scholarly journals Predictors of skilled birth attendance among married women in Cameroon: further analysis of 2018 Cameroon Demographic and Health Survey

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Betregiorgis Zegeye ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Edward Kwabena Ameyaw ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Maternal Education ◽  
Economic Status ◽  
Healthcare Services ◽  
Skilled Birth Attendance ◽  
Married Women ◽  
Maternal Healthcare ◽  
Maternal Deaths ◽  
Services Utilization ◽  
Birth Attendance

Abstract Background In Cameroon, maternal deaths remain high. The high maternal deaths in the country have been attributed to the low utilization of maternal healthcare services, including skilled birth attendance. This study examined the predictors of skilled birth services utilization among married women in Cameroon. Methods Data from the 2018 Cameroon Demographic and Health Survey was analyzed on 7881 married women of reproductive age (15–49 years). Both bivariate and multivariable logistic regression analyses were carried out to determine the predictors of skilled childbirth services. The results were presented with crude odds ratio (cOR) and adjusted odds ratio (aOR) and 95% confidence interval (CI). Results The coverage of skilled birth attendance among married women of reproductive age in Cameroon was 66.2%. After adjusting for potential confounders, media exposure (aOR = 1.46, 95% CI: 1.11–1.91), higher decision making (aOR = 1.88, 95% CI: 1.36–2.59), maternal education (aOR = 2.38, 95% CI; 1.65–3.42), place of residence (aOR = 0.50, 95% CI; 0.33–0.74), religion (aOR = 0.55, 95% CI; 0.35–0.87), economic status (aOR = 5.16, 95% CI; 2.58–10.30), wife beating attitude (aOR = 1.32, 95% CI; 1.05–1.65), parity (aOR = 0.62, 95% CI; 0.41–0.93) and skilled antenatal care (aOR = 14.46, 95% CI; 10.01–20.89) were found to be significant predictors of skilled birth attendance. Conclusions This study demonstrates that social, economic, regional, and cultural factors can act as barriers to skilled childbirth services utilization in Cameroon. Interventions that target women empowerment, antenatal care awareness and strengthening are needed, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women. Such policies and interventions should also aim at reducing geographical barriers to access to maternal healthcare services, including skilled birth attendance. Due to the presence of inequities in the use of skilled birth attendance services, programs aimed at social protection and empowerment of economically disadvantaged women are necessary for the achievement of the post-2015 targets and the Sustainable Development Goals. Plain English Summary Globally, Cameroon is one of the countries with high maternal deaths. Low utilization of maternal healthcare services, including skilled birth attendance have been found to account for the high maternal deaths in the country. This study sought to examine the factors associated with skilled childbirth services utilization among married women in Cameroon. Using data from the 2018 Cameroon Demographic and Health Survey, we found that the coverage of skilled birth attendance among married women of reproductive age in Cameroon is high. Factors such as higher decision-making power, higher maternal education, place of residence, religion, higher economic status, wife beating attitude, parity and skilled antenatal care were found to be the significant predictors of skilled birth attendance. This study has shown that socio-economic, regional and cultural factors account for the utilization of skilled childbirth services utilization in Cameroon. Interventions aimed at enhancing the utilization of skilled childbirth services in Cameroon should target women empowerment, antenatal care awareness creation and sensitization, especially among the rural poor, to reduce barriers to care seeking. Maternal healthcare services utilization interventions and policies in Cameroon need to focus on specific equity gaps that relate to socio-economic status, maternal education, and the economic empowerment of women.

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

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.

scholarly journals Maternal Healthcare Services Utilization Trajectories in Four Regions of Ethiopia: A Latent Class Analysis

2020 ◽  
Author(s):  
Alemayehu Hunduma ◽  
Gurmessa Tura ◽  
Lelisa Sena ◽  
Yemisrach B. Okwaraji
Keyword(s):  
Latent Class Analysis ◽  
Healthcare Utilization ◽  
Latent Class ◽  
Economic Status ◽  
Healthcare Services ◽  
Birth Preparedness ◽  
Class Analysis ◽  
Maternal Healthcare ◽  
Services Utilization ◽  
Socio Economic Status

Abstract Background: Globally, in 2015 as result of complications related to pregnancy, childbirth, or the postnatal period, 303,000 women died. Among these mortality the lion share burden were in sub-Saharan and Southern Asian countries. To avert the preventable maternal mortality, providing the recommended pregnancy care, delivery and postnatal cares in a continuum manner is imperative. This study aims to assess the trajectories and determinants of maternal healthcare services utilization in four major regions of Ethiopia. Methods: Seven indicator variables were used to construct the maternal healthcare utilization variable. Latent class analysis was used to identify subgroups of maternal healthcare utilization along the continuum of care. Further, ordinal logistic regression was utilized to identify the determinants of the trajectories of maternal healthcare utilization. STATA 14 was used for data management and analysis and 5% level of significance was used to declare statistical significance. Result: There were 590 mothers who delivered a live-birth in the 12 months period before the interview date. The result of latent class analysis indicates that a little more than two in five of the mothers (43.9%) did not attempt to visit a health facility during pregnancy or for delivery or for postnatal checkup. While women with a good practice of maternal healthcare accounted 6.1%, half (50%) of the women had an inadequate maternal healthcare practice. The trajectory of maternal healthcare utilization has shown a marked difference by region and religious affiliation of women. Whereas older women and women of lowest socio-economic status tend to be in the lowest classes of maternal healthcare utilization, educated women, women of highest socio-economic status and women having a better birth preparedness and complication readiness are found to be in the highest classes of maternal health care service utilization. Conclusions: Women of lower socio-economic status and women of below secondary level of education should be targeted to intensify awareness of the benefit of maternal healthcare services utilization and plan births and deal with complications that arise with pregnancy and childbirth.

scholarly journals Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Agbaglo ◽  
Collins Adu ◽  
Eugene Budu ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Survey ◽  
Wealth Quintile ◽  
Skilled Birth Attendance ◽  
Demographic And Health Survey ◽  
Sub Saharan Africa ◽  
Level Of Education ◽  
Services Utilization ◽  
Birth Attendance ◽  
Childbearing Women

Abstract Background Globally, maternal health remains a major priority. Most of maternal deaths globally occur in sub-Saharan Africa, with most of these deaths linked to lack of access to antenatal care and skilled assistance during delivery. This study assessed the determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea. Methods Data for this study were obtained from the 2018 Guinea Demographic and Health Survey (GDHS). Data of 4,917 childbearing women were considered as our analytical sample. The outcome variables for the study were utilization of antenatal care and skilled birth attendance. Analysis was carried out using chi-square tests and multivariable logistic regression. Results The results showed that women aged 15-24 (AOR=1.29, CI=1.03-1.62), women who had secondary/higher level of education (AOR=1.70, CI=1.33-2.19), and those whose partners had secondary/higher level of education (AOR=1.46, CI=1.22-1.75), women in the richest wealth quintile (AOR=5.09, CI=3.70-7.00), those with planned pregnancies (AOR=1.50, CI=1.23-1.81), Muslim women (AOR=1.65, CI=1.38-2.12), those who take healthcare decisions alone (AOR=1.53, CI=1.24-1.89), and those who listened to radio less than once a week (AOR= 1.30, CI=1.10-1.53) had higher odds of antenatal care uptake. Also, women with secondary/higher level of education (AOR=1.83, CI=1.25-2.68), those whose partners had secondary/higher level of education (AOR=1.40, CI=1.11-1.76), those in the richest wealth quintile (AOR=10.79, CI=6.64-17.51), those with planned pregnancies (AOR=1.25, CI=1.03-1.52), Christian women (AOR=4.13, CI=3.17-5.39), those living in urban areas (AOR=3.00, CI=2.29-3.94), women with one birth (AOR= 1.58, CI=1.20-2.06), those who take healthcare decisions alone (AOR=1.87, CI=1.46-2.39), those who read newspaper at least once a week (AOR= 1.19, CI=1.01-1.40), those who watched television at least once week (AOR=1.69, CI=1.30-2.19), and those in female-headed households (AOR=1.52, CI=1.20-1.92) were more likely to utilize the services of skilled birth attendants. Conclusion The study proved that various socio-economic and contextual factors influence antenatal care and skilled birth attendance in Guinea. These findings suggest the need to design community-based interventions (e.g., miniature local ANC clinics, early screening services) that prioritize women’s education and vocational training, media accessibility, especially among the poor, and those residing in rural settings. Such interventions should not ignore the influence of other socio-cultural norms that hinder the utilization of antenatal care and skilled birth attendance services in Guinea.

scholarly journals Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

2021 ◽  
Vol 13 (4(J)) ◽  
pp. 17-30
Author(s):  
Ruth Atuhaire ◽  
Robert Wamala ◽  
Leonard. K. Atuhaire ◽  
Elizabeth Nansubuga
Keyword(s):  
Antenatal Care ◽  
Community Health ◽  
Health Facility ◽  
Maternal Education ◽  
Health Workers ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Care Health

This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.

scholarly journals Piecing the evidences: Barriers to utilization of Antenatal Care Services by Currently Married Women in Rural Uttarakhand- A community-based study

2020 ◽  
Vol 32 (1) ◽  
pp. 114-119
Author(s):  
Ruchi Juyal ◽  
Jayanti Semwal ◽  
Sunil Dutt Kandpal ◽  
Ashok Kumar Srivastava ◽  
Deep Shikha ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Economic Status ◽  
Married Women ◽  
Chi Square ◽  
Services Utilization ◽  
Care Services ◽  
Chi Square Test ◽  
Area Of Concern

Background: High maternal mortality has always been an area of concern in developing countries. Availability and availment of adequate antenatal care play a significant role in reduction of maternal deaths. Aim & Objective: To know the extent of antenatal care (ANC) services utilization by the currently married women of rural Uttarakhand during their last pregnancy, to find the barriers for utilization of ANC services and correlate the socio-demographic variables with the non-utilization of ANC services. Methods and Material: This correlational study was conducted in rural areas of 3 randomly selected districts in Uttarakhand. Multistage stratified and simple random samplings were used for area selection and PPS technique was used to recruit the participants. Overall, 637 currently married women (CMW) who delivered in last 5 years prior to survey, were interviewed by trained social workers. Chi-square test was used to ascertain association between variables and regression analysis was done to adjust for confounding associations. Results: Overall 496 (77.9%) women availed one or more ANC services during their last pregnancy, but the complete package was availed by only 210 (33%) of the CMW. Majority of the women who did not avail any ANC services were older, illiterate, labourer, spouse of labourer/ unemployed person and belonged to lower socio-economic status. Unawareness was the most commonly cited reason for not availing ANC services followed by financial issues and unfelt need. Conclusions: Women in Uttarakhand are pliant to ANC services, but there is a need to create demand for it by increasing awareness and improving the quality of ANC services.

scholarly journals Effects of terrorist attacks on access to maternal healthcare services: a national longitudinal study in Burkina Faso

2020 ◽  
Vol 5 (9) ◽  
pp. e002879
Author(s):  
Thomas Druetz ◽  
Lalique Browne ◽  
Frank Bicaba ◽  
Matthew Ian Mitchell ◽  
Abel Bicaba
Keyword(s):  
Antenatal Care ◽  
Burkina Faso ◽  
Negative Binomial ◽  
Terrorist Attack ◽  
Healthcare Services ◽  
Terrorist Attacks ◽  
Cesarean Sections ◽  
Maternal Healthcare ◽  
District Hospitals ◽  
The Impact

IntroductionMost of the literature on terrorist attacks’ health impacts has focused on direct victims rather than on distal consequences in the overall population. There is limited knowledge on how terrorist attacks can be detrimental to access to healthcare services. The objective of this study is to assess the impact of terrorist attacks on the utilisation of maternal healthcare services by examining the case of Burkina Faso.MethodsThis longitudinal quasi-experimental study uses multiple interrupted time series analysis. Utilisation of healthcare services data was extracted from the National Health Information System in Burkina Faso. Data span the period of January 2013–December 2018 and include all public primary healthcare centres and district hospitals. Terrorist attack data were extracted from the Armed Conflict Location and Event Data project. Negative binomial regression models were fitted with fixed effects to isolate the immediate and long-term effects of terrorist attacks on three outcomes (antenatal care visits, of facility deliveries and of cesarean sections).ResultsDuring the next month of an attack, the incidence of assisted deliveries in healthcare facilities is significantly reduced by 3.8% (95% CI 1.3 to 6.3). Multiple attacks have immediate effects more pronounced than single attacks. Longitudinal analysis show that the incremental number of terrorist attacks is associated with a decrease of the three outcomes. For every additional attack in a commune, the incidence of cesarean sections is reduced by 7.7% (95% CI 4.7 to 10.7) while, for assisted deliveries, it is reduced by 2.5% (95% CI 1.9 to 3.1) and, for antenatal care visits, by 1.8% (95% CI 1.2 to 2.5).ConclusionTerrorist attacks constitute a new barrier to access of maternal healthcare in Burkina Faso. The exponential increase in terrorist activities in West Africa is expected to have negative effects on maternal health in the entire region.

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

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.

scholarly journals 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

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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