scholarly journals Prevalence, progress, and social inequalities of home deliveries in Ghana from 2006 to 2018: insights from the multiple indicator cluster surveys

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Veronica Millicent Dzomeku ◽  
Precious Adade Duodu ◽  
Joshua Okyere ◽  
Livingstone Aduse-Poku ◽  
Nutifafa Eugene Yaw Dey ◽  
...  
Keyword(s):  
At Risk ◽  
Antenatal Care ◽  
Rural Areas ◽  
Social Inequalities ◽  
Survey Design ◽  
Healthcare Services ◽  
Multiple Indicator ◽  
Home Deliveries ◽  
The Government ◽  
At Home

Abstract Background Delivery in unsafe and unsupervised conditions is common in developing countries including Ghana. Over the years, the Government of Ghana has attempted to improve maternal and child healthcare services including the reduction of home deliveries through programs such as fee waiver for delivery in 2003, abolishment of delivery care cost in 2005, and the introduction of the National Health Insurance Scheme in 2005. Though these efforts have yielded some results, home delivery is still an issue of great concern in Ghana. Therefore, the aim of the present study was to identify the risk factors that are consistently associated with home deliveries in Ghana between 2006 and 2017–18. Methods The study relied on datasets from three waves (2006, 2011, and 2017–18) of the Ghana Multiple Indicator Cluster surveys (GMICS). Summary statistics were used to describe the sample. The survey design of the GMICS was accounted for using the ‘svyset’ command in STATA-14 before the association tests. Robust Poisson regression was used to estimate the relationship between sociodemographic factors and home deliveries in Ghana in both bivariate and multivariable models. Results The proportion of women who give birth at home during the period under consideration has decreased. The proportion of home deliveries has reduced from 50.56% in 2006 to 21.37% in 2017–18. In the multivariable model, women who had less than eight antenatal care visits, as well as those who dwelt in households with decreasing wealth, rural areas of residence, were consistently at risk of delivering in the home throughout the three data waves. Residing in the Upper East region was associated with a lower likelihood of delivering at home. Conclusion Policies should target the at-risk-women to achieve complete reduction in home deliveries. Access to facility-based deliveries should be expanded to ensure that the expansion measures are pro-poor, pro-rural, and pro-uneducated. Innovative measures such as mobile antenatal care programs should be organized in every community in the population segments that were consistently choosing home deliveries over facility-based deliveries.

scholarly journals Why women choose to deliver at home in India: a study of prevalence, factors, and socio-economic inequality

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ratna Patel ◽  
Strong P. Marbaniang ◽  
Shobhit Srivastava ◽  
Pradeep Kumar ◽  
Shekhar Chauhan
Keyword(s):  
Rural Women ◽  
Rural Areas ◽  
Contact Point ◽  
Decomposition Analysis ◽  
Home Delivery ◽  
Targeted Interventions ◽  
Factors Influencing ◽  
Home Deliveries ◽  
The Government ◽  
At Home

Abstract Background To promote institutional delivery, the Government of India, through the Janani Suraksha Yojana (JSY) program, gives monetary reward to all pregnant women who give birth at the government or private health center. Despite providing cash assistance, a higher number of women are still preferring delivering at home. Therefore, this study sought to determine the prevalence of home births and identifying the factors influencing women’s choice of home deliveries. Methods Data from the National Family Health Survey (NFHS) conducted during 2005–06 and 2015–16 were used in the study. The respondents were women 15–49 years; a sample of 36,850 and 190,898 women in 2005–06 and 2015–16 respectively were included in the study. Multivariate logistic regression was used to determine the factors influencing home delivery. Income-related inequality in home delivery was quantified by the concentration index (CI) and the concentration curve (CC), and decomposition analysis was used to examine the inequality in the prevalence of home deliveries. Results The prevalence of home deliveries has reduced from 58.5% in 2005–06 to 18.9% in 2015–16. The odds of delivering babies at home were lower among women who had full ANC in 2005–06 [AOR: 0.34; CI: 0.28–0.41] and in 2015–16 [AOR: 0.41; CI: 0.38–0.45] and were higher among women with four or higher parity in 2005–06 [AOR: 1.70; CI: 1.49–1.92] and in 2015–19 [AOR: 2.16; CI: 2.03–2.30]. Furthermore, the odds of delivering babies at home were higher among rural women and were lower among women with higher education. It was found that the value of CI increased from − 0.25 to − 0.39 from 2005-06 to 2015–16; this depicts that women delivering babies at home got more concentrated among women from lower socio-economic status. Conclusion There is a need to promote institutional deliveries, particular focus to be given to poor women, women with higher parity, uneducated women, and rural women. ANC is the most concurring contact point for mothers to get relevant information about the risks and complications they may encounter during delivery. Therefore, effort should be directed to provide full ANC. Targeted interventions are called for to bring improvements in rural areas.

scholarly journals Factors Affecting the Utilization of a Minimum of Four Antenatal Care Services in Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Garoma Wakjira Basha
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Wealth Index ◽  
Complete Information ◽  
Healthcare Services ◽  
Household Wealth ◽  
Routine Care ◽  
Factors Affecting ◽  
Poor Households ◽  
Nationally Representative

Background. Antenatal care is defined as the routine care of pregnant women provided between conception and the onset of labor. This study is aimed to identify factors affecting the utilization of antenatal care (ANC) services in Ethiopia. Methods. The study used data from the nationally representative 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 7,167 mothers who gave birth within five years preceding the 2016 EDHS whose complete information was available in the survey were included in this study. Logistic regression statistical analyses were used to identify factors associated with the utilization of a minimum of 4 ANC services in Ethiopia. Results. Among the 7,167 women included in this study, 2,598 (36.6%) had utilized a minimum of 4 ANC services in Ethiopia. This study showed that factors such as place of residence, region, mothers’ education level, household wealth index, desire for pregnancy, frequency of reading newspaper, frequency of listening to radio, and frequency of watching TV were associated with the utilization of a minimum of four ANC services at 5% level of significance in Ethiopia. Conclusion. Strategies to increase the accessibility and availability of healthcare services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting mothers with no education are vital to increase their awareness about the importance of antenatal services.

scholarly journals Factors Affecting Home Delivery among Women Living in Remote Areas of Rural Zambia: A Cross-Sectional, Mixed-Methods Analysis

2021 ◽  
pp. 1-13
Author(s):  
Ireen Chola Mwape Musonda
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Low Income ◽  
Rural Areas ◽  
Home Delivery ◽  
Childbearing Age ◽  
Long Distance ◽  
Cross Sectional ◽  
Home Deliveries ◽  
At Home

Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. Despite the policy to stopping traditional birth attendants from conducting deliveries at home and encouraging all women to give birth at the health facility under skilled care, many women still give birth at home. An exploratory cross section survey was used to gather data by conducting structured interviews with 50 women of childbearing age who had a recent or previous home delivery. The following factors were found to be associated with home deliveries in surrounding villages in kashikishi; abrupt onset/precipitate labor, long distance/transport difficulties to reach the nearest health facility, having had successful HD, poverty/low income and gender though having a small percentage. Parity in which the majority were multiparas’ women, attitude was also associated with home deliveries and other unforeseen circumstances such as a funeral and being alone at home at the onset of labour.

scholarly journals What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244811
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
Ebenezer Agbaglo ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Wealth Quintile ◽  
Home Delivery ◽  
Northern Region ◽  
Demographic And Health Survey ◽  
Factors Associated ◽  
At Home

Background In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana. Materials and methods Data for this study was obtained from the 2014 Ghana Demographic and Health Survey. We used data of 1,441 women who gave birth in the 5 years preceding the survey and were dwelling in urban areas. By the use of Stata version 14.2, we conducted both descriptive and multivariable logistic regression analyses. Results We found that 7.9% of women in urban areas in Ghana delivered at home. The study revealed that, compared to women who lived in the Northern region, women who lived in the Brong Ahafo region [AOR = 0.38, CI = 0.17–0.84] were less likely to deliver at home. The likelihood of home delivery was high among women in the poorest wealth quintile [AOR = 2.02, CI = 1.06–3.86], women who professed other religions [AOR = 3.45; CI = 1.53–7.81], and those who had no antenatal care visits [AOR = 7.17; 1.64–31.3]. Conversely, the likelihood of home delivery was lower among women who had attained secondary/higher education [AOR = 0.30; 0.17–0.53], compared to those with no formal education. Conclusion The study identified region of residence, wealth quintile, religion, antenatal care visits, and level of education as factors associated with home delivery among urban residents in Ghana. Therefore, health promotion programs targeted at home delivery need to focus on these factors. We also recommend that a qualitative study should be conducted to investigate the factors responsible for the differences in home delivery in terms of region, as the present study could not do so.

scholarly journals Determinants of Households’ Access to Improved Drinking Water Sources: A Secondary Analysis of Eswatini 2010 and 2014 Multiple Indicator Cluster Surveys

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Maswati S. Simelane ◽  
Mduduzi Colani Shongwe ◽  
Kerry Vermaak ◽  
Eugene Zwane
Keyword(s):  
Drinking Water ◽  
Rural Areas ◽  
Urban Areas ◽  
Household Head ◽  
Wealth Index ◽  
Water Sources ◽  
Lower Odds ◽  
Drinking Water Sources ◽  
Multiple Indicator ◽  
The Government

Worldwide, millions of people still die from diseases associated with inadequate water supply, sanitation, and hygiene, despite the fact that the United Nations recognized access to clean drinking water and sanitation as a human right nearly a decade ago. The objective of this study was to describe the determinants of access to improved drinking water sources in Eswatini in 2010 and 2014. Using the Eswatini Multiple Indicator Cluster Surveys (EMICSs), data for 4,819 households in 2010 and 4,843 in 2014 were analyzed. Bivariate and multivariate complementary log-log regression analyses were conducted to identify the determinants of households’ access to improved drinking water sources. The study found that households’ access to improved drinking water sources significantly improved from 73.1% in 2010 to 77.7% in 2014 (p<0.0001). In 2010, households whose heads were aged 35–54 and 55 years had lower odds of having access to improved drinking water sources than those with younger ones. In 2014, female-headed households had lower odds, while, in 2010, sex of the household head was not associated with access to improved drinking water sources. In both years, an increase in the number of household members was negatively associated with access to improved drinking water sources compared to those with fewer members. In both years, the odds of access to improved drinking water sources increased with an increase in the wealth index of the household, and households located in urban areas had higher odds of access to improved drinking water sources compared to those in rural settings. In both years, households from the Shiselweni and Lubombo regions had lower odds of access to improved drinking water sources. The government and its partners should continue to upscale efforts aimed at increasing access to improved drinking water, especially in rural areas, to reduce the disparity that exists between urban and rural households.

scholarly journals Investigating the accessibility factors that influence antenatal care services utilisation in Mangwe district, Zimbabwe

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Leoba Nyathi ◽  
Augustine K. Tugli ◽  
Takalani G. Tshitangano ◽  
Molyn Mpofu
Keyword(s):  
Health Care ◽  
Infant Mortality ◽  
Antenatal Care ◽  
Rural Areas ◽  
Public Health Problem ◽  
Health Department ◽  
Health Care Facilities ◽  
Structured Interviews ◽  
District Health ◽  
The Government

Background: Maternal and infant mortality remains a huge public health problem in developing countries. One of the strategies to minimise the risks of both maternal and infant mortality is access to and utilisation of antenatal care (ANC) services.Aim: This study aimed to investigate the accessibility factors that influence the use of ANC services in Mangwe district.Methods: A qualitative approach using explorative design was adopted to target women who have babies under 1 year of age. The study was conducted in Mangwe district, Matabeleland South province, Zimbabwe. Data were collected through semi-structured interviews and observations. Data saturation was reached after 15 women who were conveniently sampled were interviewed. Field notes were analysed thematically using Tech’s steps. Lincoln and Guba’s criteria ensured trustworthiness of the study findings.Results: Accessibility factors such as lack of transport, high transport costs and long distances to health care facilities, health care workers’ attitudes, type and quality of services as well as delays in receiving care influence women’s utilisation of ANC services in Mangwe district, Zimbabwe.Conclusion: The study concluded that women were still facing problems of unavailability of nearby clinics; therefore, it was recommended that the government should avail resources for women to use.Recommendations: Mangwe District Health Department should provide mobile clinics rendering ANC services in distant rural areas.

scholarly journals Under-Utilization of Maternal-Child Healthcare Services and Adverse Outcomes of Unwanted Pregnancies in Urban and Rural Areas of Indonesia

2021 ◽  
Vol 30 ◽  
pp. 170-182
Author(s):  
Yunisa Astiarani ◽  
◽  
Maybelline . ◽  
Giovani I.G. Putri ◽  
Nur Fitriah ◽  
...  
Keyword(s):  
Child Health ◽  
Antenatal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Unwanted Pregnancy ◽  
Healthcare Services ◽  
Maternal Child Health ◽  
Rural Settings ◽  
Child Healthcare ◽  
Maternal Child

The study examines the association of unwanted pregnancy and the utilization of maternal-child health services, and the adverse health outcomes in urban and rural settings. The study employed data from the 2017 Indonesia Demographic Health Survey that included 13,806 live births; the mothers were not pregnant at the interview and were married participants. The multiple logistic regression analysis concerning residential areas was conducted separately to compare outcomes related to unwanted pregnancy. Non-standard antenatal care visits (adjusted odds ratio [AOR]=1.7; 95% confidence interval [CI]=1.2–2.4), prolonged labor (AOR=1.6; 95% CI=1.2–2.1), the absence of child’s birth documentation (AOR=1.3; 95% CI=1.0–1.6), and smaller baby size (AOR=1.2; 95% CI=1.0–1.4) are associated with unwanted pregnancy in urban areas. In rural settings, on the other hand, unwanted pregnancy is associated with non-standard antenatal care (AOR=1.6; 95% CI=1.2–2.2). Therefore, in Indonesia, urban areas lack maternal-child healthcare services utilization and higher adverse events due to unwanted pregnancy than rural areas. An adjustment approach is required in maternal-child health-related programs in both areas, particularly for women living in urban.

scholarly journals Common Symptoms in COVID-19 Confirmed Cases Followed-Up at Home by Primary Healthcare Services

2021 ◽  
Vol 10 (3) ◽  
pp. 115-124
Author(s):  
Yeliz Mercan ◽  
Figen Digin ◽  
Seda Bulut
Keyword(s):  
Rural Areas ◽  
Health Care Services ◽  
Care Home ◽  
Family Health ◽  
Healthcare Services ◽  
High Fever ◽  
Polymerase Chain Reaction Test ◽  
Asymptomatic Patients ◽  
Chain Reaction Test ◽  
At Home

Aim: This study aims to determine common symptoms in COVID-19 confirmed patients who were followed up at home by primary health care services. Methods: This descriptive study was conducted in Kırklareli, Turkey between July 2020 and December 2020. The study was conducted with 315 patients aged 18 years and over who were confirmed positive by the Polymerase Chain Reaction test and followed up at home by a Family Health Center. Results: The mean age of the participants was 43.13±16.33 years. 53.7% were male, 87% lived in rural areas, 98.1% had health insurance and 54.9% were employed. Of the adults, 5.1% had the adult vaccine and 25.4% had a chronic disease. While at least one symptom was observed in 84.8% of the patients, 15.2% had no symptoms. The symptoms detected among the participants were cough (26.3%), headache (26.3%), and high fever (24.1%). The frequency of symptoms was higher in women than in men, and myalgia, arthralgia, nausea, and vomiting were also more frequent. The symptom of chills was more common in adults at 40 years and over compared to those under 40. Conclusion: In case of cough, headache, or high fever among adults, a healthcare provider should be consulted and screening for other symptoms. In terms of follow-up, symptom management, and treatment of the disease, women, and individuals 40 years and over should be prioritized, carefully followed up, and provided with the necessary isolation. There are also asymptomatic cases of COVID-19 disease. Isolation of asymptomatic patients is also important because of the high contagiousness of the disease. Keywords: COVID-19, symptoms, primary care, home care

scholarly journals Implementation fidelity of village health and nutrition days in Hardoi District, Uttar Pradesh, India: a cross-sectional survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mira Johri ◽  
Louis Rodgers ◽  
Dinesh Chandra ◽  
Cybil Abou-Rizk ◽  
Eleanor Nash ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Institutional Delivery ◽  
Uttar Pradesh ◽  
Implementation Fidelity ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
The Government ◽  
Village Health

Abstract Background Village Health and Nutrition Days (VHNDs) are a cornerstone of the Government of India’s strategy to provide first-contact primary health care to rural areas. Recent government programmes such as the Janani Suraksha Yojana (JSY) and Mission Indradhanush (MI) have catalysed important changes impacting VHNDs. To learn how VHNDs are currently being delivered, we assessed the fidelity of services provided as compared to government norms in a priority district of Uttar Pradesh. Methods We fielded a cross-sectional study of VHNDs to provide a snapshot of health services functioning. Process evaluation data were collected via administrative sources, non-participant observation using a standardised form, and structured questionnaires. Questionnaires were designed using a framework to assess implementation fidelity. Key respondents were VHND participants, front-line workers involved in VHND delivery, and VHND non-participants (pregnant women due for antenatal care or children due for vaccination as per administrative records). Results were summarised as counts, frequencies, and proportions. Results In the 30 villages randomly selected for inclusion, 36 VHNDs were scheduled but four (11.1%) were cancelled and one VHND was not surveyed. Vaccination and antenatal care were offered at 96.8% (30/31) and child weighing at 83.9% (26/31) of VHNDs. Other normed services were infrequently provided or completely absent. Health education and promotion were particularly weak; institutional delivery was the only topic discussed in a majority of VHNDs. The true proportion of any serious problem impeding vaccine delivery was 47.2% (17/36), comprising 4 VHND cancellations and 13 VHNDs experiencing vaccine shortages. Of the 13 incidents of vaccine shortage, 11 related to an unexpected global shortage of injectable polio vaccine (IPV). Over the 31 VHNDs, 37.8% (171 of the 452 scheduled beneficiaries) did not participate. Analysis of missed opportunities for vaccination highlighted inaccuracies in beneficiary identification and tracking and demand side-factors. Conclusions The transformative potential of VHNDs to improve population health is only partially being met. A core subset of high-priority services for antenatal care, institutional delivery, and vaccination associated with high-priority government programmes (JSY, MI) is now being provided quite successfully. Other basic health promotion and prevention services are largely not provided, constituting a critical missed opportunity.

scholarly journals A qualitative study of bereaved family caregivers: feeling of security, facilitators and barriers for rural home care and death for persons with advanced cancer

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anne Sæle Barlund ◽  
Beate André ◽  
Kari Sand ◽  
Anne-Tove Brenne
Keyword(s):  
Palliative Care ◽  
Qualitative Study ◽  
End Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Rural Areas ◽  
Healthcare Professionals ◽  
Healthcare Services ◽  
Personal Factors ◽  
At Home

Abstract Background For cancer patients and their family, an important factor that determines the choice to die at home is the caregivers’ feeling of security when caring for the patient at home. Support to caregivers from healthcare professionals is important for the feeling of security. In rural areas, long distances and variable infrastructure may influence on access to healthcare services. This study explored factors that determined the security of caregivers of patients with advanced cancer who cared for the patients at home at the end of life in the rural region of Sogn og Fjordane in Norway, and what factors that facilitated home death. Methods A qualitative study using semi-structured in-depth interviews with bereaved with experience from caring for cancer patients at home at the end of life was performed. Meaning units were extracted from the transcribed interviews and divided into categories and subcategories using Kvale and Brinkmann’s qualitative method for analysis. Results Ten bereaved caregivers from nine families where recruited. Five had lived together with the deceased. Three main categories of factors contributing to security emerged from the analysis: “Personal factors”, “Healthcare professionals” and “Organization” of healthcare. Healthcare professionals and the organization of healthcare services contributed most to the feeling of security. Conclusion Good competence in palliative care among healthcare professionals caring for patients with advanced cancer at home and well- organized palliative care services with defined responsibilities provided security to caregivers caring for advanced cancer patients at home in Sogn og Fjordane.

Sign in / Sign up

Export Citation Format

Share Document