Determinants of Antenatal Care Utilisation in India: A Count Data Modelling Approach

2021 ◽  
pp. 245513332110303
Author(s):  
Arvind Kumar Yadav ◽  
Susanta Nag ◽  
Pabitra Kumar Jena ◽  
Kirtti Ranjan Paltasingh
Keyword(s):  
Antenatal Care ◽  
Regression Model ◽  
Pregnant Women ◽  
Count Data ◽  
Rural Areas ◽  
Family Health ◽  
Reproductive Age ◽  
Data Regression ◽  
Health Centres ◽  
Before And After

The article explores the micro-level factors (social, economic and demographic) that determine the utilisation of antenatal care (ANC) services in India using the Bayesian count data regression model. The primary purpose is to rectify the methodological loopholes in the existing literature using a count data regression model that overcomes the problems of overdispersion in the data. Using data from ‘National Family Health Survey’ (NFHS) data on women of reproductive age (15–49 years), we find that about 33% of pregnant women have not availed ANC during their pregnancy. The factors such as women’s education and partner/husband’s education, children’s birth order, household income, availability of basic amenities, like clean drinking water, media exposure, holding of bank accounts and use of mobile phones are statistically significant and positively affect ANC utilisation. Therefore, the study calls for prioritisation of and special attention to uneducated or less educated rural pregnant women. They should be incentivised adequately to utilise ANC services, which may drastically reduce inadequacy in ANC utilisation and improve mothers’ health before and after delivery. Awareness camps should be organised in every village in rural areas about pregnancy-related complications and the benefits of ANC check-ups. Massive infrastructure in the form of primary health centres or community health centres is the need of the hour in rural India.

Quantifying Pregnant Women’s Knowledge of Educational Components of Antenatal Care in Lesotho

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Tabeta Seeiso ◽  
Mamutle M. Todd-Maja
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Rural Areas ◽  
Geographic Location ◽  
Sub Saharan Africa ◽  
World Health ◽  
Cross Sectional ◽  
Danger Signs ◽  
In Pregnancy

Antenatal care (ANC) literacy is particularly important for pregnant women who need to make appropriate decisions for care during their pregnancy and childbirth. The link between inadequate health literacy on the educational components of ANC and maternal mortality in sub-Saharan Africa (SSA) is undisputable. Yet, little is known about the ANC literacy of pregnant women in SSA, with most studies inadequately assessing the four critical components of ANC literacy recommended by the World Health Organization, namely danger signs in pregnancy; true signs of labour; nutrition; and preparedness for childbirth. Lesotho, a country with one of the highest maternal mortality rates in SSA, is also underexplored in this research area. This cross-sectional study explored the levels of ANC literacy and the associated factors in 451 purposively sampled women in two districts in Lesotho using a structured questionnaire, making recourse to statistical principles. Overall, 16.4 per cent of the participants had grossly inadequate ANC literacy, while 79.8 per cent had marginal levels of such knowledge. The geographic location and level of education were the most significant predictors of ANC literacy, with the latter variable further subjected to post hoc margins test with the Bonferroni correction. The participants had the lowest scores on knowledge of danger signs in pregnancy and true signs of labour. Adequate ANC literacy is critical to reducing maternal mortality in Lesotho. Improving access to ANC education, particularly in rural areas, is recommended. This study also provides important recommendations critical to informing the national midwifery curriculum.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

scholarly journals Determinants of Antenatal Care Attendance among Pregnant Women Living in Endemic Malaria Settings: Experience from the Democratic Republic of Congo

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Célestin Ndosimao Nsibu ◽  
Célestin Manianga ◽  
Serge Kapanga ◽  
Esther Mona ◽  
Philippe Pululu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Male Partner ◽  
First Trimester ◽  
Reproductive Age ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Republic Of Congo

Background. Antenatal care (ANC) attendance helps pregnant women to benefit from preventive and curative services.Methods. Determinants for ANC attendance were identified through a cross-sectional survey in the Democratic Republic of Congo. Sociocultural bottlenecks were assessed via focus groups discussion of married men and women.Results. In this survey, 28 of the 500 interviewed pregnant women (5.6%) did not attend ANC services and 82.4% booked over the first trimester. The first visit is positively influenced by the reproductive age (OR: 0.52, 95% CI(0.28–0.95),p<0.04), the educational level (OR: 0.41,95% CI(0.17–0.97),p<0.04), the nearby health center (OR: 0.43, 95% CI(0.2–0.92),p<0.03), and the presence of a male partner (OR: 10.48, 95% CI(2.1–52.23),p<0.001). The barriers to early booking were (i) the cost of service; (ii) the appearance or individual income; (iii) the geographical inaccessibility or distance to health facilities; (iv) social and religious prohibitions; (v) the stigmatization from other women when conceiving in the late ages or young or while still lactating (parity); (vi) the time for waiting for services.Conclusion. The early ANC attendance is delayed among poor women with little education and living alone.

scholarly journals Assessment of knowledge and practices of Internally Displaced pregnant women attending to antenatal clinic center at Arbat camp in Sulaimani, Kurdistan Region of Iraq

2017 ◽  
Vol 3 (1) ◽  
pp. 52-56
Author(s):  
Layla Abdulkhalk Abass
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Low Income ◽  
Reproductive Age ◽  
Good Knowledge ◽  
Internally Displaced Persons ◽  
Islamic State ◽  
Displaced Persons ◽  
Kurdistan Region ◽  
Internally Displaced

Internally displaced persons are peoples displaced in it is own country but not crossed a border. After (Islamic State of Iraq and Syria attacked in 2014 to Iraq, millions of Iraqi people flee from their own city war zone to safe camps in Kurdistan region north of Iraq, Arbat camp is one of these camps. Iraqi civilian people constitute most new displacement persons around the world as at least 2.2 million were displaced in 2014. An important part of basic maternal health care is antenatal care that must be provided during pregnancy. Aim of this study is to provide demographic data of Internally Displaced Persons pregnant women and the effect on antenatal care knowledge and practices among of Arbat camp that visits to camp health centers on their health. Assessment of knowledge and practices of pregnant women about antennal care. A cross-sectional descriptive study has been conducted to assess the knowledge and practices of (103) women attended to antenatal care of internally displaced persons) at Arbat camps between 1 January to 30 June 2016. Data collected through the questionnaire form by face-to-face interview. Statistical analyses performed by using SPSS version 16.0, to find descriptive analysis like percentage and frequency and for relative statistical analysis. The results have revealed that most of the pregnant women were in the active reproductive age group 18-25 years old 56(54.4%) pregnant women, housewives 102(99%), illiterate 48(46.6%) pregnant women, were in families that have low income with 48(46.6%) pregnant women with significant relation to the knowledge and practices to antenatal care. In conclusion, most pregnant women have very good knowledge about antenatal care except about performing oral health hygiene during pregnancy. The majority of pregnant women in camps have very good knowledge about all practices that must be do during antenatal except taking medication without a physician prescription.

scholarly journals A case of anencephaly in an Unbooked Primipara diagnosed at 35 weeks gestation

2021 ◽  
Vol 12 (2) ◽  
pp. 555-558
Author(s):  
Awopola Ibiebelem Jumbo ◽  
Esther Ijeoma Nonye-Enyidah
Keyword(s):  
Folic Acid ◽  
Rural Communities ◽  
Antenatal Care ◽  
Rural Areas ◽  
Psychological Trauma ◽  
Reproductive Age ◽  
University Teaching ◽  
Diagnostic Tools ◽  
Folic Acid Deficiency ◽  
History Of

Background: Anencephaly is a rare but lethal congenital anomaly of the neural tube. Ideally, the diagnosis is made early in pregnancy and the pregnancy is usually terminated. This is to prevent avoidable complications during pregnancy and childbirth as well as the accompanying psychological trauma from late intrauterine foetal death or death during the neonatal period. Objective: To report a case of anencephaly in an unbooked primipara at 35 weeks gestation. Methods: The case note of the patient and how she was managed were reviewed. A relevant review of the literature on the subject was also done. Case report: Mrs A.N was a 22year old unbooked G3P1+1 who was referred to the Rivers State University Teaching Hospital (RSUTH) on the 4th of September, 2021 with a three-day history of bleeding per vaginam and an ultrasound scan report of an absent cranium and club foot at 35weeks gestation. She resided in a rural area and was on herbal medication in the index pregnancy. She did not receive routine antenatal medications and had no family history of congenital malformations. She had an induction of labour at presentation and delivered a severely asphyxiated male anencephalic baby weighing 2.0kg. The baby died 9minutes after delivery. Conclusion: Anencephaly is a lethal anomaly that is associated with folic acid deficiency. Despite available diagnostic tools, most women in rural areas lack access to antenatal care and will have a late diagnosis and increased morbidity. Thus, there is a need to improve access to antenatal care for women in rural communities, as well as supplement food with folic acid for women in the reproductive age group.

scholarly journals Labour room violence in Uttar Pradesh, India: evidence from longitudinal study of pregnancy and childbirth

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028688 ◽  
Author(s):  
Srinivas Goli ◽  
Dibyasree Ganguly ◽  
Swastika Chakravorty ◽  
Mohammad Zahid Siddiqui ◽  
Harchand Ram ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Pregnant Women ◽  
Rural Areas ◽  
Logistic Regression Model ◽  
Uttar Pradesh ◽  
First Trimester ◽  
General Category ◽  
Obstetric Violence ◽  
Labour Room

ObjectivesThe major objective of this study was to investigate the prevalence of labour room violence (LRV) (one of the forms of obstetric violence) faced by the women during the time of delivery in Uttar Pradesh (UP) (the largest populous state of India which is also considered to be a microcosm of India). Furthermore, this study also analyses the association between prevalence of obstetric violence and socioeconomic characteristics of the respondents.DesignThe study was longitudinal in design with the first visit to women made at the time of first trimester. The second visit was made at the time of second trimester and the last visit was made after the delivery. However, we have continuously tracked women over phone to keep record of developments and adverse consequences.SettingsUrban and rural areas of UP, India.ParticipantsSample of 504 pregnant women was systematically selected from the Integrated Child Development Scheme Register of pregnant women.OutcomeWe aimed to assess the levels and determinants of LRV using data collected from 504 pregnant women in a longitudinal survey conducted in UP, India. The dataset comprised three waves of survey from the inception of pregnancy to childbirth and postnatal care. Logistic regression model has been used to assess the association between prevalence of LRV faced by the women at the time of delivery and their background characteristics.ResultAbout 15.12% of women are facing LRV in UP, India. Results from logistic regression model (OR) show that LRV is higher among Muslim women (OR 1.8, 95% CI 0.7 to 4.3) relative to Hindu women (OR 1). The prevalence of LRV is higher among lower castes relative to general category, and is higher among those women who have no mass media exposure (OR 4.7, 95% CI 1.7 to 12.8) compared with those who have (OR 1).ConclusionIn comparison with global evidence, the level of LRV in India is high. Women from socially disadvantaged communities are facing higher LRV than their counterparts.

scholarly journals Geometric Regression for Modelling Count Data on the Time-to-First Antenatal Care Visit

2020 ◽  
Vol 23 (1) ◽  
pp. 35-57
Author(s):  
Zainab Mohammed Darwish Al-Balushi ◽  
◽  
M. Mazharul Islam ◽  
Keyword(s):  
Antenatal Care ◽  
Regression Model ◽  
Count Data ◽  
Negative Binomial ◽  
Geometric Distribution ◽  
Discrete Distribution ◽  
Mass Function ◽  
Probability Mass Function ◽  
Antenatal Care Visit ◽  
Care Visit

Geometric distribution belongs to the family of discrete distribution that deals with the count of trail needed for first occurrence or success of any event. However, little attention has been paid in applying the GLM for the geometric distribution, which has a very simple form for its probability mass function with a single parameter. In this study, an attempt has been made to introduce geometric regression for modelling the count data. We have illustrated the suitability of the geometric regression model for analyzing the count data on time to first antenatal care visit that displayed under-dispersion, and the results were compared with Poisson and negative binomial regressions. We conclude that the geometric regression model may provide a flexible model for fitting count data sets which may present over-dispersion or under-dispersion, and the model may serve as an alternative model to the very familiar Poisson and negative binomial models for modelling count data.

scholarly journals Impact of antenatal counselling on couples’ knowledge and practice of contraception in Mansoura, Egypt

1999 ◽  
Vol 5 (5) ◽  
pp. 1002-1013
Author(s):  
M. H. Soliman
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Study Groups ◽  
Study Group ◽  
Before And After ◽  
Joint Decisions ◽  
Knowledge And Practice ◽  
The Impact ◽  
Interview Questionnaire

The impact of antenatal counselling on couples’ knowledge and practice of contraception was investigated. An interview questionnaire was used before and after conducting counselling sessions with 200 pregnant women and 100 spouses. The participants were followed up immediately after delivery and 3 months later. Both the control and study groups displayed a lack of knowledge of contraception. Counselling sessions improved the couples’ knowledge and practice in the study group. Involving husbands in family planning counselling sessions led to joint decisions being made and encouraged women’s use of contraception. The majority of couples retained most of the information given. Integrating family planning counselling into antenatal care in all facilities and involving the husband are recommended

scholarly journals A assistência pré-natal das trabalhadoras rurais na estratégia saúde da família

2017 ◽  
Vol 11 (12) ◽  
pp. 4970
Author(s):  
Lucimare Ferraz ◽  
Paula Marco Marchiori ◽  
Patricia Pereira Oliveira
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Rural Areas ◽  
Family Health ◽  
Medical Professional ◽  
Women Farmers ◽  
Structured Interviews ◽  
Health Strategy ◽  
The Family ◽  
Family Health Strategy

RESUMO Objetivo: conhecer a assistência pré-natal desenvolvida na Estratégia Saúde da Família. Método: estudo descritivo, de abordagem qualitativa, com a participação de gestantes, médicos e enfermeiros do meio rural. A coleta de dados foi por meio de entrevistas semiestruturadas e a análise por meio da técnica de Análise de conteúdo na modalidade Análise Temática. Resultados: constatou-se que as consultas de pré-natal são centradas no profissional médico, que os profissionais de saúde não abordam o ambiente e o processo de trabalho das gestantes agricultoras e, nas orientações, evidenciou-se que o processo de comunicação entre os profissionais e a gestante precisa ser melhorado. Conclusão: a assistência ao pré-natal de baixo risco na Estratégia Saúde da Familia no meio rural é focada no modelo Biomédico, sendo que poucos profissionais (re)conhecem o ambiente e os processos de trabalho das gestantes agricultoras. Descritores: Trabalhadores Rurais; Cuidado Pré-Natal; Estratégia Saúde da Família. ABSTRACTObjective: to know prenatal care developed in the Family Health Strategy. Method: this is a descriptive study with a qualitative approach, with the participation of pregnant women, doctors and nurses from rural areas. The data collection was through semi-structured interviews and the analysis through the technique of Content Analysis in the Thematic Analysis modality. Results: it was verified that the prenatal consultations are focused on the medical professional, that the health professionals do not approach the environment and the work process of pregnant farmers. The guidelines showed that the process of communication between the professionals and the pregnant woman needs to be improved. Conclusion: low-risk prenatal care in the Family Health Strategy in rural areas is focused on the Biomedical model, and few professionals recognize/know the environment and the work processes of pregnant women farmers. Descriptors: Rural Workers; Prenatal Care; Family Health Strategy.RESUMENObjetivo: conocer la asistencia prenatal desarrollada en la Estrategia Salud de la Familia. Método: estudio descriptivo, de enfoque cualitativo, con la participación de gestantes, médicos y enfermeros del área rural. La recolección de datos fue por medio de entrevistas semi-estructuradas y el análisis por medio de la técnica de Análisis de contenido en la modalidad Análisis Temático. Resultados: se constató que las consultas de prenatal son centradas en el profesional médico, que los profesionales de salud no enfocan el ambiente y el proceso de trabajo de las gestantes agricultoras. En las orientaciones se evidenció que el proceso de comunicación entre los profesionales y la gestante precisa ser mejorado. Conclusión: la asistencia al prenatal de bajo riego en la Estrategia Salud de la Familia en el área rural es enfocada en el modelo Biomédico, siendo que pocos profesionales (re) conocen el ambiente y los procesos de trabajo de las gestantes agricultoras. Descriptores: Trabajadores Rurales; Atención Prenatal; Estrategia de Salud Familiar.

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