scholarly journals Perinatal mortality and its association with antenatal care visit, maternal tetanus toxoid immunization and partograph utilization in Ethiopia: a meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Melaku Desta ◽  
Tadesse Yirga Akalu ◽  
Yoseph Merkeb Alamneh ◽  
Asmare Talie ◽  
Addisu Alehegn Alemu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Perinatal Mortality ◽  
Tetanus Toxoid ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Previous History ◽  
Major Public Health Problem ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Tetanus Toxoid Immunization

AbstractDespite remarkable progress in the reduction of under-five mortality; perinatal mortality is the major public health problem in Africa. In Ethiopia, the study findings on perinatal mortality and its predictors were inconsistent. Therefore, this systematic review and meta-analysis estimated the pooled perinatal mortality, and its association with antenatal care visit, maternal tetanus toxoid immunization, and partograph monitoring. International databases like PubMed, SCOPUS, Google Scholar and Science Direct were systematically searched. I squared statistics was used to determine the levels of heterogeneity across studies and the pooled estimate was computed using a random-effect model. The meta-analysis showed that a pooled prevalence of perinatal mortality in Ethiopia was 6.00% (95% CI 5.00%, 7.00%). The highest proportion of perinatal mortality was a stillbirth, 5.00% (95% CI 4.00%, 7.00%). Women who had antenatal care visit [OR = 0.20 (95% CI 0.12, 0.34)], maternal tetanus toxoid immunization [OR = 0.43 (95% CI 0.24, 0.77)] and partograph monitoring [POR = 0.22 (95% CI 0.06, 0.76)] reduced the risk of perinatal mortality. Whereas, previous history of perinatal mortality [POR = 7.95 (95% CI 5.59, 11.30)] and abortion history (POR = 2.02 (95% CI 1.18, 3.46)) significantly increased the risk of perinatal mortality. Therefore, antenatal care visit, maternal tetanus toxoid vaccination uptake, and partograph utilization should be an area of improvements to reduce perinatal mortality.

scholarly journals Determinants of Antenatal Care Service Satisfaction among Women in Ethiopia: A systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Kenbon Seyoum
Keyword(s):  
Antenatal Care ◽  
English Language ◽  
Care Service ◽  
Meta Analysis ◽  
Service Satisfaction ◽  
Respectful Maternity Care ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Unplanned Pregnancies

Abstract Background: Antenatal care service satisfaction is a measure of the degree to which a woman seeking care is happy with the antenatal care service provided to her. It is important to increase woman utilization of antenatal care service and to improve maternal health. Thus, the aim of this study is to identify factors that determine antenatal care service satisfaction in Ethiopia.Method: PubMed, Hinari, and Google Scholar were systematically searched for eligible studies. The author also conducted gray literature search (e.g., in Google) and hand searched the reference lists of all included studies. All articles reported in the English language irrespective of their duration of publication were included. The Joanna Briggs Institute's (JBI) critical appraisal tools were used to assess the quality of included articles. The Cochrane Q-statistics and I2 tests were used to assess heterogeneity among included studies. Publication bias was assessed using Egger’s tests. Results: Of the 274 articles identified through systematic search of literatures, 13 studies fulfilling inclusion criteria were included in this meta-analysis. First antenatal care visit (AOR = 0.62 and 95% CI: 0.40, 0.96), women waited <60 min (AOR: 1.87 and 95% CI: 1.40-2.50), women whose privacy was maintained (AOR: 3.91 and 95% CI: 1.97-7.77), women treated respectfully (AOR: 5.07 and 95% CI: 2.34-10.96), and unplanned pregnancies (AOR = 0.28 and 95% CI: 0.10-0.77) were significantly associated with antenatal care service satisfaction.Conclusion: The study assessed determinants of antenatal care service satisfaction in Ethiopia. First antenatal care visit, waiting time (<60 min) to see care provider, maintenance of privacy, respectful treatment, and pregnancy unplanned were found to be determinants of antenatal care service satisfaction. Counselling a woman to comply with minimum required antenatal care visit and compassionate and respectful maternity care will increase maternal satisfaction with antenatal care service.

scholarly journals Individual and community-level determinants of poor tetanus toxoid immunization among pregnant women in Ethiopia using data from 2016 Ethiopian demographic and health survey; multilevel analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Alemneh Mekuriaw Liyew ◽  
Hiwotie Getaneh Ayalew
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tetanus Toxoid ◽  
Logistic Regression Model ◽  
Community Level ◽  
Multilevel Logistic Regression ◽  
Care Visit ◽  
Multilevel Logistic Regression Model ◽  
Tetanus Toxoid Immunization

Abstract Background Tetanus is a vaccine-preventable disease that can occur in all populations, with neonates and pregnant women being at the most risk. Ethiopia has the highest maternal and neonatal tetanus morbidity and mortality rates. Besides, only 49% of mothers get vaccinated with adequate tetanus toxoid in Ethiopia which is below the world health organization recommendation. To date, there is limited evidence on the individual and community level determinants of poor tetanus toxoid (TT) immunization. Therefore, this study aimed to assess individual and community-level factors associated with poor TT immunization coverage in Ethiopia. Method Secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey. A total of 7043 pregnant women were included in the current study. A multilevel logistic regression model was used to identify individual and community level determinants of poor tetanus toxoid immunization. Finally, the adjusted odds ratio with a 95% confidence interval was reported. Results In the multilevel logistic regression model adjustment, having no Antenatal care visit (AOR = 5.64; 95% CI:2.48,7.30) and having one to three antenatal care visit (AOR = 1.50; 95% CI: 1.19–1.82); poor wealth index (AOR = 1.26; 95% CI: 1.03, 1.54); not being exposed to media (AOR = 1.29; 95% CI: 1.10, 1.51); maternal unemployment (AOR = 1.15; 95% CI: 1.10, 1.31); rural residence (AOR = 1.13; 95% CI: 1.08, 1.72); and high community illiteracy (AOR = 1.28; 95% CI: 1.03, 1.58) were associated with higher odds of poor tetanus toxoid immunization. Whereas, iron uptake during pregnancy (AOR = 0.59; 95% CI: 0.51, 0.68), was associated with lower odds of poor tetanus toxoid immunization. Conclusion In this study tetanus toxoid (TT) vaccine utilization was affected by both community and individual-level factors. Therefore, focusing on antenatal care services especially encouraging pregnant women to have at least four visits, consulting women to be exposed to media, improving community literacy and maternal employment will help to minimize TT underutilization.

scholarly journals Tetanus Toxoid Vaccination Coverage and Associated Factors among Childbearing Women in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Moges Mareg
Keyword(s):  
Systematic Review ◽  
Health Facility ◽  
Tetanus Toxoid ◽  
Associated Factors ◽  
Meta Analysis ◽  
Immunization Coverage ◽  
Educational Status ◽  
Maternal Health Service ◽  
Childbearing Women ◽  
Tetanus Toxoid Immunization

Background. Tetanus is a bacterial disease caused by the Clostridium tetani, which is a highly fatal, noncommunicable, and toxin-mediated disease. Globally, maternal and neonatal tetanus is a public health problem due to low maternal tetanus toxoid immunization. Ethiopia has the highest neonatal mortality and morbidity related to tetanus due to low tetanus toxoid immunization and the high number of home deliveries. The main objective of this systematic review and meta-analysis was to estimate the pooled coverage of at least two doses of tetanus toxoid immunization, and the pooled effect sizes of associated factors in Ethiopia. Methods. Primary studies for this review were searched from the PubMed/MEDLINE online, ScienceDirect, Hinari, Google, and Google Scholar databases. Primary articles published from 2010 up to August 30, 2020, were included in this meta-analysis. Data were extracted in Microsoft Excel format and exported to STATA Version 14.0. A random-effects meta-analysis model was used to estimate the pooled coverage of two or more tetanus toxoid immunizations and its associated factors. Heterogeneity was evaluated by the I 2 test. Egger’s weighted regression test was used to assess publication bias. Results. We retrieved 212 records; of these, 199 articles were excluded for reasons. Finally, 14 studies were included in this meta-analysis. The pooled estimate of receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia was 52.2% (95% CI: 42.47-61.93, I 2 = 98.4 % ). Antenatal care ( OR = 7.8 (95% CI: 3.2, 19.2), I 2 = 96.3 % ), media exposure ( OR = 8.3 (95% CI: 2.1, 33.3), I 2 = 98.1 % ), distance from the health facility ( OR = 2.64 (95% CI: 1.1, 6.6), I 2 = 94.1 % ), educational status of women ( OR = 4.7 (95% CI: 2.07, 9.56), I 2 = 94.2 % ), and educational status of husbands ( OR = 2.995 (95% CI: 1.194, 7.512), I 2 = 92.5 % ) were factors significantly associated with receiving at least two doses of tetanus toxoid immunization coverage in Ethiopia. Conclusions. The coverage of tetanus toxoid immunization among childbearing women was low in Ethiopia. Strengthening maternal health service utilization (antinatal care and institutional delivery) to the nearest health facility even in health posts and empowering education for both women and their husbands is recommended to increase tetanus toxoid immunization coverage in Ethiopia.

scholarly journals Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257782
Author(s):  
Jesmin Pervin ◽  
Mahima Venkateswaran ◽  
U. Tin Nu ◽  
Monjur Rahman ◽  
Brian F. O’Donnell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Facility Delivery ◽  
Health Facilities ◽  
Community Level ◽  
Delivery Care ◽  
Multivariate Logistic Regression ◽  
Antenatal Care Visit ◽  
Care Visit

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.

scholarly journals Early antenatal care visit as indicator for health equity monitoring

2018 ◽  
Vol 6 (1) ◽  
pp. e35 ◽  
Author(s):  
Oliver Razum ◽  
Jürgen Breckenkamp ◽  
Theda Borde ◽  
Matthias David ◽  
Kayvan Bozorgmehr
Keyword(s):  
Antenatal Care ◽  
Health Equity ◽  
Antenatal Care Visit ◽  
Care Visit

Utilization and Determinants of Antenatal Care Visits in East African Countries: A Multicountry Analysis of Demographic and Health Surveys

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zemenu Tadesse Tessema ◽  
Amare Minyihun
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Logistic Regression Model ◽  
East African ◽  
African Countries ◽  
Wealth Status ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Planned Pregnancy ◽  
Contraceptive Utilization

Background. The health care a woman receives during pregnancy is important for her survival and baby, both at the time of delivery and shortly after that. In the context of high maternal morbidity and mortality in sub-Saharan Africa, fewer than 80% of pregnant women receive antenatal care visit services. Receiving antenatal care visits at least four times increases the likelihood of receiving effective maternal health interventions through the antenatal period. This study aimed to identify the utilization and determinants of attending at least four visits in 12 East African countries. Methods. The study used the demographic and health survey data from 12 East African countries from 2008 to 2018. The DHS program adopts standardized methods involving uniform questionnaires, manuals, and field procedures to gather information comparable across countries globally. A multivariable logistic regression model was fitted to identify the determinants of completing at least four antenatal care services. With their 95% CI obtained from the adjusted multilevel logistic regression model, the adjusted odds ratio was presented to show the magnitude of the relationship between the independent variable and completing antenatal care visits. Results. The pooled utilization of attending at least four antenatal care visit in the East African region was 52.44% (95% CI: 52.13, 52.74), with the highest attending at least four or more antenatal care visit visits in Zimbabwe (75.72%) and the lowest attending at least four or more antenatal care visit visits in Ethiopia (31.82%). The significant determinants of completing at least four ANC visits were age category (24–34 (AOR = 1.24, 95% CI: 1.18, 1.31) and 35–49 (AOR = 1.42, 95% CI: 1.32, 1.53)); being married women (AOR = 1.11, 95% CI: 1.1.05, 1.16); education levels of primary education (AOR = 1.20, 95% CI: 1.13, 1.27), secondary education (AOR = 1.24, 95% CI: 1.24, 1.47), and higher education (AOR = 1.91, 95% CI: 1.62, 2.14); birth order (2–4 (AOR = 0.75, 95% CI: 0.70, 0.79) and 5+ (AOR = 0.63, 95% CI: 0.58, 0.68)); planned pregnancy (AOR = 0.81, 95% CI: 0.75, 0.86); contraceptive utilization (AOR = 1.36, 95% CI: 1.29, 1.43); wealth status of middle (AOR = 1.11, 95% CI: 1.05, 1.17) and rich (AOR = 1.25, 95% CI: 1.18, 1.32); having no problem accessing health care (AOR = 1.0.95, 95% CI: 0.89, 0.97); and living countries. Conclusions. The coverage of completing the recommended antenatal care visit was low in the region. Age, marital status, mother’s and partner’s education, women’s occupation, birth order, planned pregnancy, contraceptive utilization, wealth status, healthcare accessibility, and living countries were the major determinants of completing recommended antenatal care visits. Therefore, intersectoral collaboration to promote female education and empowerment, improve geographical access to health care, and strengthen implementation of antenatal care policies with active community participation is recommended. In addition, creating a conducive environment in entrepreneurial activities for poor women is needed.

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