scholarly journals Women Empowerment and Skilled Birth Attendants among Women in Rural Ghana

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Kwamena Sekyi Dickson
Keyword(s):  
Decision Making ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Health Facility ◽  
Wife Beating ◽  
Women Empowerment ◽  
Knowledge Level ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Rural Ghana

Background. A critical public health issue is maternal mortality. Around 810 women die per day from pregnancy and childbirth, with approximately 99 percent of these deaths recorded in low-and middle-income countries (LMICs). In sub-Saharan Africa (SSA), more than half of these mortalities are registered. The situation is remarkably similar in Ghana, with maternal mortality standing at 319 deaths per 100,000 live births in 2015. Methods. Using data from 2014 Demographic and Health Surveys, the study examined the association between women empowerment and skilled birth attendance among women in rural Ghana. Results. Women with medium decision-making ( OR = 0.75 , CI = 0.61 , 0.93), low knowledge level ( OR = 0.55 , CI = 0.40 , 0.76), high acceptance of wife beating ( OR = 0.68 , CI = 0.51 , 0.90), with less than 4 ANC visits ( OR = 0.25 , CI = 0.19 , 0.32), whose partner had higher education ( OR = 1.96 , CI = 1.05 , 3.64), and who had a big problem with the distance getting to the health facility ( OR = 0.63 , CI = 0.50 , 0.78) had a significant association with skilled birth attendants. Decision-making power, women’s knowledge level, acceptance of wife beating, antenatal care visit, partner’s education, getting medical help for self, and distance to health facility were seen to have a significant association with skilled birth attendants among women in Ghana. Conclusion. Efforts to increase the current SBA should concentrate on the empowerment of women, male involvement in maternal health problems, women’s education, and participation in the ANC. There is a need to review current policies, strategies, and services to improve maternal health conditions.

Geographic access and maternal health services utilization in Sélingué Health District, Mali.

2020 ◽  
Author(s):  
Moctar TOUNKARA ◽  
Oumar Sangho ◽  
Madeleine Beebe ◽  
Lillian Joyce Whiting-Collins ◽  
Rebecca R. Goins ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Facility ◽  
Health Services Utilization ◽  
Maternal Health Services ◽  
Health District ◽  
Geographic Access ◽  
Services Utilization ◽  
The Impact

Abstract Introduction. Maternal mortality is one of the main causes of death for women of childbearing age in Mali, and improving this outcome is slow, even in high geographic-access regions. Disparities in maternal health services utilization can constitute a major obstacle in the reduction of maternal mortality and denotes a lack of equity in the Malian health system.Literature on maternal health inequity has explored structural and individual factors influencing outcomes but has not examined inequities in health facility distribution within moderate geographic access districts in Mali. The purpose of this article is to examine disparities in education and geographic distance and how they affect utilization of maternal care within the Sélingué health district, a district with moderate geographic access to care, near Bamako, Mali.Methods. We conducted a cross sectional survey with cluster sampling in the Sélingué health district. Maternal health services characteristics and indicators were described. Association between dependent and independent variables was verified using Kendall’s tau-b correlation, Chi square, logistic regression with odds ratio and 95% confidence interval. Gini index and concentration curve were used to measure inequity.Results. The majority of the participants were 20 to 24 years old. Over 68% of our sample had some education, 65% completed at least four ANC visits, and 60.8% delivered at a health facility. Despite this evidence of healthcare access in Sélingué, disparities within the health district impede the other roughly 40% of our sample from utilizing maternal healthcare. The concentration index demonstrated the impact of inequity in geographic access comparing women residing near and far from the referral care facility.Conclusion. Maternal health services underutilization, within a district with moderate geographic access, indicates that deliberate attention should be paid to addressing geographic access even in such a district.

scholarly journals Determinants of skilled birth attendants for delivery in Nepal

2012 ◽  
Vol 8 (3) ◽  
pp. 325-332 ◽  
Author(s):  
Y R Baral ◽  
K Lyons ◽  
J Skinner ◽  
E R Van Teijlingen
Keyword(s):  
Qualitative Research ◽  
Maternal Health ◽  
Health Services ◽  
Quantitative Research ◽  
Skilled Birth Attendance ◽  
Maternal Health Services ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Birth Attendance ◽  
Women's Role

This review is to explore the factors affecting the uptake of skilled birth attendants for delivery and the issues associated with women’s role and choices of maternal health care service for delivery in Nepal. Literature was reviewed across the globe and discussed in a Nepalese context. Delivery by Skilled Birth Attendance serves as an indicator of progress towards reducing maternal mortality worldwide, the fifth Millennium Development Goal. Nepal has committed to reducing its maternal mortality by 75% by 2015 through ensuring accessibility to the availability and utilisation of skilled care at every birth. The literature suggests that several socio-economic, cultural and religious factors play a significant role in the use of Skilled Birth Attendance for delivery in Nepal. Availability of transportation and distance to the health facility; poor infrastructure and lack of services; availability and accessibility of the services; cost and convenience; staff shortages and attitudes; gender inequality; status of women in society; women’s involvement in decision making; and women’s autonomy and place of residence are significant contributing factors for uptake of Skilled Birth Attendance for delivery in Nepal. The review found more quantitative research studies exploring the determinants of utilisation of the maternal health services during pregnancy in Nepal than qualitative studies. Findings of quantitative research show that different social demographic, economic, socio-cultural and religious factors are responsible for the utilisation of maternal health services but very few studies discussed how and why these factors are responsible for utilisation of skilled birth attendants in pregnancy. It is suggested that there is need for more qualitative research to explore the women’s role and choice regarding use of skilled birth attendants services and to find out how and why these factors are responsible for utilisation of skilled birth attendants for delivery. Qualitative research will help further exploration of the issues and contribute to improvement of maternal health services.DOI: http://dx.doi.org/10.3126/kumj.v8i3.6223 Kathmandu Univ Med J 2010;8(3):325-32 

scholarly journals Traditional and Skilled Birth Attendants in Zimbabwe: A Situational Analysis and Some Policy Considerations

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Naume Zorodzai Choguya
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Rural Women ◽  
Urban Areas ◽  
Care Service ◽  
Health Care Service ◽  
Maternal Health Care ◽  
Situational Analysis ◽  
Skilled Birth Attendants ◽  
Birth Attendants

The paper focuses on the situational analysis of traditional birth attendants (TBAs) and skilled birth attendants (SBAs) in Zimbabwe. Against a background of a frail health care system, characterised by a shortage in skilled professionals, increased cost of medical care, and geographic and economic inaccessibility of health care centres among others, TBAs have remained a life-line for especially many rural women in maternal health care provision. Moreover, TBAs have also found their way into the urban areas of Zimbabwe. The shift in international policy and health funding toward skilled birth attendants (i.e., an accredited health professional) has materialized into concerted government efforts to increase numbers of both midwifery training institutions and midwives themselves. The call for SBAs, though a worthy ideal, is out of touch with the lived realities of pregnant women in low resource settings such as Zimbabwe. The study is concerned with situational analysis of TBAs and SBAs in maternal health care service provision in Zimbabwe analysing and evaluating policy considerations.

scholarly journals Women’s empowerment and fertility decision-making in 53 low and middle resource countries: a pooled analysis of demographic and health surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045952
Author(s):  
Rezwanul Haque ◽  
Khorshed Alam ◽  
Syed Mahbubur Rahman ◽  
Syed Afroz Keramat ◽  
Mohammed Khaled Al-Hanawi
Keyword(s):  
Decision Making ◽  
Women's Empowerment ◽  
Wife Beating ◽  
Women’S Empowerment ◽  
Women Empowerment ◽  
Fertility Desire ◽  
Household Decision ◽  
Number Of Children ◽  
Household Decision Making ◽  
Ideal Number

ObjectiveWomen’s empowerment and its association with fertility preference are vital for central-level promotional health policy strategies. This study examines the association between women’s empowerment and fertility decision-making in low and middle resource countries (LMRCs).DesignThis cross-sectional study uses the Demographic and Health Survey database.Settings53 LMRCs from six different regions for the period ranging from 2006 to 2018.ParticipantsThe data of women-only aged 35 years and above is used as a unit of analysis. The final sample consists of 91 070 married women.MethodsWe considered two outcome variables: women’s perceived ideal number of children and their ability to achieve preferred fertility desire and the association with women empowerment. Women empowerment was measured by their participation in household decision-making and attitude towards wife-beating. The negative binomial regression model was used to assess women’s perceived ideal number of children, and multivariable logistic regression was used to evaluate women’s ability to achieve their preferred fertility desire.ResultsOur study found that empowered women have a relatively low ideal number of children irrespective of the measures used to assess women empowerment. In this study, the measures were participation in household decision-making (incidence rate ratio (IRR): 0.92, 95% CI: 0.91 to 0.93) and attitude towards wife-beating (IRR: 0.96, 95% CI: 0.95 to 0.97). In the LMRCs, household decision-making and negative attitude towards wife-beating have been found associated with 1.12 and 1.08 times greater odds of having more than their ideal number of children.ConclusionOur findings suggest that women’s perceived fertility desire can be achieved by enhancing their empowerment. Therefore, a modified community-based family planning programme at the national level is required, highlighting the importance of women’s empowerment on reproductive healthcare as a part of the mission to assist women and couples to have only the number of children they desire.

scholarly journals Accuracy of the Community Maternal Danger Score Algorithm for Predicting Pregnant Women Requiring Skilled Birth Attendants and at High-risk for Mortality

2021 ◽  
Author(s):  
Rajan Bola ◽  
Fanan Ujoh ◽  
Ugochinyere Vivian Ukah ◽  
Ronald Lett
Keyword(s):  
Literature Review ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Low Cost ◽  
Maternal Mortality Ratio ◽  
Multivariate Logistic Regression Analysis ◽  
Receiver Operating Curve ◽  
Skilled Birth Attendants ◽  
Maternal Risk ◽  
Birth Attendants

Abstract BackgroundHigh rates of maternal mortality in low-and-middle-income countries (LMICs) are associated with the lack of skilled birth attendants (SBAs) at delivery. Risk analysis tools may be useful to identify pregnant women who are at risk of mortality in LMICs. We sought to develop a low-cost maternal risk tool, the Community Maternal Danger Score (CMDS), to identify pregnant women who need an SBA at delivery.MethodsTo design the CMDS algorithm, an initial literature review was conducted to identify predictors of the need for an SBA. Medical records of women who delivered at the Federal Medical Centre in Makurdi, Nigeria (2019-2020) were examined for predictors identified from the literature review. Outcomes associated with the need for an SBA were recorded: caesarean section, postpartum hemorrhage, eclampsia, and sepsis. A maternal mortality ratio (MMR) was determined. Multivariate logistic regression analysis and area under the receiver operating curve (AUC) were used to assess the predictive ability of the CMDS algorithm.ResultsSeven factors from the literature predicted the need for an SBA: age (under 20 years of age or 35 and older), parity (nulliparity or grand-multiparity), BMI (underweight or overweight), fetal size (less than 35cm or 40cm and over), adverse obstetrical history, signs of pre-eclampsia, and co-existing medical conditions. These factors were recorded in 589 women of whom 67% required an SBA (n=396) and 1% died (n=7). The MMR was 1,189 per 100,000 (95%CI: 478-2,449). Signs of pre-eclampsia, obstetrical history, and co-existing conditions were highly associated with the need for an SBA. Age was found to interact with parity, suggesting that the CMDS requires adjustment for younger multigravida and older primigravida women. The CMDS algorithm had an AUC of 0.73 (95%CI: 0.69-0.77) for predicting whether women required an SBA, and an AUC of 0.85 (95%CI: 0.67-1.00) for in-hospital mortality.ConclusionsThe CMDS is a low-cost, evidence-based tool that uses 7 risk factors assessed on 589 women from Makurdi. Non-specialist health workers can use the CMDS to standardize patient assessment and encourage pregnant women to seek an SBA in preparation for delivery, thus improving care in countries with high rates of maternal mortality.

Women's autonomy and antenatal care utilization in Nepal: A study from Nepal demographic and health survey 2016

2019 ◽  
Vol 8 (4) ◽  
pp. 261-267
Author(s):  
Naba Raj Thapa
Keyword(s):  
Decision Making ◽  
Maternal Health ◽  
Health Survey ◽  
Wealth Quintile ◽  
Maternal Health Services ◽  
Demographic And Health Survey ◽  
Wife Beating ◽  
Care Utilization ◽  
Women’S Autonomy ◽  
Women's Autonomy

Nepal has made remarkable progress in reduction of maternal mortality but utilization of maternal health services is below the acceptance level. This study seeks to examine the effect of women's autonomy on the utilization ANC services in Nepal. Data is taken from the 2016 Nepal Demographic and Health Survey. A total of 3,998 women age 15-49 who had given birth in the 5 year preceding the survey. Logistic regression analysis is performed to examine the effects of women's autonomy on the use of ANC. The results of Model I revealed that women's decision making autonomy and attitudes towards wife beating are significantly associated with at least four ANC visits. When women's autonomy variables and other socio-demographic variables are taken into consideration, women decision making autonomy and attitudes towards wife beating are not significant association with at least four ANC visits. To improve maternal health care, the interventions are needed to target women of low autonomy, less educated and from low wealth quintile.

scholarly journals Influence of Birth Preparedness, Decision-Making on Location of Birth and Assistance by Skilled Birth Attendants among Women in South-Western Uganda

PLoS ONE ◽  
2012 ◽  
Vol 7 (4) ◽  
pp. e35747 ◽  
Author(s):  
Jerome K. Kabakyenga ◽  
Per-Olof Östergren ◽  
Eleanor Turyakira ◽  
Karen Odberg Pettersson
Keyword(s):  
Decision Making ◽  
Birth Preparedness ◽  
Skilled Birth Attendants ◽  
Birth Attendants ◽  
Western Uganda

scholarly journals How did Nepal Reduce the Maternal Mortality? A Result from Analysing the Determinants of Maternal Mortality

2012 ◽  
Vol 52 (186) ◽  
Author(s):  
R Karkee
Keyword(s):  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Literature Analysis ◽  
Demographic Health Survey ◽  
Skilled Birth Attendants ◽  
Rate Reduction ◽  
Safe Abortion ◽  
Birth Attendants ◽  
Mortality Ratio ◽  
Determinants Of Maternal Mortality

Nepal reportedly reduced the maternal mortality ratio by 48% within one decade between 1996-2005 and received the Millennium development goal award for this. However, there is debate regarding the accuracy of this figure. On the basis of framework of determinants of maternal mortality proposed by McCarthy and Maine in 1992 and successive data from Nepal demographic health survey of 1996, 2001 and 2006, a literature analysis was done to identify the important factors behind this decline. Although facility delivery and skilled birth attendants are acclaimed as best strategy of reducing maternal mortality, a proportionate increase in these factors was not found to account the maternal mortality rate reduction in Nepal. Alternatively, intermediate factors particularly women awareness, family planning and safe abortion might have played a significant role. Hence, Nepal as well as similar other developing countries should pay equal attention to such intermediate factors while concentrating on biomedical care strategy. Keywords: Determinants, maternal mortality, Nepal, reduction.

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