Factors associated with health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016

Abstract Background Almost all maternal deaths and related morbidities occur in low-income countries. Childbirth supervised by a skilled provider in a health facility is a key intervention to prevent maternal and perinatal morbidity and mortality. Our study aimed to establish the factors associated with health facility utilization during childbirth in Uganda. Methods We used the Uganda Demographic and Health Survey 2016 data of 10,152 women aged 15 to 49 years. The study focused on their most recent live birth in 5 years preceding the survey. We applied multistage stratified sampling to select study participants and we conducted multivariable logistic regression to establish the factors associated with health facility utilization during childbirth, using SPSS (version 25). Results The proportion of women who gave birth at a health facility was 76.6% (7780/10,152: (95% confidence interval, CI, 75.8–77.5). The odds of women aged 15–19 years giving birth at health facilities were twice as those of women aged 40 to 49 years (adjusted odds ratio, AOR = 2.29; 95% CI: 1.71–3.07). Residing in urban areas and attending antenatal care (ANC) were associated with health facility use. The odds of women in the northern region of Uganda using health facilities were three times of those of women in the central region (AOR = 3.13; 95% CI: 2.15–4.56). Women with tertiary education (AOR = 4.96; 95% CI: 2.71–9.11) and those in the richest wealth quintile (AOR = 4.55; 95% CI: 3.27–6.32) had higher odds of using a health facility during child birth as compared to those with no education and those in the poorest wealth quintile, respectively. Muslims, Baganda, women exposed to mass media and having no problem with distance to health facility had higher odds of utilizing health facilities during childbirth as compared to Catholic, non Baganda, women not exposed to mass media and those having challenges with distance to access healthcare. Conclusion Health facility utilization during childbirth was high and it was associated with decreasing age, increasing level of education and wealth index, urban residence, Northern region of Uganda, ANC attendance, exposure to mass media, tribe, religion and distance to the nearby health facility. We recommend that interventions to promote health facility childbirths in Uganda target the poor, less educated, and older women especially those residing in rural areas with less exposure to mass media.

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Determinants of health facility utilization during childbirth among 15 to 49-year-old women in Uganda: evidence from the Uganda demographic health survey 2016

10.21203/rs.3.rs-113832/v1 ◽

2020 ◽

Author(s):

Quraish Sserwanja ◽

David Mukunya ◽

Milton Musaba ◽

Joseph Kawuki ◽

Freddy Eric Kitutu

Keyword(s):

Health Facility ◽

Health Survey ◽

Low Income ◽

Rural Areas ◽

Wealth Index ◽

Northern Region ◽

Health Facilities ◽

Determinants Of Health ◽

Facility Birth ◽

Health Facility Birth

Abstract BackgroundAlmost all maternal deaths and other related morbidities occur in low income countries. Childbirth supervised by a skilled provider in a health facility is a key intervention to prevent maternal and perinatal morbidity and mortality. Our study aimed to establish the determinants of health facility utilization during childbirth in Uganda. MethodsWe used Uganda Demographic and Health Survey (UDHS) 2016 data of 10,152 women aged 15 to 49 years. Multistage stratified sampling was used to select study participants and we conducted multivariable logistic regression to establish the determinants of health facility utilization during childbirth. All our analyses were done using SPSS version 25. ResultsThe proportion of women who gave birth from a health facility was 76.6% (7,780/10,152: (95% CI: 75.8-77.5). Odds of health facility birth decreased with older age. Women aged 15-19 years were twice as likely to give birth from health facilities compared to women aged 40 to 49 years (AOR=2.25; 95% CI: 1.71- 2.96). Women residing in urban areas were more likely to give birth from a health facility compared to those in rural areas (AOR=1.48; 95% CI: 1.18- 1.86), as well as those who attended ANC (AOR=3.60; 95% CI: 2.47- 5.24). Women in the Northern region were more likely to use health facilities compared to those in the Central region (AOR=2.42; 95% CI: 1.81- 3.22). Odds of health facility birth increased with rise in wealth index and education level. Women with higher education (AOR=5.15; 95% CI: 2.79- 9.52) and those in the richest wealth index (AOR=5.14; 95% CI: 3.72- 7.10) were five times more likely to give birth from a health facility compared to those with no education and those in the poorest wealth index respectively. ConclusionHealth facility utilization during childbirth was high and positively associated with; decreasing age, increasing level of education and wealth index, urban residence, Northern region and ANC attendance. We recommended that interventions to promote health facility childbirths in Uganda should target the poor, less educated and older women especially those residing in rural areas.

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

PLoS ONE ◽

10.1371/journal.pone.0244811 ◽

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.

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Factors associated with the preference of institutional delivery after antenatal care attendance in Northwest Ethiopia

BMC Health Services Research ◽

10.1186/s12913-019-4636-6 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Araya Mesfin Nigatu ◽

Kassahun Alemu Gelaye

Keyword(s):

Health Education ◽

Antenatal Care ◽

Low Income ◽

Institutional Delivery ◽

Statistical Significance ◽

Health Facilities ◽

Low Income Countries ◽

Contributing Factors ◽

Place Of Delivery ◽

Factors Associated

Abstract Background Even though maternal mortality during the time of delivery can be prevented with proper medical care in the health facilities with skilled healthcare professionals, unexpectedly death is still high and is a persistent challenge for low-income countries. Therefore identifying factors affecting the preference of institutional delivery after antenatal care service attendance is a key intervention to reduce maternal morbidity and mortality. Method A community-based cross-sectional study was conducted using face to face using interviewer-administered questionnaire from a total of 528 women who gave their last birth within 12 months prior to the study period who attended antenatal care (ANC) services. Descriptive statistics, bivariable and multivariable logistic regressions analysis were performed. Statistical significance was considered at p < 0.05 and odds ratio with 95% CI were calculated to examine factors associated with institutional delivery. Results Of the 528 pregnant women attending ANC services, 250 (47.3%) gave birth in health facilities (95% CI: 43.2, 51.7%). Urban residence [AOR = 7.8, 95% CI: 4.1, 15.6], four or more ANC visits [AOR = 4.5, 95% CI: 1.6, 12.3], those who got health education on ANC [AOR = 2.9, 95% CI: 1.5, 5.6] and decision on place of delivery with her partner agreement [AOR = 3.3, 95% CI: 1.3, 8.7] were found to be contributing factors for the preference of institutional delivery. Conclusion Institutional delivery was not adequate. Residence, number of antenatal care visits, health education, decisions making on a place of delivery and having awareness of the difference of place of delivery were contributing factors for the preference of institutional delivery.

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Factors Associated With Undernutrition Among 20 to 49 Year Old Women in Uganda: A Secondary Analysis of the Uganda Demographic Health Survey 2016

10.21203/rs.3.rs-22884/v1 ◽

2020 ◽

Author(s):

Quraish Sserwanja ◽

David Mukunya ◽

Theogene Habumugisha ◽

Linet M. Mutisya ◽

Robert Tuke ◽

...

Keyword(s):

Health Survey ◽

Rural Areas ◽

Urban Areas ◽

Wealth Index ◽

Wealth Quintile ◽

Northern Region ◽

Reproductive Age ◽

Obstetric Outcomes ◽

Factors Associated ◽

Maternal Undernutrition

Abstract Background Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda.Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4,640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda.Results The prevalence of underweight and stunting were 6.9% (n = 4640) and 1.3% (n = 4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44–13.20) and Western (AOR 4.77, 95% CI 1.28–17.78) regions were more likely to be stunted compared to those in the Northern region.Conclusion The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.

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Factors associated with undernutrition among 20 to 49 year old women in Uganda: a secondary analysis of the Uganda demographic health survey 2016

10.21203/rs.3.rs-22884/v2 ◽

2020 ◽

Author(s):

Quraish Sserwanja ◽

David Mukunya ◽

Theogene Habumugisha ◽

Linet M. Mutisya ◽

Robert Tuke ◽

...

Keyword(s):

Health Survey ◽

Rural Areas ◽

Urban Areas ◽

Wealth Index ◽

Wealth Quintile ◽

Northern Region ◽

Reproductive Age ◽

Obstetric Outcomes ◽

Factors Associated ◽

Maternal Undernutrition

Abstract Background: Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda.Methods: We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4,640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda.Results: The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44-13.20) and Western (AOR 4.77, 95% CI 1.28-17.78) regions were more likely to be stunted compared to those in the Northern region.Conclusion: The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.

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Factors associated with undernutrition among 20 to 49 year old women in Uganda: a secondary analysis of the Uganda demographic health survey 2016

10.21203/rs.3.rs-22884/v3 ◽

2020 ◽

Author(s):

Quraish Sserwanja ◽

David Mukunya ◽

Theogene Habumugisha ◽

Linet M. Mutisya ◽

Robert Tuke ◽

...

Keyword(s):

Health Survey ◽

Rural Areas ◽

Urban Areas ◽

Wealth Index ◽

Wealth Quintile ◽

Northern Region ◽

Reproductive Age ◽

Obstetric Outcomes ◽

Factors Associated ◽

Maternal Undernutrition

Abstract Background: Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda.Methods: We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4,640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda. Results: The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44-13.20) and Western (AOR 4.77, 95% CI 1.28-17.78) regions were more likely to be stunted compared to those in the Northern region.Conclusion: The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.

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Factors associated with undernutrition among 20 to 49 year old women in Uganda: a secondary analysis of the Uganda demographic health survey 2016

BMC Public Health ◽

10.1186/s12889-020-09775-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Quraish Sserwanja ◽

David Mukunya ◽

Theogene Habumugisha ◽

Linet M. Mutisya ◽

Robert Tuke ◽

...

Keyword(s):

Health Survey ◽

Rural Areas ◽

Urban Areas ◽

Wealth Index ◽

Wealth Quintile ◽

Northern Region ◽

Reproductive Age ◽

Obstetric Outcomes ◽

Factors Associated ◽

Maternal Undernutrition

Abstract Background Women are at risk of undernutrition due to biological, socio-economic, and cultural factors. Undernourished women have higher risk of poor obstetric outcomes. We aimed to determine the prevalence and factors associated with undernutrition among women of reproductive age in Uganda. Methods We used Uganda Demographic and Health Survey (UDHS) 2016 data of 4640 women aged 20 to 49 years excluding pregnant and post-menopausal women. Multistage stratified sampling was used to select study participants and data were collected using validated questionnaires. We used multivariable logistic regression to determine factors associated with underweight and stunting among 20 to 49 year old women in Uganda. Results The prevalence of underweight and stunting were 6.9% (318/4640) and 1.3% (58/4640) respectively. Women who belonged to the poorest wealth quintile (Adjusted Odds Ratio (AOR) 3.60, 95% CI 1.85–7.00) were more likely to be underweight compared to those who belonged to the richest wealth quintile. Women residing in rural areas were less likely to be underweight (AOR 0.63, 95%CI 0.41–0.96) compared to women in urban areas. Women in Western (AOR 0.30, 95% CI 0.20–0.44), Eastern (AOR 0.42, 95% CI 0.28–0.63) and Central regions (AOR 0.42, 95% CI 0.25–0.72) were less likely to be underweight compared to those in the Northern region. Women belonging to Central (AOR 4.37, 95% CI 1.44–13.20) and Western (AOR 4.77, 95% CI 1.28–17.78) regions were more likely to be stunted compared to those in the Northern region. Conclusion The present study showed wealth index, place of residence and region to be associated with undernutrition among 20 to 49 year old women in Uganda. There is need to address socio-economic determinants of maternal undernutrition mainly poverty and regional inequalities.

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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052439 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2439

Author(s):

Brendon Stubbs ◽

Kamran Siddiqi ◽

Helen Elsey ◽

Najma Siddiqi ◽

Ruimin Ma ◽

...

Keyword(s):

Health Survey ◽

Low Income ◽

World Health ◽

Low Income Countries ◽

Multivariable Logistic Regression Analysis ◽

World Health Survey ◽

Middle Income ◽

Middle Income Countries ◽

The World ◽

Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

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

BMJ Global Health ◽

10.1136/bmjgh-2019-002169 ◽

2020 ◽

Vol 5 (12) ◽

pp. e002169

Author(s):

Ngatho Samuel Mugo ◽

Kyaw Swa Mya ◽

Camille Raynes-Greenow

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Adolescent Mothers ◽

Health Survey ◽

Rural Areas ◽

Urban Areas ◽

Multinomial Logistic Regression ◽

Wealth Quintile ◽

Adjusted Risk ◽

Factors Associated

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

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Improving Tanzanian childbirth service quality

International Journal of Health Care Quality Assurance ◽

10.1108/ijhcqa-10-2015-0122 ◽

2018 ◽

Vol 31 (3) ◽

pp. 190-202 ◽

Cited By ~ 3

Author(s):

Jennie Jaribu ◽

Suzanne Penfold ◽

Cathy Green ◽

Fatuma Manzi ◽

Joanna Schellenberg

Keyword(s):

Health Facility ◽

Low Income ◽

Healthcare Providers ◽

Health Facilities ◽

Rural District ◽

Local Data ◽

Content Type ◽

Primary Health ◽

Primary Health Facilities ◽

Childbirth Care

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

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