scholarly journals Association of identification of facility and transportation for childbirth with institutional delivery in high priority districts of Uttar Pradesh, India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Divya Rajvanshi ◽  
John Anthony ◽  
Vasanthakumar Namasivayam ◽  
Bidyadhar Dehury ◽  
Ramesh Banadakoppa Manjappa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Rural Areas ◽  
Institutional Delivery ◽  
Uttar Pradesh ◽  
System Level ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Safe Delivery

Abstract Background Timely and skilled care is key to reducing maternal and neonatal mortality. Birth preparedness involves preparation for safe childbirth during the antenatal period to reach the appropriate health facility for ensuring safe delivery. Hence, understanding the factors associated with birth preparedness and its significance for safe delivery is essential. This paper aims to assess the levels of birth preparedness, its determinants and association with institutional deliveries in High Priority Districts of Uttar Pradesh, India. Methods A community-based cross-sectional survey was conducted between June–October 2018 in the rural areas of 25 high priority districts of Uttar Pradesh, India. Simple random sampling was used to select 40 blocks among 294 blocks in 25 districts and 2646 primary sampling units within the selected blocks. The survey interviewed 9458 women who had a delivery 2 months prior to the survey. Descriptive statistics were included to characterize the study population. Multivariable logistic regression analyses were performed to identify the determinants of birth preparedness and to examine the association of birth preparedness with institutional delivery. Results Among the 9458 respondents, 61.8% had birth preparedness (both facility and transportation identified) and 79.1% delivered in a health facility. Women in other caste category (aOR = 1.24, CI 1.06–1.45) and those with 10 or more years of education (aOR = 1.68, CI 1.46–1.92) were more likely to have birth preparedness. Antenatal care (ANC) service uptake related factors like early registration for ANC (aOR = 1.14, CI 1.04–1.25) and three or more front line worker contacts (aOR = 1.61, CI 1.46–1.79) were also found to be significantly associated with birth preparedness. The adjusted multivariate model showed that those who identified both facility and transport were seven times more likely to undergo delivery in a health facility (aOR = 7.00, CI 6.07–8.08). Conclusion The results indicate the need for focussing on marginalized groups for improving birth preparedness. Increasing ANC registration in the first trimester of pregnancy, improving frontline worker contact, and optimum utilization of antenatal care check-ups for effective counselling on birth preparedness along with system level improvements could improve birth preparedness and consequently institutional delivery rates in Uttar Pradesh, India.

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 Exploring COVID-19 Related Factors Influencing Antenatal Care Services Uptake: A Qualitative Study among Women in a Rural Community in Southwest Ethiopia

2021 ◽  
Vol 12 ◽  
pp. 215013272199689
Author(s):  
Shewangizaw Hailemariam ◽  
Wubetu Agegnehu ◽  
Misganaw Derese
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Qualitative Study ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Health Facility ◽  
Care Service ◽  
Maternal Health Service ◽  
Related Factors ◽  
Factors Influencing

Introduction: Evidences suggest a significant decline in maternal health service uptake following the coronavirus disease 2019 (COVID-19) pandemic in Ethiopia. However, COVID-19 related factors impacting the service uptake are not sufficiently addressed. Hence, the current study was intended to explore COVID-19 related factors influencing antenatal care service uptake in rural Ethiopia. Methods: A community-based qualitative study was conducted from September 25/2020 to November 25/2020 among selected pregnant women residing in rural districts of Bench-Sheko Zone, and healthcare providers working in the local health care facilities. Six focus group discussions and 9 in-depth interviews were made between pregnant women, and health care providers, respectively. Data was collected by health education and behavioral science professionals who also have experience in qualitative data collection procedure. Data were transcribed, translated, and analyzed thematically using Open Code 4.0 software. Result: The study revealed several COVID-19 related factors influencing the uptake of antenatal care service during the pandemic. Health facility related barriers, perceived poor quality of care during the pandemic, government measures against COVID-19, anxiety related to the pandemic, and risk minimization were the identified factors possibly influencing the current antenatal care service uptake among women in rural Bench-Sheko Zone. Conclusion: COVID-19 preventive measures, and health facility related factors and individual factors were responsible for the current decline in antenatal care service uptake. Preserving essential health care service is critical to prevent avoidable losses of maternal and child lives during the pandemic period. Hence, programs and strategies designed to maintain maternal health services particularly, antenatal care service have better take the above determinants into consideration.

scholarly journals Determinants of antenatal care visits and their impact on the choice of birthplace among mothers in Uganda: a systematic review

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Shallon Atuhaire ◽  
John Francis Mugisha
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Cochrane Review ◽  
Maternal Health Services ◽  
Economic Factors ◽  
Sustainable Livelihood ◽  
Intrinsic Factors ◽  
Socio Economic Factors

Objective: The utilization of Antenatal Care (ANC) services to the recommended time by WHO is still low in developing countries. In Uganda, about 990,000 women become pregnant annually, 90 to 94% of whom attend at least the first ANC visit while 65% and 58% of them attend four or more times in urban and rural areas respectively with eventual health facility birth at about 62%, homebirth and TBA together at about 38%. The study determined antenatal care attendance and the mother’s choice of birthplace in Uganda. Materials and methods: Using electronic databases mainly Google Scholar, Science Direct, PubMed and African Journals Online, and journal articles of international Website, 70,195 articles were identified but only 19 met the Cochrane review inclusion criteria hence were reviewed. Results: Reviewed studies attribute a decline in antenatal care visits and subsequent choice of birthplace to institutional, demographic and socio-economic factors. The demographic factors are maternal age (mothers less than eighteen years are less likely to utilize maternal health services than those above), marital status, occupation, residency, distance from home to the health facility, and parity. The socio-economic factors are mothers’ and partners’ levels of education (less educated women and their partners are less likely to utilize ANC), household income which affects transportation and medical bills, cultural norms and taboos, patriarchy society, enrollment on ANC in the third trimester, and intrinsic factors of attending ANC such as obtaining ANC card to present in case of emergency. Institutional factors include quality of medical care, availability of logistics and supplies, and health workers’ influence in terms of attitude, referral, competences, and staffing. Conclusion: Pregnant women who attend ANC are more likely to deliver in the health facility than those who do not at all. To enable them to attend ANC to full term and have a health facility delivery, their empowerment for increased self-efficacy through education, sustainable livelihood training and provision of subsidized capital alongside partner involvement. The facilitation of health facilities would also attract them.

scholarly journals Health professionals’ experiences and views on obstetric ultrasound in Vietnam: a regional, cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031761
Author(s):  
Sophia Holmlund ◽  
Pham Thi Lan ◽  
Kristina Edvardsson ◽  
Ho Dang Phuc ◽  
Joseph Ntaganira ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Health Professionals ◽  
Rural Areas ◽  
Fetal Heart ◽  
Cross Sectional Study ◽  
Obstetric Ultrasound ◽  
Cross Sectional ◽  
Uncomplicated Pregnancy ◽  
Ultrasound Study

ObjectivesObstetric ultrasound is an important part of antenatal care in Vietnam, although there are great differences in access to antenatal care and ultrasound services across the country. The aim of this study was to explore Vietnamese health professionals’ experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.DesignA cross-sectional questionnaire study was performed as part of the CROss Country UltraSound study.SettingHealth facilities (n=29) in urban, semiurban and rural areas of Hanoi region in Vietnam.ParticipantsParticipants were 289 obstetricians/gynaecologists and 535 midwives.ResultsA majority (88%) of participants agreed that ‘every woman should undergo ultrasound examination’ during pregnancy to determine gestational age. Participants reported an average of six ultrasound examinations as medically indicated during an uncomplicated pregnancy. Access to ultrasound at participants’ workplaces was reported as always available regardless of health facility level. Most participants performing ultrasound reported high-level skills for fetal heart rate examination (70%), whereas few (23%) reported being skilled in examination of the anatomy of the fetal heart. Insufficient ultrasound training leading to suboptimal pregnancy management was reported by 37% of all participants. ‘Better quality of ultrasound machines’, ‘more physicians trained in ultrasound’ and ‘more training for health professionals currently performing ultrasound’ were reported as ways to improve the utilisation of ultrasound.ConclusionsObstetric ultrasound is used as an integral part of antenatal care at all selected health facility levels in the region of Hanoi, and access was reported as high. However, reports of insufficient ultrasound training resulting in suboptimal pregnancy management indicate a need for additional training of ultrasound operators to improve utilisation of ultrasound.

scholarly journals Variation in body mass index and their determinants among married women in Uttar Pradesh

2015 ◽  
Vol 3 (2) ◽  
pp. 52
Author(s):  
Sonam Maheshwari ◽  
Brijesh Singh ◽  
Omprakash Singh ◽  
Puneet Gupta
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Rural Areas ◽  
Nutrition Transition ◽  
Uttar Pradesh ◽  
Married Women ◽  
The Body ◽  
Nutrition Status ◽  
Related Factors ◽  
Nutrition Research

<p>The body mass index of married women is a high quality sign of a country’s health status as well as economic condition. Nutrition    research in India has previously focused on the serious problem of under nutrition related to nutrient deficit and high rates of infection. BMI provide an indicator for supporting to wipe out many preventable diseases. Alteration in nutritional status plays an important role in the course of a person’s health. Hence, BMI can be used as an indicator for nutrition status, and association with some diseases can be expected. This study observes the emerging nutrition transition among 7559 married and currently non –pregnant women aged between 15-49 years and also the differential impact of some demographic, socioeconomic, environmental and health-related factors on the body mass index living in Uttar Pradesh, India. The third wave of National Family Health Survey (2005-06) data provides nationally representative data on women’s weight and height. Average BMI is 21.11 kg/m2, and a turn down tendency in BMI was found during the last about 20 years.  Body mass index increased with increasing age, education level of the woman, standard of living index. Lower BMI was especially pronounced among women who were living in rural areas, Hindus, employed women and women who are anemic.</p>

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Micheal A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7% and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78).Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.

scholarly journals Antenatal Care Visits of Child-Bearing Mothers Having a Child Five Years Preceding in the Survey and Associated Factors in Benchi-Sheko Zone, Southwestern Ethiopia: Cross-Sectional Study

2021 ◽  
Author(s):  
Assaye Belay Gelaw ◽  
Solomon Abebaw Andargie ◽  
Abiyot Negsh Terefe
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional Survey ◽  
Related Factors ◽  
Cross Sectional ◽  
Southwestern Ethiopia ◽  
Education Status ◽  
Health Institutions

Abstract Background Antenatal care (ANC) is the service given by the caregiver for pregnant women to make safe the health of both pregnant women and babies during the pregnancy period Objectives The objective of the current study was to persuade high-quality public health service and plan the mothers and their households expressively and mentally for being motherhood by ever-increasing antenatal care visits from health institutions. Methods Community-based cross-sectional study design was applied. Cross-sectional survey design mainly used for the collection of information on the Utilization of Antenatal Care Visit of Women During Pregnancy and its Related Factors in Bench-Sheko Zone, South Nation Nationalities Peoples of Region, Southwestern Ethiopia: Cross-sectional study. The study populations are all populations who are living in the study area, South Nation Nationalities peoples of Region, Southwestern Ethiopia. Results Evidence tells us, one hundred twenty-nine (16.9%) of pregnant women were not visited by the caregiver during pregnancy. Around eighty-three percent of pregnant women were visited in health institutions at least once prior in the five years in the survey. The Poisson regression model was preferred to fit the data. As the output indicated in analysis, the odds ratio of women whose husband education status is illiterate is equal to exp(-0.272) = 0.76(95% CI:-0.507,-0.038) (other variables are adjusted), it indicates that the women whose husband education status is 0.76 less likely to ANC visit than women whose husband education status is higher and above. Conclusions The remark conclusion that the source of information, religion, educational status, birth order, knowledge of danger signs for pregnancy, and service satisfaction were significant at the alpha level of significance on the ANC visit of Women during pregnancy.

Challenges Faced by B.P.L. Population in Availing Public Healthcare – Analysing Government Initiatives, Technology and Cultural Barriers in Aligarh District, U.P

2021 ◽  
Vol 2 (5) ◽  
pp. 1-19
Author(s):  
Fahad Afzal ◽  
P.S. Raychaudhuri ◽  
Mohd Atif Afzal ◽  
Afaq Amir Ahmad
Keyword(s):  
Public Health ◽  
Data Analysis ◽  
Low Income ◽  
Rural Areas ◽  
Uttar Pradesh ◽  
Secondary Data ◽  
Survey Study ◽  
Public Healthcare ◽  
Cross Sectional Survey ◽  
Low Income Population

Public healthcare and government health initiative have always been in question regarding their availability, efficiency, and quality. This matter most for the poor section of society who have to go through various hurdles to avail the basic treatment, besides financial problems. The aim of this survey study was to analyze the present scenario of public healthcare system and the challenges in availing public healthcare faced by BPL (Below Poverty Line) and low-income population of Uttar Pradesh. A cross-sectional survey (direct interview) of 104 respondents was conducted in March 2021. Thematic analysis of generated qualitative data was done using ATLAS.ti (version 9.0.15). The quantitative data was analyzed by using SPSS (version 22.0.0.0). The respondents were from 2 rural areas near the Aligarh district in UP. The secondary data from published research articles and government sources were also analyzed. Analysis of data revealed there are various challenges faced by low-income population while availing public healthcare services. The nature of challenges has a considerable variation, from lack of information to documents’ unavailability, from technical issues in government schemes to cultural pressure. Data analysis revealed, the majority of respondents (59%) faced one or more types of challenges during treatment from public health facilities. Awareness level is identified as a significant problem among respondents. Analysis of secondary data and literature review revealed uneven resource allocation and discrepancies in government initiatives toward UHC (Universal Health Coverage). Results indicated the contrasting nature of healthcare in Uttar Pradesh. Data analysis revealed the disparity of ‘average OOP travelling expenditure’ for male and female. The correlation analysis revealed that there is negative correlation (y = -0.1377x + 11.119) of ‘age of respondent’ and ‘average satisfaction from public health service’ (r = -0.911; R² = 0.8301). This research article provides the evidence that there exists a communication gap between policymakers and end-users (BPL & low-income section). This article underscored some technical flaw in the UHC policies that act as a barrier for low socio economic and BPL population. This article suggests strategies to control various identified challenges.

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Michael A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Background Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania. Methods We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study. Results Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7 and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78). Conclusion Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.

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