Home childbirth among young mothers aged 15–24 years in Nigeria: a national population-based cross-sectional study

ObjectiveTo estimate the prevalence and identify factors associated with home childbirth (delivery) among young mothers aged 15–24 years in Nigeria.DesignA secondary analysis of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (NDHS).SettingNigeria.ParticipantsA total of 7543 young mothers aged 15–24 years.Outcome measurePlace of delivery.ResultsThe prevalence of home delivery among young mothers aged 15–24 years was 69.5% (95% CI 67.1% to 71.8%) in Nigeria—78.9% (95%CI 76.3% to 81.2%) in rural and 43.9% (95%CI 38.5% to 49.5%, p<0.001) in urban Nigeria. Using the Andersen’s behavioural model, increased odds of home delivery were associated with the two environmental factors: rural residence (adjusted OR, AOR: 1.39, 95% CI 1.06 to 1.85) and regions of residence (North-East: AOR: 1.97, 95% CI 1.14 to 3.34; North-West: AOR: 2.94, 95% CI 1.80 to 4.83; and South-South: AOR: 3.81, 95% CI 2.38 to 6.06). Three of the enabling factors (lack of health insurance: AOR: 2.34, 95% CI 1.16 to 4.71; difficulty with distance to healthcare facilities: AOR: 1.48, 95% CI 1.15 to 1.88; and <4 times antenatal attendance: AOR: 3.80, 95% CI 3.00 to 4.85) similarly increased the odds of home delivery. Lastly, six predisposing factors—lack of maternal and husband’s education, poor wealth index, Islamic religion, high parity and low frequency of listening to radio—were associated with increased odds of home delivery.ConclusionsYoung mothers aged 15–24 years had a higher prevalence of home delivery than the national average for all women of reproductive age in Nigeria. Priority attention is required for young mothers in poor households, rural areas, North-East, North-West and South-South regions. Faith-based interventions, a youth-oriented antenatal care package, education of girls and access to health insurance coverage are recommended to speed up the reduction of home delivery among young mothers in Nigeria.

Download Full-text

Socio Demographic Determinants of Delivery Practice in Rural Women of Bangladesh

Delta Medical College Journal ◽

10.3329/dmcj.v1i2.15917 ◽

2013 ◽

Vol 1 (2) ◽

pp. 42-45 ◽

Cited By ~ 1

Author(s):

Meherunnessa Begum ◽

Khondoker Bulbul Sarwar ◽

Nasreen Akther ◽

Rokshana Sabnom ◽

Asma Begum ◽

...

Keyword(s):

Maternal Health ◽

Rural Women ◽

Rural Areas ◽

Urban Areas ◽

Cross Sectional Study ◽

Home Delivery ◽

Reproductive Age ◽

Cross Sectional ◽

Mortality And Morbidity ◽

At Home

Background: Every year, world wide, 200 million women become pregnant. The development of urban areas allowed women to receive more care and treatment. However, in rural areas such measures are not available to every woman. Data on delivery practice of rural woman may help the social and public health planners and decision makers to minimize and prevent maternal mortality and morbidity ensuring safe motherhood.Objective: The aim of the study was to observe the delivery practice of rural women of Bangladesh. Materials and method: A cross-sectional study was conducted and data were collected from Dhamrai upazila, Dhaka, Bangladesh in April 2008. Total 159 women of reproductive age group at least having one child were selected purposively to elicit information on various demographic, socioeconomic, cultural and selected programmatic variables including maternal health care and delivery practices. Results: Among the respondents about 55% were literate. Majority (80%) of the respondents delivered at home and most of the them (71%) felt that home delivery was comfortable where as about 29% of the respondents were compelled to deliver at home due to family decision and financial constraint. Among the deliveries about 82% occurred normally and 18.2% were by cesarean section. A considerable percentage of deliveries (49%) were attended by traditional birth attendants. Blade was used for cutting umbilical cord in majority of the cases (74%) who delivered at home. Most of the respondents (90%) took ante natal check up and about 74% were vaccinated by tetanus toxoid. Conclusion: The results of the study suggest that a lot of work is still to do for the policy makers and health planners to target, plan, develop and deliver maternal health services to the rural women of Bangladesh. DOI: http://dx.doi.org/10.3329/dmcj.v1i2.15917 Delta Med Col J. Jul 2013;1(2):42-45

Download Full-text

Women’s Status and its Association With Home Delivery: A Cross-Sectional Study Conducted in Khyber-Pakhtunkhwa, Pakistan

Maternal and Child Health Journal ◽

10.1007/s10995-021-03294-1 ◽

2022 ◽

Author(s):

Hussain Ali ◽

Qaisar Khalid Mahmood ◽

Aisha Jalil ◽

Florian Fischer

Keyword(s):

Decision Making ◽

Maternal Health ◽

Rural Areas ◽

Partner Violence ◽

Home Delivery ◽

Reproductive Age ◽

Cluster Sampling ◽

Binary Logistic Regression Model ◽

Cross Sectional ◽

Khyber Pakhtunkhwa

Abstract Introduction Home delivery is a predominant driver of maternal and neonatal deaths in developing countries. Despite the efforts of international organizations in Pakistan, home childbirth is common in the remote and rural areas of Khyber Pakhtunkhwa province. We studied women’s position within the household (socio-economic dependence, maternal health decision making, and social mobility) and its association with the preference for home delivery. Methods We conducted a cross-sectional household survey among 503 ever-married women of reproductive age (15–49 years), who have had childbirth in the last twelve months or were pregnant (more than 6 months) at the time of the interview. A two-stage cluster sampling technique has been used for recruitment. Descriptive and bivariate analyses have been conducted. A binary logistic regression model was calculated to present odds ratios and corresponding 95% confidence intervals for factor associated with home delivery. Results An inferior status of women, restrictions in mobility and limited power in decision making related to household purchases, maternal health care, and outdoor socializing are contributing factors of home delivery. Furthermore, women having faced intimate partner violence were much more likely to deliver at home (OR = 2.66, 95% CI: 1.83.3.86, p < 0.001). Discussion We concluded that women are in a position with minimal authority in decision making to access and deliver the baby in any health facility. We recommend that the government should ensure the availability of health facilities in nearby locations to increase institutional deliveries in the study area.

Download Full-text

Cost of Ante-natal Care among Health Insurance (HI) Enrollees and Out-of-Pocket (OOP) Payers accessing Maternal Healthcare Services in a Tertiary Health Institution in Southwest Nigeria

TEXILA INTERNATIONAL JOURNAL OF PUBLIC HEALTH ◽

10.21522/tijph.2013.09.02.art002 ◽

2021 ◽

Vol 9 (2) ◽

pp. 11-22

Author(s):

Taofeek Adedayo Sanni

Keyword(s):

Health Insurance ◽

Antenatal Care ◽

Healthcare Services ◽

Reproductive Age ◽

P Value ◽

Maternal Healthcare ◽

Cross Sectional ◽

Health Institution ◽

Total Cost ◽

Southwest Nigeria

Maternal Mortality Remains A Leading Cause Of Death Among Women Of Reproductive Age Group. This Study Determined The Cost Of Antenatal Care Among Health Insurance (HI) Enrollees And Out-Of-Pocket (OOP) Payers Accessing Maternal Healthcare Services In A Tertiary Health Institution In Southwest Nigeria. A Comparative Cross-Sectional Study Was Carried Out Among 380 Women (190 HI Enrollees And 190 OOP Payers) Attending Antenatal Care Services In A Tertiary Health Institution In Southwest Nigeria Using A Systematic Random Sampling Technique. Data Was Gathered Using An Interviewer-Administered Semi-Structured Questionnaire And Analyzed Using IBM SPSS Version 23. Chi-Square And Binary Logistic Regression Were Used To Assess The Association Between Dependent And Independent Variables And A P-Value Of <0.05 Was Taken As Significant. The Overall Mean Age Of Respondents In This Study Was 33.8 ± 5.0 Years (HI Group: 34.1 ± 4.9 Years And OOP Group: 33.6 ± 5.0 Years). The Mean Total Cost Of Antenatal Care (ANC) Is Lesser For HI Enrollees (₦5,095.2 ± 1,753.1 Equivalent To $13.3 ± 4.6) As Compared With OOP Payers (₦15,050.6 ± 5,548.9 Equivalent To $39.6 ± 14.6). Predictors And Enablers For HI Uptake Are Marital Status, Family Size, Level Of Education, Occupation, Appropriate And Quality HI Package, And Trust In The HI Scheme. It Was Concluded That The Total Cost Of Antenatal Care Is Lower Among The Health Insurance Enrollees Than The Out-Of-Pocket Payers. Therefore, Interventions To Increase Awareness And Designing More Enticing HI Packages Are Recommended.

Download Full-text

Decomposing the Effect of Women Educational Status on Fertility Across the Six Geo-political Zones in Nigeria: 2003-2018

10.21203/rs.3.rs-51297/v1 ◽

2020 ◽

Author(s):

Tubosun Alex Olowolafe

Keyword(s):

Educational Status ◽

Fertility Rate ◽

Reproductive Age ◽

High Fertility ◽

Age At First Birth ◽

Fertility Level ◽

Cross Sectional ◽

North East ◽

Fertility Variation ◽

Fertility Differentials

Abstract Background: High level of fertility has been consistently reported in Nigeria. Women education is often identified as one of the important factors that have contributed to reduction in fertility across countries. It is essential to identify the factors that explain the fertility variation in educational status and know the extent of association of these factors across the regions in Nigeria. Thus, this study aimed to examine the fertility differentials among uneducated and educated women in Nigeria.Methods: A cross-sectional population-based design which involved secondary data analyses of the weighted sample of 2003 (n1=7620), 2008 (n2=33385), 2013 (n3=38948) and 2018 (n4=41821) Nigeria Demographic and Health Survey data sets was used. Fertility was measured from information on the full births history of women aged 15-49 years. Oaxaca-Blinder decomposition was used to identify factors that explain fertility differentials among educated and not educate women (α=0.05).Result: Total fertility rate estimate was higher among uneducated women (6.7) than educated women (4.5) in 2018. The pattern was similar across the regions and survey periods. The mean children ever born among women aged 45-49 years was significantly higher among the uneducated than educated women in each of the survey year. Maternal age at first marriage, wealth index and age at first birth were contributory factors to the dissimilarities found in fertility between the educated and uneducated women. Risk difference (RD) of high fertility between uneducated-educated women was highest in South-East (RD=56.9; 95%CI=49.1-64.8) and least in North-East (RD=15.0; 95%CI=9.9-20.1).Conclusion: The fertility level in Nigeria was high but more prominent among the uneducated than educated. Improving the level of educational enrolment of women of reproductive age will facilitate reduction in the fertility rate in Nigeria.

Download Full-text

Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey

BMJ Open ◽

10.1136/bmjopen-2018-023013 ◽

2018 ◽

Vol 8 (9) ◽

pp. e023013 ◽

Cited By ~ 6

Author(s):

Deogratius Bintabara ◽

Keiko Nakamura ◽

Kaoruko Seino

Keyword(s):

Health Insurance ◽

Low Income ◽

Formal Education ◽

Wealth Index ◽

Population Based ◽

Reproductive Age ◽

Low Income Countries ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Low Income Country

ObjectiveThis study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country.DesignPopulation-based cross-sectional survey.SettingNationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed.Primary outcome measuresA composite variable, ‘problems in accessing healthcare’, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively.ResultsA total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare.ConclusionThis study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing women’s problems associated with accessing healthcare.

Download Full-text

Trends, prevalence and risk factors of overweight and obesity among women of reproductive age in Bangladesh: a pooled analysis of five national cross-sectional surveys

BMJ Open ◽

10.1136/bmjopen-2017-018468 ◽

2018 ◽

Vol 8 (7) ◽

pp. e018468 ◽

Cited By ~ 22

Author(s):

Muhammad Abdul Baker Chowdhury ◽

Md Mohiuddin Adnan ◽

Md Zakiul Hassan

Keyword(s):

Risk Factors ◽

Rural Areas ◽

Low Cost ◽

Wealth Index ◽

Overweight And Obesity ◽

Reproductive Age ◽

Demographic And Health Surveys ◽

Obesity Prevalence ◽

Women Of Reproductive Age ◽

Cross Sectional

ObjectiveTo determine the trends, prevalence and risk factors of overweight and obesity among Bangladeshi women of reproductive age from 1999 to 2014.DesignWe analysed nationally representative data from the 1999, 2004, 2007, 2011 and 2014 cross-sectional Bangladesh Demographic and Health Surveys.SettingBangladesh.ParticipantsWomen aged 15–49 years.Primary outcomeOverweight/obesity.ResultsA total of 58 192 women were included in the analysis. The prevalence of overweight and obesity among women of reproductive age increased significantly from 7.53% (95% CI 6.83 to 8.29) and 1.82% (95% CI 1.48 to 2.24) in 1999 to 28.37% (95% CI 27.49 to 29.28) and 10.77% (95% CI 10.22 to 11.35) in 2014, respectively. Age, education, wealth index, watching television and contraceptive use were associated with overweight and obesity in both urban and rural areas.ConclusionsOverweight and obesity prevalence increased significantly among Bangladeshi women of reproductive age between 1999 and 2014. Development of effective low-cost strategies to address the increasing burden of obesity should be a high priority.

Download Full-text

Population Geography and Settlement Studies

Libyan Studies ◽

10.1017/s0263718900006750 ◽

1989 ◽

Vol 20 ◽

pp. 251-258

Author(s):

R. I. Lawless

Keyword(s):

Rural Areas ◽

Service Sector ◽

Urban Migration ◽

Interregional Migration ◽

North West ◽

North East ◽

The North ◽

Mass Migration ◽

Rural To Urban Migration ◽

Settlement Studies

Oil wealth has transformed Libya, a desertic and sparsely populated country, bringing dramatic demographic changes (Zoghlami 1979). El Mehdawi and Clarke (1982) and Lawless and Kezeiri (1983) describe and analyse the growing polarisation of the population in the north-west and north-east coastal regions which contain the two largest cities, Tripoli and Benghazi. They show that in recent years spatial duality has been sharply intensified by strong rural to urban migration and also by an increase in interregional migration. The concentration of new development programmes in certain urban centres has been the main cause of the development differential among the regions. As a result the regions which include the most important urban centres have become the most prosperous and the others have become less developed or even depressed. This has been the main cause of the rapid increase in both rural to urban migration and interregional migration. The inhabitants of the less developed regions have continued to move in increasing numbers to those which are more developed. The large majority of migrants who moved from these less developed regions are represented by rural people who have changed their place of residence and their occupation. They have left their work in the rural sector to seek employment in the industrial and service sector. As a result agricultural production has declined. The agrarian sector now employs less than a quarter of the Libyan workforce and the percentage of nomads and semi-nomads has declined to under 10% of the population. Albergani and Vignet-Zunz (1982) have shown that colonial invasion and occupation followed by the Second World War threatened the Bedouin of the Jebel Akhdar with extinction, not through sedentarisation but through the mass migration of a devastated rural population. The advent of oil and the high salary levels available in urban centres further encouraged this tendency. Gannous (1979) studied the movement of Bedouin from rural areas to the town of Al Abiyar and the erosion of Bedouin culture by urban values.

Download Full-text

Knowledge and Perception of Chronic Kidney Disease in a Semi-urban Community in North-east Nigeria

Journal of BioMedical Research and Clinical Practice ◽

10.46912/jbrcp.96 ◽

2019 ◽

Vol 2 (1) ◽

pp. 25-31

Author(s):

A Abdu ◽

M S Umar ◽

K Y Audi

Keyword(s):

Kidney Disease ◽

Rural Areas ◽

Urban Community ◽

Great Majority ◽

Developed Countries ◽

Cross Sectional Study ◽

Cross Sectional ◽

Middle Income ◽

North East ◽

End Stage

Of the nine million individuals on dialysis worldwide, more than 90% are in developed countries with lower figures reported from lower to middle-income countries. This is mainly due to Unaffordability of this therapy by the great majority of people who are poor and living in rural areas. There is, therefore, the need for effective preventive measures to reduce the progression of patients to End-Stage Kidney Disease (ESKD). This can only be achieved by properly educating the people. This community-based cross-sectional study was conducted on World Kidney day 2018 at Bayara a semi-urban community near Bauchi metropolis. Interviewer-assisted questionnaires were administered to all individuals to assess the knowledge and perception of the participants. A total of 132 individuals completed the questionnaire out of which 81.8% were females. The mean age of the participants was 39.98±12.5 years and a range of 15-65 years. About 27.3% of the respondents didn’t know the correct number and position of the kidney. 65% didn’t know any risk factor for kidney disease while 4.5% and 1.5% could mention hypertension and diabetes mellitus.

Download Full-text

Assessment of Utilization of Integrated Child Development Services Scheme in Uttarakhand

Indian Journal of Community Health ◽

10.47203/ijch.2020.v32i01.026 ◽

2020 ◽

Vol 32 (1) ◽

pp. 130-132

Author(s):

Navuluri Kranthi Kumar Reddy ◽

Surekha Kishore ◽

Smita Sinha ◽

Ajeet Singh Bhadoria ◽

Yogesh Bahurupi ◽

...

Keyword(s):

Rural Areas ◽

Preschool Education ◽

Health Indicators ◽

Cross Sectional Study ◽

Reproductive Age ◽

Cross Sectional ◽

Immunization Service ◽

Utilization Of Services ◽

Education Services ◽

Urban And Rural Areas

Background: ICDS scheme has been playing its role effectively since 1975 when it was launched, but still there are some short comings which need to be addressed. Uttarakhand being one of the states with poor health indicators with respect to child and mother there is need to increase research on implementation of programs. Aims & Objectives: The present study was conducted to see utilization of services provided under ICDS scheme in Uttarakhand. Material & Methods: A cross sectional study was conducted in selected areas of Uttarakhand from October 2018 to June 2019. 505 households from 16 Anganwadi centers, from both urban and rural areas of Dehradun and Haridwar districts were included. Assessment of utilization of services was done by household interviews. Data was analyzed using SPSS V 23 software. Results: Availing supplementary nutrition services was the most utilized service (94.5%) followed by health education services (88.3%), health and referral services (83.2%), preschool education services (76.7%) and least utilized service was immunization service (69.3%). Conclusion: Various factors independently affecting utilization of services were identified. Overall utilization of services is highest among pregnant women and least among adolescent girls and women of reproductive age group.

Download Full-text

Colostrum avoidance practice and associated factors among mothers of children aged less than six months in Bure District, Amhara Region, North West, Ethiopia: A community-based cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0245233 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0245233

Author(s):

Ayenew Mose ◽

Merga Dheresa ◽

Bezatu Mengistie ◽

Biresaw Wassihun ◽

Haimanot Abebe

Keyword(s):

Cesarean Section ◽

Antenatal Care ◽

Cross Sectional Study ◽

Home Delivery ◽

Care Group ◽

Cross Sectional ◽

North West ◽

North West Ethiopia ◽

Colostrum Feeding ◽

Study Participants

Introduction The World Health Organization and the United Nations International Children’s Emergency Fund jointly recommend colostrum feeding immediately following delivery of the newborn. Colostrum avoidance is the practice of discarding colostrum at least once within the first three days after delivery of the newborn. Colostrum contains antibodies that protect the newborn against disease. Despite this fact, many Ethiopian mothers see colostrum feeding as a cause of neonatal morbidity and mortality, and they believe colostrum should be discarded to alleviate its effects. However, the cause of this misconception about colostrum is not well researched in Ethiopia, particularly in the study area. Objective To assess the prevalence of colostrum avoidance and associated factors among mothers of children aged less than six months in Bure district, Amhara Region, North West, Ethiopia. Methods A community-based cross-sectional study was conducted from March 1st to 30th, 2019 in Bure district. Structured questionnaires and face to face interviews were used to collect data from 621 study participants. Multistage sampling technique was used to select study participants. Data were entered into Epi Data version 4.2.0 and then exported to Statistical Package for the Social Sciences version 23. Bivariate and multivariate logistic regression analyses were performed to identify predictors of colostrum avoidance practice. Results Six hundred twenty-one (621) mothers of children aged less than six months participated. The prevalence of colostrum avoidance was 14.5% (95%CI; 11.5–17.4). The multivariate analysis indicated that home delivery [AOR = 3.350, (95%CI; 2.517–14.847)], giving birth through cesarean section [AOR = 3.368, (95%CI; 1.339–8.471)], no participation in an antenatal care group [AOR = 1.889, (95%CI; 1.144–3.533)], poor knowledge of mothers about colostrum [AOR = 3.44, (95%CI; 2.45–4.977)], and poor attitude of mothers towards colostrum [AOR = 3.053, (95%CI; 1.157–8.054)] were important predictors of colostrum avoidance practice. Conclusion and recommendations Home delivery, giving birth through cesarean section, no participation in an antenatal care group, poor knowledge of mothers about colostrum, and poor attitude of mothers towards colostrum were significantly associated with colostrum avoidance practice. Therefore, health care workers in the district should promote institutional delivery, reduce the magnitude of cesarean section, encourage pregnant mothers to participate in an antenatal care group, and enhance maternal awareness about the merits of colostrum feeding. Moreover, health educations for mothers to have a positive attitude towards colostrum are important recommendations to be taken to prevent the further practice of colostrum avoidance.

Download Full-text