Determinants of maternal healthcare service utilisation among Indonesian mothers: A population-based study

Background: In Indonesia, maternal health care services are widely available, aiming to improve health and survival among mothers. However, these services remain underutilised, and its determining factor was unknown. This study sought to identify determinant factors of maternal healthcare services utilisation among Indonesian mothers. Methods: This population-based cross-sectional study leveraged the 2017 Indonesia Demographic and Health Survey data. A total of 12,033 mothers aged from 15 to 49 years who had a live birth in the five years preceding the survey were included in the analysis. Multivariable logistic regressions were used to identify the determinant factors. Results: Approximately 93.44% of the mothers had adequate antenatal care, 83.73% had a delivery at the healthcare facility, and 71.46% received postnatal care. The mother’s age and household wealth index were the typical determinants of all maternal healthcare services. Determinants of antenatal care visits were husband’s occupational status, the number of children, and access to the healthcare facility. Next, factors that drive mothers’ delivery at the healthcare facility were the mother’s education level, husband’s educational level, and residential area. The use of postnatal care was determined by the mother’s occupational status, husband’s educational level, number of children, wealth index, access to the healthcare facility, and residential area. Conclusions: Although there were differences in the determinant factors of three key maternal healthcare services, the mother’s age and household wealth index were the typical determinants of all maternal healthcare services utilisation. Providing a tailored programme aligned with these determinant factors may ensure that mothers can access and adequately utilise maternal healthcare services.

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Does gender inequality matter for access to and utilization of maternal healthcare services in Bangladesh?

PLoS ONE ◽

10.1371/journal.pone.0257388 ◽

2021 ◽

Vol 16 (9) ◽

pp. e0257388

Author(s):

Firoz Ahmed ◽

Fahmida Akter Oni ◽

Sk. Sharafat Hossen

Keyword(s):

Gender Inequality ◽

Gender Gap ◽

Partner Violence ◽

Bargaining Power ◽

Healthcare Services ◽

Household Wealth ◽

Maternal Healthcare ◽

Intrahousehold Bargaining ◽

Women’S Autonomy ◽

Women's Autonomy

There is a high prevalence of gender gap in Bangladesh which might affect women’s likelihood to receive maternal healthcare services. In this backdrop, we aim to investigate how gender inequality measured by intrahousehold bargaining power (or autonomy) of women and their attitudes towards intimate partner violence (IPV) affects accessing and utilizing maternal health care services. We used Bangladesh Demographic and Health Survey (BDHS) data of 2014 covering 5460 women who gave birth at least one child in the last three years preceding the survey. We performed logistic regression to estimate the effect of women’s autonomy and their attitude towards IPV on access to and utilization of maternal healthcare services. Besides, we employed different channels to understand the heterogeneous effect of gender inequality on access to maternal healthcare services. We observed that women having autonomy positively influenced attaining five required antenatal care (ANC) services (AOR: 1.17; 95% CI: 0.98–1.41) and women’s negative attitudes towards IPV were positively associated with five ANC services (AOR: 1.42; 95% CI: 1.02–1.97), sufficient ANC visits (COR: 1.55; CI: 1.19–2.01), skilled birth attendant (SBA) (AOR: 1.43; 95% CI: 1.05–1.94) and postnatal care (PNC) services (AOR: 1.44; 95% CI: 1.12–1.84). Besides, rural residency, religion, household wealth, education of both women and husband were found to have some of the important channels which were making stronger effect of gender inequality on access to maternal healthcare services. The findings of our study indicate a significant association between access to maternal healthcare services and women’s autonomy as well as attitude towards IPV in Bangladesh. We, therefore, recommend to protect women from violence at home and mprove their intrahousehold bargaining power to increase their access to and utilization of required maternal healthcare services.

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Household food insecurity is independently associated with poor utilization of maternal healthcare services in Bangladesh

FACETS ◽

10.1139/facets-2017-0018 ◽

2017 ◽

Vol 2 (2) ◽

pp. 969-983 ◽

Cited By ~ 3

Author(s):

Ghose Bishwajit ◽

Sanni Yaya

Keyword(s):

Food Insecurity ◽

Wealth Index ◽

Healthcare Services ◽

Sociodemographic Factors ◽

Outcome Variable ◽

Household Food Insecurity ◽

Maternal Healthcare ◽

Individual Level ◽

Household Food ◽

The Impact

Introduction: Food insecurity at the individual level has been shown to be associated with the adoption of risky behavior and poor healthcare-seeking behavior. However, the impact of household food insecurity (HFI) on the utilization of maternal healthcare services (MHS) remains unexplored. In this study, we aimed to investigate whether or not household food insecurity was associated with non/inadequate utilization of MHS. Methods: Participants consisted of 3562 mothers aged between 15 and 49 years and with at least one child. The outcome variable was the utilization of MHS, e.g., institutional delivery, attendance ante-, and pre-natal visits. The explanatory variables included various sociodemographic factors (e.g., age, residence, education, wealth) apart from HFI. HFI was measured using the Household Food Insecurity Access Scale (HFIAS). Result: The prevalence of non- and under-utilization of MHS was 5.3 and 36.5, respectively. In the multivariate analysis, HFI, wealth index, and educational level were independently associated with MHS status. The odds of non- and under-utilization of MHS were 3.467 (CI = 1.058–11.354) and 4.104 (CI = 1.794–9.388) times higher, respectively, among women from households reporting severe food insecurity. Conclusion: Severe HFI was significantly associated with both under- and non-utilization of MHS. Interventions programs that address HFI and the empowerment of women can potentially contribute to an increased utilization of MHS.

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Factors Affecting the Utilization of a Minimum of Four Antenatal Care Services in Ethiopia

Obstetrics and Gynecology International ◽

10.1155/2019/5036783 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Garoma Wakjira Basha

Keyword(s):

Antenatal Care ◽

Rural Areas ◽

Wealth Index ◽

Complete Information ◽

Healthcare Services ◽

Household Wealth ◽

Routine Care ◽

Factors Affecting ◽

Poor Households ◽

Nationally Representative

Background. Antenatal care is defined as the routine care of pregnant women provided between conception and the onset of labor. This study is aimed to identify factors affecting the utilization of antenatal care (ANC) services in Ethiopia. Methods. The study used data from the nationally representative 2016 Ethiopia Demographic and Health Survey (EDHS). A total of 7,167 mothers who gave birth within five years preceding the 2016 EDHS whose complete information was available in the survey were included in this study. Logistic regression statistical analyses were used to identify factors associated with the utilization of a minimum of 4 ANC services in Ethiopia. Results. Among the 7,167 women included in this study, 2,598 (36.6%) had utilized a minimum of 4 ANC services in Ethiopia. This study showed that factors such as place of residence, region, mothers’ education level, household wealth index, desire for pregnancy, frequency of reading newspaper, frequency of listening to radio, and frequency of watching TV were associated with the utilization of a minimum of four ANC services at 5% level of significance in Ethiopia. Conclusion. Strategies to increase the accessibility and availability of healthcare services are important particularly for communities in rural areas. Financial support that enables mothers from poor households to use health services will be beneficial. Health promotion programs targeting mothers with no education are vital to increase their awareness about the importance of antenatal services.

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A multilevel analysis of factors influencing child mortality in Ghana

The International Journal of Social Sciences and Humanities Invention ◽

10.18535/ijsshi/v5i2.06 ◽

2018 ◽

Vol 5 (2) ◽

pp. 4425-4432

Author(s):

Anthony Abbam

Keyword(s):

Child Mortality ◽

Socioeconomic Development ◽

Wealth Index ◽

Maternal Health Services ◽

Household Wealth ◽

Economic Conditions ◽

Policy Makers ◽

Substantial Impact ◽

Mother’S Age ◽

Core Indicator

Child mortality being a core indicator for child health and the health status of children has significant effect on health in adulthood and socioeconomic development of a nation. This paper uses the Ghana Demographic and Health Survey (GDHS) 2013–2014 to investigate the predictors of child (age 1-4 years] mortality in a developing country like Ghana. The multilevel logistic regression technique has been used to estimate the predictors of child mortality. The study found that both child and mother-level characteristics such as birth weight, birth order, mother’s age, educational attainment of the mother have substantial impact on child mortality in Ghana Besides, household wealth index has significant impact on child mortality. The findings also show that place of residence and southern-northern dichotomy has momentous effect on child mortality. The paper recommends that governments must pursue policies that seek to improve the economic conditions of households. In addition, steps should be taken by policy makers to reduce spatial disparities in the availability of maternal health services as the absence of this perhaps contributes to child mortality.

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Parents Determination Factors Influencing Incomplete Basic Immunization For Infants In Sorong City, West Papua Province

PUINOVAKESMAS ◽

10.29238/puinova.v1i1.434 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Alva Cherry Mustamu ◽

Serly A. Markus

Keyword(s):

Occupational Status ◽

Immunization Coverage ◽

Health Centers ◽

Cross Sectional ◽

Staff Support ◽

Number Of Children ◽

West Papua ◽

Status Number ◽

Mother’S Age ◽

The City

The implementation of complete Indonesian basic immunization has decreased in the period of 2012 - 2015. West Papua is one of the provinces with the lowest immunization coverage, which is 57.1% and the city of Sorong is only 21.9%. This research is to investigate the determinant factors of parents' incomplete basic immunization of infants months in Sorong city, West Papua Province. This study was cross-sectional in design. The subjects consisted of purposive sampling of 134 parents of children aged 1-5 years old, have incomplete basic immunization from immunization records and who visit 10 health centers in Sorong City. Data were collected from parents using questionnaires and immunization records. This study used logistic regression to analyze multivariate data Simultaneously, the mother’s age, education level, occupational status, number of children, the experience of having children, distance to the place of immunization, knowledge, family support, immunization officers and attitudes did not affect the incompleteness basic immunization (f count 1.768). Only the number of children (t = 0.017) and immunization staff support (t = 0.044) which affected the incomplete immunization. sequentially, number of children ( = 0.003), immunization support staff ( = 0.004), distance to immunization site ( = 0.035) and attitudes ( = 0.027) which most contribute to incomplete immunization. The number of children, immunization officers support, distance to immunization site and attitudes which contribute to incomplete immunization.

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Health Insurance Deepening and Its Impact on Maternal Healthcare Demand in Private Hospitals in Kenya

JOURNAL OF SOCIAL SCIENCE RESEARCH ◽

10.24297/jssr.v16i.8855 ◽

2020 ◽

Vol 16 ◽

pp. 62-76

Author(s):

George N. Mose ◽

Joseph Abuga Orayo

Keyword(s):

Health Insurance ◽

Maternal Health ◽

Insurance Coverage ◽

Wealth Index ◽

Health Insurance Coverage ◽

Healthcare Services ◽

Significant Rise ◽

Probit Regression ◽

Maternal Healthcare ◽

Private Hospitals

Promotion of maternal healthcare services through the expansion of health insurance coverage has been a core strategy that has been adopted in the reduction of maternal and child mortalities in Kenya. In this study, we seek to establish how health insurance coverage and benefits influence the demand for maternal health utilization in private hospitals in Kenya. The study utilized the latest Kenya Demographic Household Survey 2014 data to estimate the relationship. The binary probit regression model was employed in estimation. From the findings, only 15 percent of mothers were enrolled in a health insurance plan, whereas 14 percent of the women reported to have attended antenatal clinics in private health facilities, and 13 percent benefited from skilled delivery in private healthcare facilities. Results further revealed that health insurance ownership led to a significant increase in the likelihood of utilizing maternal health care services in private hospitals in Kenya. Similarly, age of the mother, marital status, birth order, higher education level, all wealth index categories, and employment status were cofactors associated significantly with use of healthcare services. It was concluded that the advent and increase of health insurance coverage is associated with a significant rise in demand of maternal healthcare services in private hospitals. This study argues that the current health subsidies would be more effective if they were channeled through health insurance with wider coverage of private hospitals. The study recommends reforms in policies and guidelines governing insurance coverage, which we argue would significantly bring down the cost of insurance coverage, thus become more accessible to more Kenyans.

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Disability, Caste and Intersectionality: Does Co-Existence of Disability and Caste Compound Marginalization for Women Seeking Maternal Healthcare in Southern Nepal?

10.20944/preprints202103.0115.v1 ◽

2021 ◽

Author(s):

Hridaya Raj Devkota ◽

Andrew Clarke ◽

Emily Murray ◽

Maria Kett ◽

Nora Groce

Keyword(s):

Service Utilization ◽

Healthcare Service ◽

Healthcare Services ◽

Household Wealth ◽

Service Development ◽

Maternal Healthcare ◽

Women With Disabilities ◽

Disabled Women ◽

Dalit Women ◽

Natal Care

Background: Disability and caste are two different forms of oppression, however Dalits and people with disabilities commonly face similar types of marginalities. Dalit women with disabilities may experience double discrimination because of the intersectionality of disability and caste. This study examines whether the disability and caste identity of women together affects and compounds the utilization of maternal healthcare services. Methods: A cross-sectional survey was conducted using a semi-structured questionnaire among a total of 354 Dalit and non-Dalit women, with and without a disability aged between 15 – 49 years. Maternal healthcare service utilization was assessed by Ante-Natal Care (ANC), health facility (HF) delivery, and Post-Natal Care (PNC) during the last pregnancy. Logistic regression was performed to detect the predictors of service utilization and identify whether disability and caste were associated with service utilization. First, disability and caste were fitted separately in models. Secondly, the intersectionality of disability and caste was tested by the inclusion of disability*caste interaction term. Finally, the confounding effect of socio-demographic factors was investigated. Results: Out of surveyed women, 73% had 4+ ANC visits, 65% had HF delivery and 29% had a PNC visit during their last pregnancy. Women with a disability had lower odds of HF delivery (OR 0.50, CI 0.30 – 0.84) and PNC (OR 0.47, CI 0.25 – 0.88) than women without a disability. Adjustment for women’s age and household wealth explained associations in HF delivery by women with disabilities. There was no association between caste and service utilization. Disability overrode caste and there was no other evidence of effect modification by women’s caste status in the utilization. However, a weak interaction effect in the utilization of ANC services was found in the caste group by their education (OR 0.19, 95% CI 0.05 – 0.74). Conclusions: Disabled women – whether Dalit or non-Dalit - had lower rates of utilizing all maternal healthcare services than non-disabled women. However, Dalit women with disabilities were more likely to receive PNC than non-Dalit women with disabilities. Increasing equity in maternal healthcare service utilization requires that traditional approaches to service development and program intervention to be re-examined and more nuanced interventions considered to ensure improved access and outcome among all vulnerable groups.

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Trends, wealth inequalities and the role of the private sector in caesarean section in the Middle East and North Africa: A repeat cross-sectional analysis of population-based surveys

PLoS ONE ◽

10.1371/journal.pone.0259791 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0259791

Author(s):

Stephen J. McCall ◽

Aline Semaan ◽

Noon Altijani ◽

Charles Opondo ◽

Mohamed Abdel-Fattah ◽

...

Keyword(s):

Middle East ◽

Caesarean Section ◽

Private Sector ◽

North Africa ◽

Wealth Index ◽

Healthcare Facility ◽

Household Wealth ◽

Arab Countries ◽

Mena Region ◽

Cross Sectional

Objective To examine trends and variations of caesarean section by economic status and type of healthcare facility in Arab countries in the Middle East and North Africa (MENA). Methods Secondary data analysis of nationally representative household surveys conducted between 2008–2020 across nine Arab countries in the MENA region. The study population was women aged 15–49 years with a live birth in the two years preceding the survey. Temporal changes in the proportion of deliveries by caesarean section in each country were calculated using generalised linear models and presented as risk differences (RD) with 95% confidence intervals (95%CI). Caesarean section was disaggregated by household wealth index and type of healthcare facility. Results Use of caesarean section ranged from 57.3% (95%CI:55.6–59.1%) in Egypt to 5.7% of births (95%CI:4.9–6.6%) in Yemen. Overall, the use of caesarean section has increased across the MENA region, except in Jordan, where there was no evidence of change (RD -2.3 (95%CI: -6.0 ‒1.4)). Across most countries, caesarean section use was highest in the richest quintile compared to the poorest quintile, for example, 42.8% (95%CI:38.0–47.6%) vs. 22.6% (95%CI:19.6–25.9%) in Iraq, respectively. Proportion of caesarean section was higher in private sector facilities compared to public sector: 21.8% (95%CI:18.2–25.9%) vs. 15.7% (95%CI:13.3–18.4%) in Yemen, respectively. Conclusion Variations in caesarean section exist within and between Arab countries, and it was more commonly used amongst the richest quintiles and in private healthcare facilities. The private sector has a prominent role in observed trends. Urgent policies and interventions are required to address non-medically indicated intervention.

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PARENTS DETERMINATION FACTORS INFLUENCING INCOMPLETE BASIC IMMUNIZATION FOR INFANTS IN SORONG CITY, WEST PAPUA PROVINCE

Media Kesehatan Politeknik Kesehatan Makassar ◽

10.32382/medkes.v14i1.718 ◽

2019 ◽

Vol 14 (1) ◽

pp. 34

Author(s):

Alva Cherry Mustamu ◽

Serly A. Markus

Keyword(s):

Occupational Status ◽

Immunization Coverage ◽

Support Staff ◽

Cross Sectional ◽

Staff Support ◽

Number Of Children ◽

West Papua ◽

Status Number ◽

Mother’S Age ◽

The City

Background: The implementation of complete Indonesian basic immunization has decreased in the period of 2012 - 2015. West Papua is one of the provinces with the lowest immunization coverage, which is 57.1% and the city of Sorong is only 21.9%.Objective: to investigate the determinant factors of parents in complete basic immunization of infants months in Sorong City, West Papua ProvinceMethods : This study was cross-sectional in design. The subjects consisted of a purposive sampling of 134 parents of children aged 1-5 years old, have incomplete basic immunization from immunization records and who visit 10 health center in Sorong City. Data were collected from parents using questionaires and immunization records. Logistic regression were used for data analysis.Results: Simultaneously, mother’s age, education level, occupational status, number of children, experience of having children, distance to the place of immunization, knowledge, family support, immunization officers and attitudes did not affect the incompleteness basic immunization (f count 1.768). Only the number of children (t = 0.017) and immunization staff support (t = 0.044) which affected the incomplete immunization. sequentially, number of children ( = 0.003), immunization support staff ( = 0.004), distance to immunization site ( = 0.035) and attitudes ( = 0.027) which most contribute to incomplete immunization.Conclusion: Number of children, immunization officers support, distance to immunization site and attitudes which contribute to incomplete immunization.

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Geographical Variations and Factors Associated with Childhood Diarrhea in Tanzania: A National Population Based Survey 2015-16

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v29i4.13 ◽

1970 ◽

Vol 29 (4) ◽

Author(s):

Paul Edwin ◽

Muluken Azage

Keyword(s):

Mixed Model ◽

Linear Mixed Model ◽

Wealth Index ◽

Population Based ◽

Childhood Diarrhea ◽

Under Five ◽

Factors Associated ◽

Under Five Children ◽

Geographical Variations ◽

Mother’S Age

BACKGROUND: Diarrhea remains the leading cause of morbidity and mortality among under 5 children in low- and middle-income countries. In Tanzania, diarrhea remains one of the major public health problems. This study aimed to investigate spatial variations and the factors correlated with diarrhea in under five children.METHODS: This is a secondary data analysis using data from the population-based cross section Tanzanian Demographic and Health Survey 2015-16 data. Spatial analysis was done using the Bernoulli model from SaTScan™ software, and a generalized linear mixed model was used to identify the factors associated with childhood diarrhea.RESULTS: The overall reported prevalence of childhood diarrhea for the under five children in Tanzania was 12.1% (95%CI 11.3%-12.9%). The SaTScan spatial statics analysis revealed that diarrhea in children was not random. The odds of diarrhea were 7.35 times higher (AOR= 7.35; 95%CI: 5.29, 10.22) among children in the 6- 11 months age group compared to children within the 48-59 months of age. As mother’s age increased, the risk of diarrhea for the under five children decreased whereas the highest risk of diarrhea was observed in the two rich income brackets richer (AOR=1.70, 95%CI=1.30, 2.22), and richest (AOR= 1.05, 95%CI=1, 1.09). The odds of diarrhea were 1.25 times higher (AOR=1.25, 95%CI=1.06, 1.46) among children with unsafe stool disposal compared to those with safe disposal.CONCLUSION: The socio-demographic factors associated with diarrhea among children were mother’s age in years, current age of the child, wealth index and child stool disposal.

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