scholarly journals Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah
Keyword(s):  
Health Facility ◽  
Health Survey ◽  
Formal Education ◽  
Unplanned Pregnancy ◽  
Facility Delivery ◽  
Health Facilities ◽  
Demographic And Health Survey ◽  
Health Facility Delivery ◽  
Childbearing Women ◽  
At Home

Abstract Background Many childbearing women in sub-Saharan African countries like Guinea still face challenges accessing and utilizing health facility delivery services and opt to deliver at home. This study examined the non-utilization of health facility delivery and its associated factors among childbearing women in Guinea. Methods Data from the 2018 Guinea Demographic and Health Survey was used in this study. Data of 5406 childbearing women were analysed using STATA version 14.2 by employing a multilevel logistic regression approach. The results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results More than three-quarters (47.6%) of childbearing women in Guinea did not deliver at health facilities. Women who had no formal education (aOR = 1.52, 95% CI = 1.09–2.12), those whose partners had no formal education (aOR = 1.25, 95% CI =1.01–1.56), those whose pregnancies were unintended (aOR = 1.40, 95% CI =1.13–1.74) and those who were Muslims (aOR = 2.87, 95% CI =1.17–7.08) were more likely to deliver at home. Furthermore, women with parity four or more (aOR = 1.78, 95% CI =1.34–2.37), those who listened to radio less than once a week (aOR = 5.05, 95% CI =1.83–13.89), those who never watched television (aOR = 1.46, 95% CI =1.12–1.91), those with poorest wealth quintile (aOR = 4.29, 95% CI =2.79–6.60), women in female-headed households (aOR = 1.38, 95% CI =1.08–1.78) and rural dwellers (aOR = 3.86, 95% CI =2.66–5.60) were more likely to deliver at home. Conclusion This study has identified low socio-economic status, inadequate exposure to media, having an unplanned pregnancy and religious disparities as key predictors of home delivery among childbearing women in Guinea. The findings call for the need to enhance advocacy and educational strategies like focus group discussions, peer teaching, mentor-mentee programmes at both national and community levels for women to encourage health facility delivery. There is also the need to improve maternal healthcare services utilization policies to promote access to health facility delivery by reducing costs and making health facilities available in communities.

Subnational Variation in Facility-based Childbirth in Nigeria: Evidence from 2013 and 2018 Nigeria Demographic Health Surveys

2021 ◽  
Vol 19 (1) ◽  
pp. 23-40
Author(s):  
Anthony Idowu Ajayi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Facility ◽  
Health Surveys ◽  
State Level ◽  
Facility Delivery ◽  
Maternal Health Care ◽  
Health Facilities ◽  
Health Facility Delivery ◽  
Access To Health

Background Previous studies have not examined the state-level variations in health facility delivery in Nigeria. Because of the decentralised system, state governments have a huge role in decision-making and policy direction for each state. As such, it is important to disaggregate the data at state level to understand patterns and best performing states that can be exemplars for others. We address this gap by examining the sub-national variations in health facility delivery in Nigeria. Methods Data of 37,928 and 40,567 live births in the 2013 and 2018 Nigeria Demographic and Health surveys (NDHS) respectively were analysed in this study. NDHS employs a multistage sampling and is representative of both the country and each of the 36 states and Federal Capital Territory (FCT). We used descriptive statistics to examine the trend in health facility delivery in Nigerian states and presented the results using maps. Also, we used logistic regression analysis to examine progress in expanding access to health facility delivery across Nigerian states. Results The proportion of births delivered in health facilities increased from 35.8% in 2013 to 39.4% in 2018, representing a 3.6% increment. After adjusting for relevant covariates, women were 17% more likely to deliver in health facilities in 2018 than in 2013 surveys. However, progress in expanding access to health facility delivery was uneven across the country. While the odds of delivering in a health facility significantly increased in 13 of the 36 states and FCT, the odds reduced significantly in seven states and no progress was recorded in 17 states. Conclusion There was a slight improvement in access to health facility delivery in Nigeria between 2013 and 2018. However, progress remains uneven across the states with only 13 states recording some progress. Four states stood out, recording over a three-fold relative increase in odds of health facility deliveries. These states implemented maternal health care policies that not only made services free but also improved infrastructure and human resources for health. Thus, providing examples of what works in improving access to maternal health care services for other states to follow.

scholarly journals Socioeconomic factors associated with choice of delivery place among mothers: a population-based cross-sectional study in Guinea-Bissau

2019 ◽  
Vol 4 (2) ◽  
pp. e001341 ◽  
Author(s):  
Sanni Yaya ◽  
Ghose Bishwajit ◽  
Nathali Gunawardena
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Outcome Variable ◽  
Service Utilisation ◽  
Health Facility Delivery ◽  
Guinea Bissau ◽  
Low Middle Income Countries ◽  
At Home

BackgroundMaternal death outcome remains high in Guinea-Bissau. Delivery-related complications and maternal mortality could be prevented by increasing women’s access to skilled pregnancy care. Socioeconomic status (SES) is often associated with low health service utilisation in low/middle-income countries. In Guinea-Bissau, little is known on the relationship between SES and use of health facility for delivery. In this study, we examined the association between women’s choice of health facility delivery with their SES.MethodsCurrent data from Multiple Indicator Cluster Survey conducted in Guinea-Bissau, 2014 were used in this study. The place of delivery (home or health facility) was the outcome variable of interest using 7532 women of reproductive age (15–49 years). Respondents’ characteristics were described by summary statistics, while multivariable logistic regression model was used to examine the association of demographic and socioeconomic characteristics on facility-based delivery. Adjusted ORs, 95% CIs and p values were computed to identify significant determinants.ResultsResults show that in proportion of women delivering at home was higher than of delivery at a health facility. Overall percentage of women who delivered at health facility was 39.8%, with the rate being substantially higher among urban (67.8%) compared with their rural (30.2%) counterparts. Percentage of delivering at home was highest in Oio region (23.8%) and that of delivery at a health facility was highest in the Sector Autónomo de Bissau region (18.7%). In the multivariable analysis, women in urban areas compared those who had no education, those who had primary and secondary/higher level of education were 2.2 and 3.3 times more likely to deliver at a health facility. The odds of facility were also highest among the women from the richest households, 5.3 and 5 times among urban and rural women, respectively.ConclusionBased on these findings, the study concludes that the percentage of health facility delivery is low in Guinea-Bissau, which can be promoted through scaling up women’s SES. The findings could guide healthcare policy-makers to address the issue of unskilled delivery services and increase the use of facility-based delivery particularly among the disadvantaged women.

scholarly journals Determinants of Postnatal Care and Timing of the First Postnatal Care for Newborns in Ethiopia: Further Analysis of 2019 Ethiopian Demographic and Health Survey

2021 ◽  
Author(s):  
Sewnet Adem Kebede ◽  
Adisu Birhanu Weldesenbet ◽  
Biruk Shalmeno Tusa
Keyword(s):  
Health Facility ◽  
Health Survey ◽  
Postnatal Care ◽  
Multinomial Logistic Regression ◽  
Educational Status ◽  
Demographic And Health Survey ◽  
The Other ◽  
Other Hand ◽  
Maternal Educational Status ◽  
At Home

Abstract Background: Neonatal mortality remain a persisting public health challenge in Ethiopia. Most of the factors that lead to neonatal deaths could be prevented through postnatal check-ups. However, in Ethiopia, coverage of PNC continues to be low. This study aims to assess the determinant factors of PNC visit and the timing of PNC among newborns in Ethiopia.Methods: Using the Ethiopian Mini Demographic and Health Survey (EMDHS) 2019, a total weighted sample of 2,105 women aged 15-49 giving birth in the 2 years preceding the survey was included in the study. Generalized linear mixed model were separately fitted to identify factors associated with any PNC for newborns delivered at home and health facility. Multinomial logistic regression was used to assess timing of PNC with their associated factors.Results: Overall, only 13% (95% CI; 11.2, 14.0) of the newborns received PNC in Ethiopia. Among newborns delivered at home, attending any PNC were determined by region, maternal educational status and birth order. On the other hand, among newborns delivered in a health facility, region, number of ANC visit and religion were determinants of any PNC. Furthermore, attending first PNC within 48 hours after delivery was determined by region and religion. On the other hand, attending first PNC after 48 hours after delivery was determined by region number of ANC visits, maternal educational status and religion. Conclusion: The finding of current study revealed low coverage of PNC among newborns regardless of place of delivery in Ethiopia. The study makes the following recommendation: increase community health literacy on postnatal care, encourage delivery at health facility, link community home birth with PNC. It will be more valuable if there is sharing of experience from regions which have better PNC coverage.

scholarly journals Factors associated with health facility deliveries among mothers living in hospital catchment areas in Rukungiri and Kanungu districts, Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard K. Mugambe ◽  
Habib Yakubu ◽  
Solomon T. Wafula ◽  
Tonny Ssekamatte ◽  
Simon Kasasa ◽  
...  
Keyword(s):  
Health Facility ◽  
Rural Areas ◽  
Health Workers ◽  
Facility Delivery ◽  
Health Facilities ◽  
Public Facility ◽  
Health Facility Delivery ◽  
Cross Sectional ◽  
Factors Associated ◽  
Catchment Areas

Abstract Background Health facility deliveries are generally associated with improved maternal and child health outcomes. However, in Uganda, little is known about factors that influence use of health facilities for delivery especially in rural areas. In this study, we assessed the factors associated with health facility deliveries among mothers living within the catchment areas of major health facilities in Rukungiri and Kanungu districts, Uganda. Methods Cross-sectional data were collected from 894 randomly-sampled mothers within the catchment of two private hospitals in Rukungiri and Kanungu districts. Data were collected on the place of delivery for the most recent child, mothers’ sociodemographic and economic characteristics, and health facility water, sanitation and hygiene (WASH) status. Modified Poisson regression was used to estimate prevalence ratios (PRs) for the determinants of health facility deliveries as well as factors associated with private versus public utilization of health facilities for childbirth. Results The majority of mothers (90.2%, 806/894) delivered in health facilities. Non-facility deliveries were attributed to faster progression of labour (77.3%, 68/88), lack of transport (31.8%, 28/88), and high cost of hospital delivery (12.5%, 11/88). Being a business-woman [APR = 1.06, 95% CI (1.01–1.11)] and belonging to the highest wealth quintile [APR = 1.09, 95% CI (1.02–1.17)] favoured facility delivery while a higher parity of 3–4 [APR = 0.93, 95% CI (0.88–0.99)] was inversely associated with health facility delivery as compared to parity of 1–2. Factors associated with delivery in a private facility compared to a public facility included availability of highly skilled health workers [APR = 1.15, 95% CI (1.05–1.26)], perceived higher quality of WASH services [APR = 1.11, 95% CI (1.04–1.17)], cost of the delivery [APR = 0.85, 95% CI (0.78–0.92)], and availability of caesarean services [APR = 1.13, 95% CI (1.08–1.19)]. Conclusion Health facility delivery service utilization was high, and associated with engaging in business, belonging to wealthiest quintile and having higher parity. Factors associated with delivery in private facilities included health facility WASH status, cost of services, and availability of skilled workforce and caesarean services.

scholarly journals Health facility delivery among women of reproductive age in Nigeria: Does age at first birth matter?

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259250
Author(s):  
Obasanjo Afolabi Bolarinwa ◽  
Effiong Fortune ◽  
Richard Gyan Aboagye ◽  
Abdul-Aziz Seidu ◽  
Olalekan Seun Olagunju ◽  
...  
Keyword(s):  
Health Facility ◽  
Facility Delivery ◽  
Health Facilities ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Age At First Birth ◽  
Health Facility Delivery ◽  
Odds Ratios ◽  
First Birth ◽  
Women Of Reproductive Age

Background High maternal mortality ratio in sub-Saharan Africa (SSA) has been linked to inadequate medical care for pregnant women due to limited health facility delivery utilization. Thus, this study, examined the association between age at first childbirth and health facility delivery among women of reproductive age in Nigeria. Methods The study used the most recent secondary dataset from Nigeria’s Demographic and Health Survey (NDHS) conducted in 2018. Only women aged15-49 were considered for the study (N = 34,193). Bi-variate and multivariable logistic regression models were used to examine the association between age at first birth and place of delivery. The results were presented as crude odds ratios and adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CIs). Statistical significance was set at p<0.05. Results The results showed that the prevalence of health facility deliveries was 41% in Nigeria. Women who had their first birth below age 20 [aOR = 0.82; 95%(CI = 0.74–0.90)] were less likely to give birth at health facilities compared to those who had their first birth at age 20 and above. Conclusion Our findings suggest the need to design interventions that will encourage women of reproductive age in Nigeria who are younger than 20 years to give birth in health facilities to avoid the risks of maternal complications associated with home delivery. Such interventions should include male involvement in antenatal care visits and the education of both partners and young women on the importance of health facility delivery.

scholarly journals Do mothers who delivered at health facilities return to health facilities for postnatal care follow-up? A multilevel analysis of the 2016 Ethiopian Demographic and Health Survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249793
Author(s):  
Brhane Ayele ◽  
Mulugeta Woldu ◽  
Haftom Gebrehiwot ◽  
Tsegay Wellay ◽  
Tsegay Hadgu ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Health Facility ◽  
Health Survey ◽  
Postnatal Care ◽  
Health Facilities ◽  
Demographic And Health Survey ◽  
Community Level ◽  
P Value ◽  
Multilevel Logistic Regression ◽  
Explanatory Variables

Introduction Returning to health facility for postnatal care (PNC) use after giving birth at health facility could reflect the health seeking behavior of mothers. However, such studies are rare though they are critically important to develop vigorous strategies to improve PNC service utilization. Therefore, this study aimed to determine the magnitude and factors associated with returning to health facilities for PNC among mothers who delivered in Ethiopian health facilities after they were discharged. Methods This cross-sectional study used 2016 Ethiopian Demographic and Health Survey data. A total of 2405mothers who gave birth in a health facility were included in this study. Multilevel mixed-effect logistic regression model was fitted to estimate both independent (fixed) effects of the explanatory variables and community-level (random) effects on return for PNC utilization. Variable with p-value of ≤ 0.25 from unadjusted multilevel logistic regression were selected to develop three models and p-value of ≤0.05 was used to declare significance of the explanatory variables on the outcome variable in the final (adjusted) model. Analysis was done using IBM SPSS statistics version 21. Result In this analysis, from the total 2405 participants, 14.3% ((95%CI: 12.1–16.8), (n = 344)) of them returned to health facilities for PNC use after they gave birth at a health facility. From the multilevel logistic regression analysis, being employed (AOR = 1.51, 95%CI: 1.04–2.19), receiving eight and above antenatal care visits (AOR = 2.90, 95%CI: 1.05–8.00), caesarean section delivery (AOR = 2.53, 95%CI: 1.40–4.58) and rural residence (AOR = 0.56, 95%CI: 0.36–0.88) were found significantly associated with return to health facilities for PNC use among women who gave birth at health facility. Conclusion Facility-based PNC utilization among mothers who delivered at health facilities is low in Ethiopia. Both individual and community level variables were determined women to return to health facilities for PNC use. Thus, adopting context-specific strategies/policies could improve PNC utilization and should be paid a due focus.

scholarly journals Facility delivery and postnatal care services use among mothers who attended four or more antenatal care visits in Ethiopia: further analysis of the 2016 Demographic and Health Survey

2018 ◽  
Author(s):  
Gedefaw Abeje Fekadu ◽  
Fentie Ambaw Getahun ◽  
Seblewongiel Ayenalem Kidanie
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Postnatal Care ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Factors Associated ◽  
Content Of Care ◽  
Care Services ◽  
At Home

AbstractIntroductionIn Ethiopia, many mothers who attend the recommended number of antenatal care visits fail to use facility delivery and postnatal care services. This study identifies factors associated with facility delivery and use of postnatal care among mothers who had four or more antenatal care visits, using data from the 2016 Ethiopian Demographic and Health Survey (EDHS).MethodsTo identify factors associated with facility delivery, we studied background and service-related characteristics among 2,415 mothers who attended four or more antenatal care visits for the most recent birth. In analyzing factors associated with postnatal care within 42 days after delivery, the study included 1,055 mothers who attended four or more antenatal care visits and delivered at home. We focused on women who delivered at home because women who deliver at a health facility are more likely also to receive postnatal care as well. A multivariable logistic regression model was fitted for each outcome to find significant associations between facility delivery and use of postnatal care.ResultsFifty-six percent of women who had four or more antenatal care visits delivered at a health facility, while 44% delivered at home. Mothers with secondary or above level of education, urban residents, women in the richest wealth quintile, and women who were working at the time of interview had higher odds of delivering in a health facility. High birth order was associated with a lower likelihood of health facility delivery. Among women who delivered at home, only 8% received postnatal care within 42 days after delivery. Quality of antenatal care as measured by the content of care received during antenatal care visits stood out as an important factor that influences both facility delivery and postnatal care. Among mothers who attended four or more antenatal care visits and delivered at home, the content of care received during ANC visits was the only factor that showed a statistically significant association with receiving postnatal care.ConclusionsThe more antenatal care components a mother receives, the higher her probability of delivering at a health facility and of receiving postnatal care. The health care system needs to increase the quality of antenatal care provided to mothers because receiving more components of antenatal care is associated with increased health facility delivery and postnatal care. Further research is recommended to identify other reasons why many women do not use facility delivery and postnatal care services even after attending four or more antenatal care visits.

scholarly journals Higher rates of early initiation of breastfeeding associated with health facility delivery in Nepal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Dharel ◽  
A Bhattarai ◽  
Y R Paudel ◽  
P Acharya ◽  
K Acharya
Keyword(s):  
Health Facility ◽  
Newborn Care ◽  
Facility Delivery ◽  
Early Initiation ◽  
Health Facility Delivery ◽  
Essential Newborn Care ◽  
Place Of Delivery ◽  
Early Initiation Of Breastfeeding ◽  
Nationally Representative ◽  
Initiation Of Breastfeeding

Abstract Background Initiation of breastfeeding within one hour from birth is one of the five key essential newborn care messages, implemented along with birth preparedness package since 2008. This study aimed to determine the trend of early initiation of breastfeeding (EIBF) and to assess the effect of health facility delivery on EIBF in Nepal. Methods We analyzed the data from the last four nationally representative Nepal Demographic and Health Surveys (NDHS) conducted in 2001,2006,2011 and 2016. Data on the early initiation of breastfeeding was obtained from the mothers of infants born within 24 months prior to the survey. The explanatory variable was the place of delivery, dichotomized as either the health facility, or home delivery. Survey year had a significant interaction with the place of delivery. Multivariable logistic regression was conducted separately on pooled samples before (NDHS 2001 and 2006) and after (NDHS 2011 and 2016) the program implementation. Adjusted odds ratio (AOR) with 95% confidence interval (CI) for EIBF was calculated after adjusting for predetermined covariates. Results The rate of EIBF increased by 26.5% points (from 32.8% in 2001 to 59.3% in 2016) among infants delivered in a health facility, compared to an increase by 17.1% points (from 29.9% to 47.0%) among home born infants. EIBF increased by 32.5% points before, compared to 49.7% points after BPP. Delivery in a health facility was associated with a higher odd of EIBF in later years (AOR2.3, 95% CI 2.0,2.8), but not in earlier years (AOR1.3, 95% CI 0.9,2.0). Delivery by caesarean section, first-born infant, and lack of maternal education were associated with a lower rate of EIBF in both periods. Conclusions Higher EIBF was associated with health facility delivery in Nepal, only after programmatic emphasis on essential newborn care messages. This implies the need for explicit focus on EIBF at birth, particularly when mother is less educated, primiparous or undergoing operative delivery. Key messages The rate of initiation of breastfeeding within an hour from birth is increasing in Nepal, with higher rates in health facility delivery, as shown by the recent four nationally representative surveys. Programmatic focus on essential newborn care messages may have contributed to significant association of higher rates of early initiation of breastfeeding when delivered in health facility.

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