scholarly journals Assessing the role of women’s autonomy and acceptability of intimate-partner violence in maternal health-care utilization in 63 low- and middle-income countries

2019 ◽  
Vol 48 (5) ◽  
pp. 1580-1592 ◽  
Author(s):  
Pooja Sripad ◽  
Charlotte E Warren ◽  
Michelle J Hindin ◽  
Mahesh Karra
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Partner Violence ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Maternal Health Care Utilization ◽  
Care Services

Abstract Background Our study investigates the associations between women’s autonomy and attitudes toward the acceptability of intimate-partner violence against women (IPVAW) and maternal health-care utilization outcomes. Methods We combine data from 113 Demographic and Health Surveys conducted between 2003 and 2016, which give us a pooled sample of 765 169 mothers and 777 352 births from 63 countries. We generate composite scores of women’s autonomy (six-point scale with reference: no contribution) and acceptability of IPVAW (five-point scale with reference: no acceptance) and assess the associations between these measures and women’s use of antenatal care services and facility delivery in pooled and unique country samples. Results A change in a woman’s autonomy score from ‘no contribution to any decision-making domain’ (a composite autonomy score of 0) to ‘contribution to all decision-making domains’ (a score of 6) is associated with a 31.2% increase in her odds of delivering in a facility and a 42.4% increase in her odds of receiving at least eight antenatal care visits over the course of her pregnancy. In contrast, a change in a woman’s attitude towards acceptability of IPVAW from ‘IPVAW is not acceptable under any scenario’ (a score of 0) to ‘IPVAW is acceptable in all scenarios’ (a score of 5) is associated with an 8.9% decrease in her odds of delivering in a facility and a 20.3% decrease in her odds of receiving eight antenatal care visits. Conclusions Our findings suggest that strong and significant associations exist between autonomy, acceptability of IPVAW and utilization of maternal health-care services.

scholarly journals Wealth Status, Health Insurance, and Maternal Health Care Utilization in Africa: Evidence from Gabon

2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
N’doh Ashken Sanogo ◽  
Sanni Yaya
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Maternal Health ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Services Utilization ◽  
Maternal Health Care Utilization ◽  
Care Services

Background. To achieve the universal health coverage among other Sustainable Development Goals, African countries have shown the commitment by implementing strategies to improve access and coverage of health care services whose access is still very low. The achievement of universal health care requires the provision and availability of an adequate financing system. This study explored the wealth-related association of compulsory health insurance on maternal health care utilization in Gabon. Methods. The study used the 6th round of Gabon Demographic and Health Surveys (GDHSs)—2012 data to explore three outcome measures of maternal health care utilization extracted on number of antenatal care (ANC) visits during pregnancy, place of birth delivery, and postnatal health care. The dependent variable was women with health insurance coverage against those without. Logistic regression and propensity scoring matching analysed associations of health insurance coverage on women’s utilization of health care. Results. Mean (+/− SD) age of women respondents of reproductive age was 29 years (9.9). The proportion of at least 4 antenatal care visits was 69.2%, facility-based delivery was 84.7%, and postnatal care utilization was 67.9%. The analysis of data showed disparities in maternal health care services utilization. The GDHS showed maternal age, and geographical region was significantly associated with maternal health care service utilization. A high proportion of urban dwellers and Christian women used maternal health care services. According to the wealth index, maternal health services utilization was higher in women from wealthy households compared to lower households wealth index (ANC (Conc. Index = 0.117; p≤0.001), facility-based delivery (Conc. Index = 0.069; p≤0.001), and postnatal care (Conc. Index = 0.075; p≤0.001), respectively). With regard to health care insurance coverage, women with health insurance were more likely to use ANC and facility-based delivery services than those without (concentration indices for ANC and facility-based delivery were statistically significant; ANC: z-stat = 2.69; p=0.007; Conc. Index: 0.125 vs. 0.096 and facility-based delivery: z-stat = 3.38; p=0.001; Conc. Index: 0.076 vs. 0.053, respectively). Conclusion. Women enrollment in health insurance and improved household’s financial status can improve key maternal health services utilization.

MEN IN MATERNAL CARE: EVIDENCE FROM INDIA

2011 ◽  
Vol 44 (2) ◽  
pp. 129-153 ◽  
Author(s):  
APARAJITA CHATTOPADHYAY
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Utilization ◽  
Antenatal Care ◽  
Health Survey ◽  
Male Involvement ◽  
Maternal Health Care ◽  
Gender Violence ◽  
Care Utilization ◽  
Maternal Health Care Utilization

SummaryMen's supportive stance is an essential component for making women's world better. There are growing debates among policymakers and researchers on the role of males in maternal health programmes, which is a big challenge in India where society is male driven. This study aims to look into the variations and determinants of maternal health care utilization in India and in three demographically and socioeconomically disparate states, namely Uttar Pradesh, West Bengal and Maharashtra, by husband's knowledge, attitude, behaviour towards maternal health care and gender violence, using data from the National Family Health Survey III 2005–06 (equivalent to the Demographic and Health Survey in India). Women's antenatal care visits, institutional delivery and freedom in health care decisions are looked into, by applying descriptive statistics and multivariate models. Men's knowledge about pregnancy-related care and a positive gender attitude enhances maternal health care utilization and women's decision-making about their health care, while their presence during antenatal care visits markedly increases the chances of women's delivery in institutions. From a policy perspective, proper dissemination of knowledge about maternal health care among husbands and making the husband's presence obligatory during antenatal care visits will help primary health care units secure better male involvement in maternal health care.

scholarly journals Determinants of Maternal Health Care Utilization in the Era of Free Maternity Services in Busia County, Kenya

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
B. Wafula ◽  
J. Arudo ◽  
M. Kipmerewo
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Utilization ◽  
Health Facility ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Maternal Health Care Utilization ◽  
Care Services ◽  
Maternal Health Care Services

Purpose. The main objective was to establish determinants of maternal health care utilization and specifically to assess the trends of maternal health care utilization and determine the predictors of maternal health care service utilization in the era of free maternity policy in Busia County. Methodology. It was a cross-sectional study design. The study was conducted between February and April 2019. The research targeted mothers within childbearing age of 15-49 years and a sample size of 634 mothers was used. Quantitative data were analyzed using SPSS version 22.0. Descriptive statistics was used to describe results on socio-demographic characteristics while inferential statistics employed bivariate and multivariate logistic regressions to investigate determinants of maternal health care utilization. Odds ratio was used to test the strength of association, and a p-value of ≤ 0.05 considered as statistically significant.  Results. In 2010, FANC increased by 5.6% from 2010 (pre-free maternity period) to 2017 (post-free maternity era). There was also an increase of 2.2% cases of health facility deliveries during pre-free maternity period (2010) and post-free maternity period (2017). Eleven predictors of maternal health care utilization were identified. Among them were respondent being a farmer (OR = 2.6; 95% CI: 1.4-4.8; p = 0.002), the status of the infrastructure of the nearest health facility maternity being good (OR = 3.2; 95% CI: 1.1-9.6; p = 0.03), fare for the public vehicle being USD 0.2 (OR = 3.4; 95% CI: 1.6-7.1; p = 0.001), all maternal health services being available in the nearest health facility (OR = 3.1; 95% CI: 1.8-5.4; p<0.0001), difficulty to attend MCH services due to non-suitability of working days (OR = 2.7; 95% CI: 1.5-4.7; p=0.0008), there being some services that clients pay for (OR = 3.3; 95% CI: 1.5-7.4; p=0.004), services being provided by nurses (midwives) (OR = 2.3; 95% CI: 1.0-4.9; p=0.04) , baby checkup being done within 24 hours by nurses (OR = 18.8; 95% CI: 8.0-44.0; p<0.0001. In conclusion, free maternity care program has led to increased utilization of facility ANC visits and deliveries in the study area. Barriers related to utilization of maternal health care services included unreliable transport especially at night, limited infrastructure and low socio-economic status of the women in the study area. National and county governments need to put in place strategies which will help them to jointly assess, map and plan investments to improve utilization of maternal health care services through prioritizing investments in human resource, infrastructure and commodities based on the anticipated demand for such services. A unique contribution to theory, practice, and policy: The study findings identified key factors that are unique to the mothers in Busia County on predisposing factors, enabling factors and the need characteristics that determine utilization of maternal health care in the era of Free Maternity services in the study area. These results contribute to both maternal health care utilization and policy change that could directly meet the social setting, geographical location and cultural needs of the people of Busia County.

scholarly journals Supply-side barriers to maternal health care utilization at health sub-centers in India

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2675 ◽  
Author(s):  
Aditya Singh
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Utilization ◽  
Service Utilization ◽  
Maternal Health Care ◽  
Rural India ◽  
Care Utilization ◽  
Supply Side ◽  
Maternal Health Care Utilization ◽  
Care Services

IntroductionThere exist several barriers to maternal health service utilization in developingcountries. Most of the previous studies conducted in India have focused on demand-side barriers, while only a few have touched upon supply-side barriers. None of the previous studies in India have investigated the factors that affect maternal health care utilization at health sub-centers (HSCs) in India, despite the fact that these institutions, which are the geographically closest available public health care facilities in rural areas, play a significant role in providing affordable maternal health care. Therefore, this study aims to examine the supply-side determinants of maternal service utilization at HSCs in rural India.Data and MethodsThis study uses health facility data from the nationally representativeDistrict-Level Household Survey, which was administered in 2007–2008 to examine the effect of supply-side variables on the utilization of maternal health care services across HSCs in rural India. Since the dependent variables (the number of antenatal registrations, in-facility deliveries, and postnatal care services) are count variables and exhibit considerable variability, the data were analyzed using negative binomial regression instead of Poisson regression.ResultsThe results show that those HSCs run by a contractual auxiliary nurse midwife (ANM) are likely to offer a lower volume of services when compared to those run by a permanent ANM. The availability of obstetric drugs, weighing scales, and blood pressure equipment is associated with the increased utilization of antenatal and postnatal services. The unavailability of a labor/examination table and bed screen is associated with a reduction in the number of deliveries and postnatal services. The utilization of services is expected to increase if essential facilities, such as water, telephones, toilets, and electricity, are available at the HSCs. Monitoring of ANM’s work by Village Health and Sanitation Committee (VHSC) and providing in-service training to ANM appear to have positive impacts on service utilization. The distance of ANM’s actual residence from the sub-center village where she works is negatively associated with the utilization of delivery and postnatal services. These findings are robust to the inclusion of several demand-side factors.ConclusionTo improve maternal health care utilization at HSCs, the government shouldensure the availability of basic infrastructure, drugs, and equipment at all locations. Monitoring of the ANMs’ work by VHSCs could play an important role in improving health care utilization at the HSCs; therefore, it is important to establish VHSCs in each sub-center village. The relatively low utilization of maternity services in those HSCs that are run solely by contractual ANMs requires further investigation.

scholarly journals Women's autonomy and utilization of maternal health care services in rural Nepal

2018 ◽  
Vol 18 (17) ◽  
pp. 73-80
Author(s):  
Kamala Lamichhane
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Logistic Regression ◽  
Maternal Health ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Care Services ◽  
Maternal Health Care Services

Nepal has one of the highest maternal mortality ratios in South Asia although the situation is improving in recent days. One of the reasons for such a high mortality may be attributed to the under-utilization of modern maternal health services during pregnancy. This study has analyzed the relationship between women’s autonomy and the utilization of maternal health care services in order to explore some possible reasons for the under-utilization of the services. Data from the Nepal demographic and Health Survey, 2011 is used for the study. The analysis is based on 2374 married women aged 15-49 years who had given a live birth during three years preceding the survey. Women's household decision making power, control over use of earning and decision on using contraception have been used to explore the indicators of women's autonomy. Logistic regression is used to assess the net effect of several independent variables on two dependent variables (adequate antenatal care and institutional delivery) of maternal health care. Logistic regression analyses reveal that the utilization of both maternal health care services are related to women's autonomy as indicated by decision making power on own health care, large household purchases and control over earnings because financial sufficiency is must at that period. Women's’ decision-making power appears to be the most powerful predictors for increasing maternal health service utilization. The study results suggest that policy actions that increase women’s autonomy at home could be effective in helping assure good maternal health.

scholarly journals Utilization pattern and associated factors of maternal health care services in Haryana, India: a study based on district level household survey data

2018 ◽  
Vol 7 (3) ◽  
pp. 1154 ◽  
Author(s):  
Shinjini Ray ◽  
Pravat Bhandari ◽  
Jang Bahadur Prasad
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Institutional Delivery ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
District Level ◽  
Care Services ◽  
Maternal Health Care Services

Background: Maternal health was one of the most important millennium development goals (MDGs), India didn’t achieve by the year 2015. Since, India is a multicultural, social and multiregional country, where some of the regions have good social and demographic achievement while some are poor. Haryana is one of them, which has 146 maternal mortality ratio. The level of receiving antenatal care (ANC) in Haryana is quite low as compared to other states of India. Objective of present study was to Understand the extent of use of maternal health care services in Haryana as well as examining the role of antenatal care and other socio-economic factors on the utilization of maternal health services.Methods: Bivariate analysis, chi-square test, and binary logistic regression have been used based on district level household and facility survey-4 data.Results: The utilization of ANC (any and full), institutional delivery and post-delivery treatment seeking varies among women by literacy, age at first marriage, age at women and place of residence. Literate women are two times more likely to access ANC [odds ratio (OR)=1.97 (any ANC), 1.95 (full ANC), p<0.01] and 1.52 times more likely to prefer institutional delivery [OR=1.52, p<0.01].Conclusions: Empowering women through the encouragement of mother’s education should be one of the most fundamental strategies to promote maternal health care services and reduce inequalities.

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