelationships between early antenatal care, health facility delivery and early postnatal care among women in Uganda: a structural equation analysis

Global Health Action ◽

10.1080/16549716.2020.1830463 ◽

2020 ◽

Vol 13 (1) ◽

pp. 1830463

Author(s):

Ruth Atuhaire ◽

Leonard K Atuhaire ◽

Robert Wamala ◽

Elizabeth Nansubuga

Keyword(s):

Antenatal Care ◽

Health Facility ◽

Postnatal Care ◽

Structural Equation ◽

Facility Delivery ◽

Health Facility Delivery ◽

Structural Equation Analysis ◽

Equation Analysis ◽

Care Health

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Facility delivery and postnatal care services use among mothers who attended four or more antenatal care visits in Ethiopia: further analysis of the 2016 Demographic and Health Survey

10.1101/347153 ◽

2018 ◽

Author(s):

Gedefaw Abeje Fekadu ◽

Fentie Ambaw Getahun ◽

Seblewongiel Ayenalem Kidanie

Keyword(s):

Antenatal Care ◽

Health Facility ◽

Postnatal Care ◽

Facility Delivery ◽

Health Facility Delivery ◽

Factors Associated ◽

Content Of Care ◽

Care Services ◽

At Home

AbstractIntroductionIn Ethiopia, many mothers who attend the recommended number of antenatal care visits fail to use facility delivery and postnatal care services. This study identifies factors associated with facility delivery and use of postnatal care among mothers who had four or more antenatal care visits, using data from the 2016 Ethiopian Demographic and Health Survey (EDHS).MethodsTo identify factors associated with facility delivery, we studied background and service-related characteristics among 2,415 mothers who attended four or more antenatal care visits for the most recent birth. In analyzing factors associated with postnatal care within 42 days after delivery, the study included 1,055 mothers who attended four or more antenatal care visits and delivered at home. We focused on women who delivered at home because women who deliver at a health facility are more likely also to receive postnatal care as well. A multivariable logistic regression model was fitted for each outcome to find significant associations between facility delivery and use of postnatal care.ResultsFifty-six percent of women who had four or more antenatal care visits delivered at a health facility, while 44% delivered at home. Mothers with secondary or above level of education, urban residents, women in the richest wealth quintile, and women who were working at the time of interview had higher odds of delivering in a health facility. High birth order was associated with a lower likelihood of health facility delivery. Among women who delivered at home, only 8% received postnatal care within 42 days after delivery. Quality of antenatal care as measured by the content of care received during antenatal care visits stood out as an important factor that influences both facility delivery and postnatal care. Among mothers who attended four or more antenatal care visits and delivered at home, the content of care received during ANC visits was the only factor that showed a statistically significant association with receiving postnatal care.ConclusionsThe more antenatal care components a mother receives, the higher her probability of delivering at a health facility and of receiving postnatal care. The health care system needs to increase the quality of antenatal care provided to mothers because receiving more components of antenatal care is associated with increased health facility delivery and postnatal care. Further research is recommended to identify other reasons why many women do not use facility delivery and postnatal care services even after attending four or more antenatal care visits.

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Minimum Acceptable Diet and its Predictors among Children Aged 6-23 Months in Mareka District, Southern Ethiopia: Community Based Cross-Sectional Study

International Journal of Child Health and Nutrition ◽

10.6000/1929-4247.2020.09.04.7 ◽

2020 ◽

Vol 9 (4) ◽

pp. 202-211

Author(s):

Fentaw Wassie Feleke ◽

◽

Getahun Fentaw Mulaw

Keyword(s):

Health Facility ◽

Service Utilization ◽

Media Exposure ◽

Cross Sectional Study ◽

Facility Delivery ◽

Sectional Study ◽

Health Facility Delivery ◽

Community Based ◽

Cross Sectional ◽

Child Age

Background: Optimal infant and young child feeding practices are essential for normal growth, better health, and mental and physical development. Even though there are a lot of nutrition intervention programs in Ethiopia, still suboptimal feeding practices are prevalent. This study was devised to assess a level of minimum acceptable diet (MAD) and predictors among children aged 6-23 months in Mareka District, south Ethiopia. Method: A community-based cross-sectional study was employed on 662 study participants from August 15 to September 15/ 2015. They were selected by a multi-stage sampling technique. Data were collected by interviewer-administered semi-structured questionnaires. Statistical significance was declared at p-value <0.05 at multivariable logistic regression. Result: The study showed that 35.5 % of the children aged 6-23 months met the recommended MAD. Maternal primary and secondary education (AOR: 1.90; 95% CI: 1.15-3.16 and AOR: 2.06, 95% CI: 1.12-3.77), Media exposure (AOR: 2.16; 95% CI: 1.46-3.29), health facility delivery (AOR:2.52; 95% CI: 1.54-4.13), child age of 9-11 and 12-23 months (AOR:2.73; 95% CI: 1.41-5.49 and AOR:2.55; 95% CI: 1.39-4.69) and GMP service utilization (AOR: 4.09; 95% CI: 2.51-6.65) were associated with MAD of children. Conclusion: The level of MAD among children was low. Maternal educational status, media exposure, institutional delivery, child age, and GMP service utilization were associated with MAD. Increasing utilization of GMP service, health facility delivery, maternal education, and media promotion was recommended to increase the level of MAD.

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Higher rates of early initiation of breastfeeding associated with health facility delivery in Nepal

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1121 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

D Dharel ◽

A Bhattarai ◽

Y R Paudel ◽

P Acharya ◽

K Acharya

Keyword(s):

Health Facility ◽

Newborn Care ◽

Facility Delivery ◽

Early Initiation ◽

Health Facility Delivery ◽

Essential Newborn Care ◽

Place Of Delivery ◽

Early Initiation Of Breastfeeding ◽

Nationally Representative ◽

Initiation Of Breastfeeding

Abstract Background Initiation of breastfeeding within one hour from birth is one of the five key essential newborn care messages, implemented along with birth preparedness package since 2008. This study aimed to determine the trend of early initiation of breastfeeding (EIBF) and to assess the effect of health facility delivery on EIBF in Nepal. Methods We analyzed the data from the last four nationally representative Nepal Demographic and Health Surveys (NDHS) conducted in 2001,2006,2011 and 2016. Data on the early initiation of breastfeeding was obtained from the mothers of infants born within 24 months prior to the survey. The explanatory variable was the place of delivery, dichotomized as either the health facility, or home delivery. Survey year had a significant interaction with the place of delivery. Multivariable logistic regression was conducted separately on pooled samples before (NDHS 2001 and 2006) and after (NDHS 2011 and 2016) the program implementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) for EIBF was calculated after adjusting for predetermined covariates. Results The rate of EIBF increased by 26.5% points (from 32.8% in 2001 to 59.3% in 2016) among infants delivered in a health facility, compared to an increase by 17.1% points (from 29.9% to 47.0%) among home born infants. EIBF increased by 32.5% points before, compared to 49.7% points after BPP. Delivery in a health facility was associated with a higher odd of EIBF in later years (AOR2.3, 95% CI 2.0,2.8), but not in earlier years (AOR1.3, 95% CI 0.9,2.0). Delivery by caesarean section, first-born infant, and lack of maternal education were associated with a lower rate of EIBF in both periods. Conclusions Higher EIBF was associated with health facility delivery in Nepal, only after programmatic emphasis on essential newborn care messages. This implies the need for explicit focus on EIBF at birth, particularly when mother is less educated, primiparous or undergoing operative delivery. Key messages The rate of initiation of breastfeeding within an hour from birth is increasing in Nepal, with higher rates in health facility delivery, as shown by the recent four nationally representative surveys. Programmatic focus on essential newborn care messages may have contributed to significant association of higher rates of early initiation of breastfeeding when delivered in health facility.

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Predicting health facility delivery among women in Egypt based on antenatal care

International Journal of Contemporary Mathematical Sciences ◽

10.12988/ijcms.2021.91587 ◽

2021 ◽

Vol 16 (2) ◽

pp. 79-99

Author(s):

H. E. Semary ◽

E. M. Hassneen ◽

R. E. Ibrahim

Keyword(s):

Antenatal Care ◽

Health Facility ◽

Facility Delivery ◽

Health Facility Delivery

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Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

10.21203/rs.2.15849/v3 ◽

2019 ◽

Author(s):

James Orwa ◽

Michaela Mantel ◽

Micheal Mugerwa ◽

Sharon Brownie ◽

Eunice Siaity Pallangyo ◽

...

Keyword(s):

Antenatal Care ◽

Health Facility ◽

Healthcare Services ◽

Facility Delivery ◽

Postpartum Care ◽

Reproductive Age ◽

Antenatal Visit ◽

Health Facility Delivery ◽

Maternal Healthcare ◽

Cross Sectional

Abstract Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services. Keywords: Antenatal care, health facility delivery, postpartum care, Mwanza, Tanzania

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Subnational Variation in Facility-based Childbirth in Nigeria: Evidence from 2013 and 2018 Nigeria Demographic Health Surveys

The Nigerian Journal of Sociology and Anthropology ◽

10.36108/njsa/1202.91.0120 ◽

2021 ◽

Vol 19 (1) ◽

pp. 23-40

Author(s):

Anthony Idowu Ajayi

Keyword(s):

Health Care ◽

Maternal Health ◽

Health Facility ◽

Health Surveys ◽

State Level ◽

Facility Delivery ◽

Maternal Health Care ◽

Health Facilities ◽

Health Facility Delivery ◽

Access To Health

Background Previous studies have not examined the state-level variations in health facility delivery in Nigeria. Because of the decentralised system, state governments have a huge role in decision-making and policy direction for each state. As such, it is important to disaggregate the data at state level to understand patterns and best performing states that can be exemplars for others. We address this gap by examining the sub-national variations in health facility delivery in Nigeria. Methods Data of 37,928 and 40,567 live births in the 2013 and 2018 Nigeria Demographic and Health surveys (NDHS) respectively were analysed in this study. NDHS employs a multistage sampling and is representative of both the country and each of the 36 states and Federal Capital Territory (FCT). We used descriptive statistics to examine the trend in health facility delivery in Nigerian states and presented the results using maps. Also, we used logistic regression analysis to examine progress in expanding access to health facility delivery across Nigerian states. Results The proportion of births delivered in health facilities increased from 35.8% in 2013 to 39.4% in 2018, representing a 3.6% increment. After adjusting for relevant covariates, women were 17% more likely to deliver in health facilities in 2018 than in 2013 surveys. However, progress in expanding access to health facility delivery was uneven across the country. While the odds of delivering in a health facility significantly increased in 13 of the 36 states and FCT, the odds reduced significantly in seven states and no progress was recorded in 17 states. Conclusion There was a slight improvement in access to health facility delivery in Nigeria between 2013 and 2018. However, progress remains uneven across the states with only 13 states recording some progress. Four states stood out, recording over a three-fold relative increase in odds of health facility deliveries. These states implemented maternal health care policies that not only made services free but also improved infrastructure and human resources for health. Thus, providing examples of what works in improving access to maternal health care services for other states to follow.

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