Do women empowerment indicators predict receipt of quality antenatal care in Cameroon? Evidence from a nationwide survey

Abstract Background World Health Organisation (WHO) recommends quality antenatal care (ANC) for all pregnant women, as one of the strategies for achieving targets 3.1 and 3.2 of the sustainable development goals. Maternal mortality ratio remains high in Cameroon (782 maternal deaths per 100,000 live births). Extant literature suggest a positive association between women empowerment indicators and maternal healthcare utilisation in general. In Cameroon, this association has not received scholarly attention. To fill this knowledge gap, we investigated the association between women empowerment indicators and quality ANC in Cameroon. Methods Data of 4615 women of reproductive age were analysed from the women’s file of the 2018 Cameroon Demographic and Health Survey. Quality ANC (measured by six indicators) was the outcome of interest. Binary Logistic Regression was conducted. All results of the Binary Logistic Regression analysis were presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). All analyses were done using Stata version 14. Results In all, 13.5% of the respondents received quality ANC. Women with low knowledge level (aOR = 0.66, CI 0.45, 0.98) had a lesser likelihood of receiving quality ANC compared to those with medium knowledge level. Women who highly approved wife beating (aOR = 0.54, CI 0.35, 0.83) had lesser odds of receiving quality ANC compared to those with low approval of wife beating. Conclusion The study has pointed to the need for multifaceted approaches aimed at enhancing the knowledge base of women. The Ministry of Public Health should collaborate and intensify female’s reproductive health education. The study suggests that women advocacy and maternal healthcare interventions in Cameroon must strive to identify women who approve of wife beating and motivate them to disapprove all forms of violence.

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Spatiotemporal distribution and determinants of delayed first antenatal care visit among reproductive age women in Ethiopia: a spatial and multilevel analysis

BMC Public Health ◽

10.1186/s12889-021-11614-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel Gashaneh Belay ◽

Fantu Mamo Aragaw ◽

Denekew Tenaw Anley ◽

Yibeltal Shitu Tegegne ◽

Kassahun Alemu Gelaye ◽

...

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Intervention Program ◽

Adverse Pregnancy Outcome ◽

Unwanted Pregnancy ◽

Binary Logistic Regression ◽

Reproductive Age ◽

Safe Motherhood ◽

Binary Logistic Regression Analysis ◽

Binary Logistic Regression Model

Abstract Background Antenatal care (ANC) is one of the four pillars of the initiative for safe motherhood. ANC helps to improve the health of pregnant women and reduce the risk of adverse pregnancy outcome. First ANC is used to know the health status of the mothers and the fetus, to estimate the gestational age and expected date of delivery. Our research aims to investigate the Spatio-temporal distribution of delayed first ANC visit and its predictors using multilevel binary logistic regression analysis. Method A total of 10,184 women (2061 in 2005, 3366 in 2011, and 4757 in 2016) were included for this study. The data were cleaned and weighted using STATA version 14. A multilevel binary logistic regression model was fitted to identify significant predictors of delayed first ANC visit. ArcGIS software was used to explore the spatial distribution of delayed first ANC visits and a Bernoulli model was fitted using SaTScan software to identify significant clusters of delayed first ANC visits. Results Overall, 77.69, 73.95, and 67.61% of women had delayed their first ANC visit in 2005, 2011, and 2016 EDHSs respectively. Women education [AOR = 0.71; 95%CI; 0.60, 0.84], unwanted pregnancy [AOR = 1.41;95%CI; 1.04, 1.89], and rural residence [AOR = 1.68;95%CI; 1.19, 2.38] have significantly associated with delayed first ANC visit. The spatial analysis revealed that delayed first ANC visit varies in each EDHS period. The SaTScan analysis result of EDHS 2005 data identified 122 primary clusters located between the border of Oromia and Eastern SNNPR regions (RR = 1.30, LLR = 32.31, P-value< 0.001), whereas in 2011 EDHS, 145 primary clusters were identified in entire Tigray, B/Gumuz, Amhara western part of Afar and northwest Oromia regions (RR = 1.30, LLR = 40.79, P-value< 0.001). Besides in 2016 EDHS,198 primary clusters were located in the entire SNNPR, Gambella, Northen B/Gumuz, and western Oromia regions. (RR = 1.35, LLR = 83.21, P-value< 0.001). Conclusion In Ethiopia delayed first ANC visit was significantly varied across the country over time Women’s education, wanted the last child, and residence were significantly associated with delayed first ANC booking. The effect of each predictor was found to be different across regions of Ethiopia. Therefore, a targeted intervention program is required in highly affected areas of Ethiopia.

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Intimate Partner Violence and its Association With Contraceptive Use Among Women in Pakistan

Pakistan Journal of Psychological Research ◽

10.33824/pjpr.2019.34.1.9 ◽

2019 ◽

Vol 34 (Spring 2019) ◽

pp. 157-173

Author(s):

Kashif Siddique ◽

Rubeena Zakar ◽

Ra’ana Malik ◽

Naveeda Farhat ◽

Farah Deeba

Keyword(s):

Intimate Partner Violence ◽

Logistic Regression ◽

Partner Violence ◽

Contraceptive Use ◽

Binary Logistic Regression ◽

Intimate Partner ◽

Married Women ◽

Reproductive Age ◽

Outcome Variable ◽

Odds Ratios

The aim of this study is to find the association between Intimate Partner Violence (IPV) and contraceptive use among married women in Pakistan. The analysis was conducted by using cross sectional secondary data from every married women of reproductive age 15-49 years who responded to domestic violence module (N = 3687) of the 2012-13 Pakistan Demographic and Health Survey. The association between contraceptive use (outcome variable) and IPV was measured by calculating unadjusted odds ratios and adjusted odds ratios with 95% confidence intervals using simple binary logistic regression and multivariable binary logistic regression. The result showed that out of 3687 women, majority of women 2126 (57.7%) were using contraceptive in their marital relationship. Among total, 1154 (31.3%) women experienced emotional IPV, 1045 (28.3%) women experienced physical IPV and 1402 (38%) women experienced both physical and emotional IPV together respectively. All types of IPV was significantly associated with contraceptive use and women who reported emotional IPV (AOR 1.44; 95% CI 1.23, 1.67), physical IPV (AOR 1.41; 95% CI 1.20, 1.65) and both emotional and physical IPV together (AOR 1.49; 95% CI 1.24, 1.72) were more likely to use contraceptives respectively. The study revealed that women who were living in violent relationship were more likely to use contraceptive in Pakistan. Still there is a need for women reproductive health services and government should take initiatives to promote family planning services, awareness and access to contraceptive method options for women to reduce unintended or mistimed pregnancies that occurred in violent relationships.

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Health insurance coverage and maternal healthcare services utilization in Jordan: evidence from the 2017–18 Jordan demographic and health survey

Archives of Public Health ◽

10.1186/s13690-021-00605-4 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Petula Fernandes ◽

Emmanuel Kolawole Odusina ◽

Bright Opoku Ahinkorah ◽

Komlan Kota ◽

Sanni Yaya

Keyword(s):

Health Insurance ◽

Antenatal Care ◽

Insurance Coverage ◽

Health Insurance Coverage ◽

Healthcare Services ◽

Skilled Birth Attendance ◽

Reproductive Age ◽

Maternal Healthcare ◽

Services Utilization ◽

Birth Attendance

Abstract Background Despite the relationship between health insurance coverage and maternal healthcare services utilization, previous studies in Jordan on the use of maternal healthcare services have mainly focused on patterns and determinants of maternal healthcare services utilization in Jordan. Therefore, this study investigated the relationship between health insurance coverage and maternal healthcare services utilization in Jordan. Methods This study used secondary data published in 2017-18 Jordan Demographic and Health Survey on 4656 women of reproductive age (15–49 years). The independent variable was health insurance coverage and the outcome variable was maternal healthcare services utilization, measured through timing of first antenatal visit, four or more antenatal care visits, and skilled birth attendance. The data were analyzed using descriptive statistics and binary logistic regression. Results Out of the total number of women who participated in the study, 38.2% were not covered by health insurance. With maternal healthcare utilization, 12.5%, 23.2%, and 10.1% respectively, failed to make early first antenatal care visit, complete four or more antenatal care visits and have their delivery attended by a skilled worker. After controlling for the socio-demographic factors, health insurance coverage was associated with increased odds of early timing of first antenatal care visits and completion of four or more antenatal care visits (aOR = 1.33, p < 0.05, aOR = 1.25, p < 0.01, respectively). However, women who were covered by health insurance were less likely to use skilled birth attendance during delivery (aOR = 0.72 p < 0.001). Conclusions Jordanian women with health insurance coverage were more likely to have early first antenatal care visits and complete four or more antenatal care visits. However, they were less likely to have their delivery attended by a skilled professional. This study provides evidence that health insurance coverage has contributed to increased maternal healthcare services utilization, only in terms of number and timing of antenatal care visits in Jordan. It is recommended that policy makers in Jordan should strengthen the coverage of health insurance in the country, especially among women of reproductive age in order to enhance the use of maternal healthcare services in the country.

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Are Ghanaian women meeting the WHO recommended maternal healthcare (MCH) utilisation? Evidence from a national survey

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03643-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Edward Kwabena Ameyaw ◽

Kwamena Sekyi Dickson ◽

Kenneth Setorwu Adde

Keyword(s):

Binary Logistic Regression ◽

Skilled Birth Attendant ◽

World Health Organisation ◽

Skilled Birth Attendance ◽

World Health ◽

Maternal Healthcare ◽

Wealth Status ◽

Maternal Characteristics ◽

Birth Attendance ◽

Three Components

Abstract Background To achieve the Sustainable Development Goal target 3.1, the World Health Organisation recommends that all pregnant women receive antenatal care (ANC) from skilled providers, utilise the services of a skilled birth attendant at birth and receive their first postnatal care (PNC) within the first 24 h after birth. In this paper, we examined the maternal characteristics that determine utilisation of skilled ANC, skilled birth attendance (SBA), and PNC within the first 24 h after delivery in Ghana. Methods We used data from the 2014 Ghana Demographic and Health Survey. Women aged 15-49 with birth history not exceeding five before the survey were included in the study. A total of 2839 women were included. Binary logistic regression was employed at a 95% level of significance to determine the association between maternal factors and maternal healthcare (MCH) utilisation. Bivariate and multivariate regression was subsequently used to assess the drivers. Results High proportion of women had ANC (93.2%) with skilled providers compared to the proportion that had SBA (76.9%) and PNC within the first 24 h after delivery (25.8%). Only 21.2% utilised all three components of MCH. Women who were covered by national health insurance scheme (NHIS) had a higher likelihood (AOR = 1.31, CI = 1.04 – 1.64) of utilising all three components of MCH as compared to those who were not covered by NHIS. Women with poorer wealth status (AOR = 0.72, CI = 0.53 – 0.97) and those living with partners (AOR = 0.65, CI = 0.49 – 0.86) were less likely to utilise all three MCH components compared to women with poorest wealth status and the married respectively. Conclusion The realisation that poorer women, those unsubscribed to NHIS and women living with partners have a lower likelihood of utilising the WHO recommended MCH strongly suggest that it is crucial for the Ministry of Health and the Ghana Health Service to take pragmatic steps to increase education about the importance of having ANC with a skilled provider, SBA, and benefits of having the first 24 h recommended PNC.

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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.

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Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

10.21203/rs.2.15849/v3 ◽

2019 ◽

Author(s):

James Orwa ◽

Michaela Mantel ◽

Micheal Mugerwa ◽

Sharon Brownie ◽

Eunice Siaity Pallangyo ◽

...

Keyword(s):

Antenatal Care ◽

Health Facility ◽

Healthcare Services ◽

Facility Delivery ◽

Postpartum Care ◽

Reproductive Age ◽

Antenatal Visit ◽

Health Facility Delivery ◽

Maternal Healthcare ◽

Cross Sectional

Abstract Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services. Keywords: Antenatal care, health facility delivery, postpartum care, Mwanza, Tanzania

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Determinants of Ethiopian Women’s Attitudes Toward Wife Beating

Journal of Interpersonal Violence ◽

10.1177/0886260517691524 ◽

2017 ◽

Vol 35 (1-2) ◽

pp. 510-520

Author(s):

Eshetu Wencheko ◽

Mekonnen Tadesse

Keyword(s):

Partner Violence ◽

Emotional Abuse ◽

Multiple Logistic Regression Analysis ◽

Intimate Partner ◽

Married Women ◽

Reproductive Age ◽

Wife Beating ◽

World Health ◽

Place Of Residence ◽

Level Of Education

The World Health Organization stipulated that intimate partner violence is one of the most common forms of violence against women and includes physical, sexual, and emotional abuse and controlling behaviors by an intimate partner. Opposition of women against any form of violence at home, beating by their husbands in particular, is a manifestation of readiness to assert their personal rights. This study used data from the 2011 Ethiopian Demographic and Health Survey to identify some predictors to determine attitudes of married Ethiopian women toward wife beating. The dataset used consisted of 5,818 married women of the reproductive age group 15 to 49 years. While 1,393 (24%) married women did not oppose wife beating, a total of 4,425 (76%) opposed the practice. In the binary multiple logistic regression analysis, age, economic status, level of education, employment status of a woman, number of children living in the household, region (federal administrative regions delineated on the basis of ethnicity), place of residence (urban vs. rural), religion, and husband’s level of education have been included as possible socioeconomic and demographic determinants of women’s attitudes toward wife beating. The findings showed that the predictors region, place of residence, number of living children in a household, and religion were significantly associated with women attitudes toward wife beating.

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Does Antenatal Care Translate into Skilled Birth Attendance? Analysis of 2014 Ghana Demographic and Health Survey

Advances in Public Health ◽

10.1155/2019/6716938 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Linus Baatiema ◽

Edward Kwabena Ameyaw ◽

Aliu Moomin ◽

Mukaila Mumuni Zankawah ◽

Doris Koramah

Keyword(s):

Logistic Regression ◽

Antenatal Care ◽

Health Survey ◽

Tertiary Education ◽

Binary Logistic Regression ◽

Skilled Birth Attendance ◽

Demographic And Health Survey ◽

Rural Setting ◽

Binary Logistic Regression Analysis ◽

Birth Attendance

Background. Despite the high antenatal care attendance rate in Ghana, skilled birth attendance is relatively low. There is limited evidence on whether antenatal care attendance translates into skilled birth attendance in the Ghanaian research discourse. This study investigates whether antenatal care attendance translates into skilled birth. Methods. We extracted data from the 2014 Ghana Demographic and Health Survey. Data were analysed using descriptive and binary logistic regression analyses at 5% confidence interval. Results. The descriptive findings indicated a vast variation between antenatal care attendance and skilled birth attendance. Skilled birth attendance was consistently low across almost all sociodemographic characteristics as compared to antenatal care attendance. The binary logistic regression analysis however indicated higher inclination toward skilled birth attendance among women who had at least four antenatal care visits [OR=5.87, CI=4.86-7.08]. The category of women noted to have higher tendencies of skilled birth attendance was those with higher/tertiary education [OR=9.13, CI=2.19-37.93], the rich [OR=4.27, CI=3.02-6.06], urban residents [OR=2.35, CI=1.88-2.93], women with maximum of four children [OR=1.36, CI=1.08-1.72], and those using modern contraceptives [OR=1.24, CI=1.03-1.50]. Conclusion. We recommend that interventions to enhance skilled birth attendance must target women who do not achieve at least four antenatal visits, those with low wealth standing, those not using contraceptives, and women without formal education. Again, an in-depth qualitative study is envisaged to deepen the understanding of these dynamics in the rural setting.

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Sub-regional disparities in the use of antenatal care service in Mauritania: findings from nationally representative demographic and health surveys (2011–2015)

BMC Public Health ◽

10.1186/s12889-021-11836-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Gebretsadik Shibre ◽

Betregiorgis Zegeye ◽

Bright Opoku Ahinkorah ◽

Dina Idriss-Wheeler ◽

Mpho Keetile ◽

...

Keyword(s):

Antenatal Care ◽

Maternal Mortality ◽

Statistical Significance ◽

Maternal Mortality Ratio ◽

Population Attributable Risk ◽

Population Attributable Fraction ◽

Regional Disparities ◽

World Health ◽

Demographic And Health Surveys ◽

Mortality Ratio

Abstract Background Skilled antenatal care (ANC) has been identified as a proven intervention to reducing maternal deaths. Despite improvements in maternal health outcomes globally, some countries are signaling increased disparities in ANC services among disadvantaged sub-groups. Mauritania is one of sub-Saharan countries in Africa with a high maternal mortality ratio. Little is known about the inequalities in the country’s antenatal care services. This study examined both the magnitude and change from 2011 to 2015 in socioeconomic and geographic-related disparities in the utilization of at least four antenatal care visits in Mauritania. Methods Using the World Health Organization’s Health Equity Assessment Toolkit (HEAT) software, data from the 2011 and 2015 Mauritania Multiple Indicator Cluster Surveys (MICS) were analyzed. The inequality analysis consisted of disaggregated rates of antenatal care utilization using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population attributable risk, Ratio and Population attributable fraction). A 95% Uncertainty Interval was constructed around point estimates to measure statistical significance. Results Substantial absolute and relative socioeconomic and geographic related disparities in attending four or more ANC visits (ANC4+ utilization) were observed favoring women who were richest/rich (PAR = 19.5, 95% UI; 16.53, 22.43), educated (PAF = 7.3 95% UI; 3.34, 11.26), urban residents (D = 19, 95% UI; 14.50, 23.51) and those living in regions such as Nouakchott (R = 2.1, 95% UI; 1.59, 2.56). While education-related disparities decreased, wealth-driven and regional disparities remained constant over the 4 years of the study period. Urban-rural inequalities were constant except with the PAR measure, which showed an increasing pattern. Conclusion A disproportionately lower ANC4+ utilization was observed among women who were poor, uneducated, living in rural areas and regions such as Guidimagha. As a result, policymakers need to design interventions that will enable disadvantaged subpopulations to benefit from ANC4+ utilization to meet the Sustainable Development Goal (SDG) of reducing the maternal mortality ratio (MMR) to 140/100, 000 live births by 2030.

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Maternal outcome following uterine rupture and its associated factors among mothers who delivered at Felege-Hiwot referral hospital, Amhara-Ethiopia

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20185349 ◽

2018 ◽

Vol 5 (1) ◽

pp. 9 ◽

Cited By ~ 1

Author(s):

Alemtsehay Wesson ◽

Enyew Assefa

Keyword(s):

Developing Countries ◽

Logistic Regression ◽

Antenatal Care ◽

Uterine Rupture ◽

Associated Factors ◽

Binary Logistic Regression ◽

Maternal Outcome ◽

Referral Hospital ◽

Felege Hiwot Referral Hospital ◽

Ruptured Uterus

Background: Ruptured uterus is one of the major causes of maternal and prenatal morbidities and mortalities in developing countries, particularly in Africa. Ethiopia is one of developing countries where maternal and prenatal mortalities are still high. The major objective of this study was to determine maternal outcomes of uterine rupture and its associated factors.Methods: The study design was facility based retrospective cross-sectional study from all mothers who visit from 01 September 2011 to 31 August 2015 at Felege-Hiwot referral hospital delivery room for delivery service with ruptured uterus was conducted in the study. A total of 312 cases were enrolled in the study. The table, graph and binary logistic regression was found to be more appropriate for analyzing the data. Results: More than 39% mothers had severe complication. The common complication was severe anemia 24.4% followed by severe shock 14.7%. There were also 2.7% maternal deaths. The binary logistic regression model showed that incidence and its complication of uterine rupture in this study were remarkably high. Antenatal care visit, duration of labor and admission to laparotomy time and hospital stay had strong association with maternal outcome.Conclusions: Improving access to antenatal care, proper monitoring of labor and early referral of high risk patients will contribute to the reduction of unfavorable maternal outcome.

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