scholarly journals Factors affecting the initiation and continuation of maternal health service utilization among women who delivered in the past one year in Enemay district, East Gojjam, Ethiopia

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Anguach Shitie ◽  
Zelalem Nigussie Azene

Abstract Background Maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skilled birth attendant (SBA), and postnatal care (PNC) within 48 h of delivery. It is one of the essential strategies for reducing maternal and newborn morbidity and mortality. Therefore, this study aimed to assess the prevalence and factors affecting the initiation and continuation of maternal health service utilization among women who delivered in the past one year in Enemay district, East Gojjam zone, Ethiopia. Methods A community-based cross-sectional study was conducted among six hundred twenty-one (621) women who gave birth in the last one year in Enemay district from February 25 to March 10, 2019. A simple random sampling technique was used to select the study participants. Data were collected by face-to-face interviewer-administered, pretested, and semi-structured questionnaire. Binary logistic regressions (bi-variable and multivariable) were fitted to identify statistically significant variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable binary logistic regression. Results In this study, around 61% of women had antenatal care follow-up. Out of those women having ante natal care follow-up, about 77.5% (95% CI 73, 81.7%) had continued to receiving skilled birth delivery service. Age (AOR = 1.7 95% CI: (1.0, 2.88)), marital status (AOR = 1.6, 95% CI: (1.01, 2.76)), women’s educational status (AOR = 2.9, 95% CI: (1.30, 6.72)), autonomy for health care decision-making (AOR = 3.71, 95%CI: (2.36, 6.02)), exposure to media (AOR = 2.8, 95% CI: (1.78, 4.6)), wanted pregnancy (AOR = 3.6 95% CI: (2.2, 5.95)), and parity (AOR = 0.34, 95%CI: (0.16, 0.71)) were statistically significant variables associated with initiation of antenatal care, whereas educational status of women (AOR = 4.65, 95% CI: (1.37, 15.7)), autonomy for health care decision making (AOR = 2.62, 95% CI:(1.0, 6.82)), and had counseled during antenatal care (AOR = 2.88 95% CI: (1.21, 6.83)) were statistically significant variables associated with the continuation of maternal health care services. Conclusions This study demonstrated that the initiation and continuity of maternal health care services are low in the study area. Age, marital status, residence, women’s educational status, health care decision-making autonomy, exposure to media, wanted pregnancy, and parity were factors significantly affecting the initiation of antenatal care. Whereas, women’s educational status, health care decision-making autonomy, and counseling during antenatal care were predictors influencing the continuation of maternal health care services (antenatal care to skilled birth delivery).

Author(s):  
Shinjini Ray ◽  
Pravat Bhandari ◽  
Jang Bahadur Prasad

Background: Maternal health was one of the most important millennium development goals (MDGs), India didn’t achieve by the year 2015. Since, India is a multicultural, social and multiregional country, where some of the regions have good social and demographic achievement while some are poor. Haryana is one of them, which has 146 maternal mortality ratio. The level of receiving antenatal care (ANC) in Haryana is quite low as compared to other states of India. Objective of present study was to Understand the extent of use of maternal health care services in Haryana as well as examining the role of antenatal care and other socio-economic factors on the utilization of maternal health services.Methods: Bivariate analysis, chi-square test, and binary logistic regression have been used based on district level household and facility survey-4 data.Results: The utilization of ANC (any and full), institutional delivery and post-delivery treatment seeking varies among women by literacy, age at first marriage, age at women and place of residence. Literate women are two times more likely to access ANC [odds ratio (OR)=1.97 (any ANC), 1.95 (full ANC), p<0.01] and 1.52 times more likely to prefer institutional delivery [OR=1.52, p<0.01].Conclusions: Empowering women through the encouragement of mother’s education should be one of the most fundamental strategies to promote maternal health care services and reduce inequalities.


2019 ◽  
Author(s):  
Eunice Nyarambi ◽  
Paddington Tinashe Mundagowa ◽  
Prosper Chonzi ◽  
Elizabeth Chadambuka

Abstract Background: Provision of quality maternal health care services is an essential component in ensuring a healthy mother-baby dyad both pre- and post-delivery. In Africa, antenatal care, postnatal care, and skilled birth attendances are very low when compared to high-income countries. The continent has a high burden of maternal and infant morbidity as well as mortality rates. According to the Harare Annual Report of 2016, the number of women seeking maternal health care services was gradually declining from 2014 and pregnant women reported various challenges in accessing health care services. Methods: A 1 to 1 case-control study was conducted in Harare West South Western District using pretested interviewer-administered questionnaires. The study was carried out at all three clinics in the district and a total of 73 cases and 73 controls were selected using a systematic random sampling method. Quantitative data were analyzed using Epi Info statistical package and qualitative data was analyzed thematically. Results: The median ages for cases and controls were 29 and 24 years, respectively and the age-group 19 to 24 years constituted the majority of participants (41%). Predictors of utilization of services were young age ( < 24 years), birth order of < 2, maternal and paternal occupation, and religion. Enabling factors included: asking for permission to seek care, absence of transport challenges, a shorter distance to the health facility, affordability of health services, and a higher household income. Besides the shortage of skilled staff at the clinics, mothers endured long waiting hours to be served. The majority of the cases (78.1 %) and controls (72.6%) preferred to be attended by male nurses. Mothers were required to pay a $25 fee for booking and city medical staff rarely visited the clinics. Conclusion: The utilization of maternal health care services in Harare is dependent on the individual, household, and system-related factors. There was a need to articulate policies and design maternal health care programs that target socially and economically marginalized women. Creating women-friendly health facilities with extended hours for the antenatal care, delivery care and post-natal care services for mothers can help to decongest the health facilities.


Author(s):  
Neeta P. N. ◽  
Sameena A. R. B. ◽  
Suresh C. M. ◽  
Gangadhar Goud ◽  
Bharat . ◽  
...  

Background: Maternal mortality and morbidity remains high even though national programs exist for improving maternal and child health in India. This could be related to several factors, an important one being non-utilization or delay in seeking care of maternal health-care services, especially amongst the rural poor and urban slum population due to either lack of awareness or access to health-care services. Our study was aimed to know the utilization of maternal health care services during antenatal and post natal period and factors affecting them.Methods: A Community based cross sectional study was carried in the rural field practice areas of VIMS, Ballari (three primary health centres (PHC) Kudithini, Koluru, Kurugodu) among all married women in the age group of 15-45 years who were in the post natal period (less than 2 months) at time of interview. A total 152 women were included in the study by door to door survey, among all the 3 PHC’s. The women absent during the survey were excluded.Results: Only 101 (66.44%) of women utilized antenatal care and 18 (11.8%) utilized post natal care (at least three postnatal visits) from the health care facility. Mothers who were of Muslim religion, <20 years of age, higher education of participant as well as husband, higher occupation status, high SES, less parity had higher odds of utilizing antenatal care. Health education by the health worker regarding post natal services to women ranged from 62.5-90.8%. Mothers of Muslim religion, higher education, higher occupation status, normal vaginal delivery and home delivery had higher odds of utilizing postnatal servicesConclusions: The study shows unacceptably low utilization of postnatal care services. It shows the coverage of postnatal care services is inadequate. This is an important message to health service providers and policy makers to strengthening not only antenatal health services and institutional deliveries but also postnatal care services to reduce maternal and neonatal morbidity and mortality. 


2021 ◽  
Author(s):  
Asmamaw Kassahun ◽  
Asrat Zewdie

Abstract Background: Autonomy of women in health care decision-making is tremendously crucial for improved maternal health outcomes and women’s empowerment. Women with greater freedom of movement are more likely to receive maternal health services. However, little has been investigated about women’s autonomy in maternal health care decision-making and contributing factors in Ethiopia. The aim of this study was to assess decision-making autonomy on maternal health care services utilization and associated factors among women.Methods: A community-based cross-sectional study was conducted in Mettu rural Woreda, Ilu Aba Bor zone, southwest Ethiopia from June 19 to August 20, 2021. Data was collected using a pretested interviewer-administered questionnaire from 541 randomly selected women. The collected data was entered into Epi-Data version 3.1 and exported to SPSS version 22 for analysis. Bivariate and multivariate logistic regression was used to identify factors associated with women's decision-making autonomy on maternal health service utilization. The significance of association was declared by using the odds ratio with a 95% confidence interval and a p-value less than 0.05 in the multivariable model.Results: Out of 522 women included in the analysis, 322 (60.5%) (95% CI: 56.2%-64.7%) were found to be autonomous on maternal health service utilization. Age category from 30-39 years, AOR=4.27 (95%CI: 1.59-11.43), attending primary education and above, AOR=3.87 (95%CI: 2.15-6.99), greater than five family size, AOR=0.25 (95%CI: 0.15-0.41), and distance from the health facility, AOR=5.33 (95%CI: 2.50-11.33) were significantly associated with women's decision-making autonomy on maternal health care services utilization.Conclusion: Even though every woman has the right to participate in her own health care decision-making, around two fifths of them have no role in making health care decisions about their own health. Socio-demographic factors like age and education were found to influence women’s autonomy. Special attention has to be given to women living in rural areas in order to reduce their dependency through education.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Joshua Panyin Craymah ◽  
Robert Kwame Oppong ◽  
Derek Anamaale Tuoyire

Background. Globally, male involvement in maternal health care services remains a challenge to effective maternal health care accessibility and utilization. Objective. This study assessed male involvement in maternal health care services and associated factors in Anomabo in the Central Region of Ghana. Methods. Random sampling procedures were employed in selecting 100 adult male respondents whose partners were pregnant or had given birth within twelve months preceding the study. Pearson Chi-Square and Fisher’s exact tests were conducted to assess the association of sociodemographic and enabling/disenabling factors with male involvement in maternal health care services. Results. Some 35%, 44%, and 20% of men accompanied their partners to antenatal care, delivery, and postnatal care services, respectively. Male involvement in antenatal care and delivery was influenced by sociodemographic (partner’s education, type of marriage, living arrangements, and number of children) and enabling/disenabling (distance to health facility, attitude of health workers, prohibitive cultural norms, unfavourable health policies, and gender roles) factors. Conclusion. The low male involvement in maternal health care services warrants interventions to improve the situation. Public health interventions should focus on designing messages to diffuse existing sociocultural perceptions and health care provider attitudes which influence male involvement in maternal health care services.


2019 ◽  
Author(s):  
Paddington Tinashe Mundagowa ◽  
Eunice Nyarambi ◽  
Elizabeth Chadambuka

Abstract Background: Provision of quality maternal health care services is an essential component in ensuring a healthy mother-baby dyad both pre- and post-delivery. In Africa, antenatal care, postnatal care, and skilled birth attendances are very low when compared to high-income countries. The continent has a high burden of maternal and infant morbidity as well as mortality rates. According to the Harare Annual Report of 2016, the number of women seeking maternal health care services was gradually declining from 2014 and pregnant women reported various challenges in accessing health care services. Methods: A 1 to 1 case-control study was conducted in Harare West South Western District using pretested interviewer-administered questionnaires. The study was carried out at all three clinics in the district and a total of 73 cases and 73 controls were selected using a systematic random sampling method. Quantitative data were analyzed using Epi Info statistical package and qualitative data was analyzed thematically. Results: The median ages for cases and controls were 29 and 24 years, respectively and the age-group 19 to 24 years constituted the majority of participants (41%). Predictors of utilization of services were young age ( < 24 years), birth order of < 2, maternal and paternal occupation, and religion. Enabling factors included: asking for permission to seek care, absence of transport challenges, a shorter distance to the health facility, affordability of health services, and a higher household income. Besides the shortage of skilled staff at the clinics, mothers endured long waiting hours to be served. The majority of the cases (78.1 %) and controls (72.6%) preferred to be attended by male nurses. Mothers were required to pay a $25 fee for booking and city medical staff rarely visited the clinics. Conclusion: The utilization of maternal health care services in Harare is dependent on the individual, household, and system-related factors. There was a need to articulate policies and design maternal health care programs that target socially and economically marginalized women. Creating women-friendly health facilities with extended hours for the antenatal care, delivery care and post-natal care services for mothers can help to decongest the health facilities.


2018 ◽  
Vol 18 (17) ◽  
pp. 73-80
Author(s):  
Kamala Lamichhane

Nepal has one of the highest maternal mortality ratios in South Asia although the situation is improving in recent days. One of the reasons for such a high mortality may be attributed to the under-utilization of modern maternal health services during pregnancy. This study has analyzed the relationship between women’s autonomy and the utilization of maternal health care services in order to explore some possible reasons for the under-utilization of the services. Data from the Nepal demographic and Health Survey, 2011 is used for the study. The analysis is based on 2374 married women aged 15-49 years who had given a live birth during three years preceding the survey. Women's household decision making power, control over use of earning and decision on using contraception have been used to explore the indicators of women's autonomy. Logistic regression is used to assess the net effect of several independent variables on two dependent variables (adequate antenatal care and institutional delivery) of maternal health care. Logistic regression analyses reveal that the utilization of both maternal health care services are related to women's autonomy as indicated by decision making power on own health care, large household purchases and control over earnings because financial sufficiency is must at that period. Women's’ decision-making power appears to be the most powerful predictors for increasing maternal health service utilization. The study results suggest that policy actions that increase women’s autonomy at home could be effective in helping assure good maternal health.


2021 ◽  
Vol 11 (10) ◽  
pp. 88-98
Author(s):  
Sharmila Ranabhat ◽  
Suman Baskota ◽  
Rama Thapa

Maternal health care services should be accessible to all women during pregnancy, delivery, and the postpartum period. The majority of maternal deaths can be prevented if women utilize maternal health care services appropriately. This study aimed to assess the utilization of maternal health services and explore the barriers in accessing maternal health care services. This descriptive cross-sectional study was conducted among 48 mothers over the age of 18 with one or more children. The data was obtained by interview and focus group discussion using the structured questionnaires and checklists, which included socio-demographic characteristics, and utilization of antenatal care, delivery practice, and postnatal care services. Among 48 mothers, only 35.41% used complete antenatal care services, 66.66% received TT vaccine during pregnancy, 54.16% delivered their last child at the hospital, and only 27.08% received postnatal services as recommended by the World Health Organization. The antenatal care services and delivery services were utilized suboptimally, and postnatal care visits were significantly lower. Socio-economic factors such as family income and education of women correlated considerably with maternal health care utilization. Women with higher education levels and higher family income were more likely to go for frequent antenatal check-ups, have TT vaccinations, deliver in hospitals, and visit more postnatal check-ups than women with lower education levels and lower family income. The findings indicate that there are unmet needs of maternal health care access to women living in the squatters of Nepal. It is therefore important to implement targeted incentive programs and maternal health awareness campaigns to increase the utilization of maternal health services among women living in squatter settlements in Nepal. Key words: Antenatal, Delivery, Postnatal, Maternal health services, Squatter.


2017 ◽  
Vol 2 (1) ◽  

The study examined the association between women’s status and utilisation of maternal health care services of primary health care centres in Anambra east L.G.A of Anambra state. Five objectives were developed. A cross sectional descriptive research design was used. The study population consisted of women of child bearing age (15-49 years) who had given birth in the last five years. A sample size of 500 participants was used after using the formula for estimating sample size from a finite population. However, only 482 copies of the questionnaire were returned, giving a response rate of 96.4%. The instrument for data collection was a questionnaire developed by the researchers based on literature review. Data were analysed using the statistical package for the social sciences (SPSS version 18). The major findings showed that 71.5% utilised ANC while 44.4% utilised delivery healthcare services; 40.2% of the women took decisions jointly with their husbands while 32.4% took decisions alone on utilisation of ANC. As regards utilisation of delivery care services, 39% took decisions alone while 36.5% took decisions jointly with their husbands on where to have their baby. There were statistical significant associations between women decision making autonomy women education, women economic status and utilization of maternal health services. However, the study showed no statistical significant association between occupational status and utilisation of maternal health care services. The study concluded that the factors that influence the utilisation of maternal health care services are women decision making autonomy, educational status and their economic status.


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