scholarly journals Determinants of utilization of antenatal and delivery care at the community level in rural Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257782
Author(s):  
Jesmin Pervin ◽  
Mahima Venkateswaran ◽  
U. Tin Nu ◽  
Monjur Rahman ◽  
Brian F. O’Donnell ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Facility Delivery ◽  
Health Facilities ◽  
Community Level ◽  
Delivery Care ◽  
Multivariate Logistic Regression ◽  
Antenatal Care Visit ◽  
Care Visit

Background Timely utilization of antenatal care and delivery services supports the health of mothers and babies. Few studies exist on the utilization and determinants of timely ANC and use of different types of health facilities at the community level in Bangladesh. This study aims to assess the utilization, timeliness of, and socio-demographic determinants of antenatal and delivery care services in two sub-districts in Bangladesh. Methods This cross-sectional study used data collected through a structured questionnaire in the eRegMat cluster-randomized controlled trial, which enrolled pregnant women between October 2018-June 2020. We undertook univariate and multivariate logistic regression analysis to determine the associations of socio-demographic variables with timely first ANC, four timely ANC visits, and facility delivery. We considered the associations in the multivariate logistic regression as statistically significant if the p-value was found to be <0.05. Results are presented as adjusted odds ratios (AOR) with 95% confidence intervals (CI). Results Data were available on 3293 pregnant women. Attendance at a timely first antenatal care visit was 59%. Uptake of four timely antenatal care visits was 4.2%. About three-fourths of the women delivered in a health facility. Women from all socio-economic groups gradually shifted from using public health facilities to private hospitals as the pregnancy advanced. Timely first antenatal care visit was associated with: women over 30 years of age (AOR: 1.52, 95% CI: 1.05–2.19); nulliparity (AOR: 1.30, 95% CI: 1.04–1.62); husbands with >10 years of education (AOR: 1.40, 95% CI: 1.09–1.81) and being in the highest wealth quintile (AOR: 1.49, 95% CI: 1.18–1.89). Facility deliveries were associated with woman’s age; parity; education; the husband’s education, and wealth index. None of the available socio-demographic factors were associated with four timely antenatal care visits. Conclusions The study observed socio-demographic inequalities associated with increased utilization of timely first antenatal care visit and facility delivery. The pregnant women, irrespective of wealth shifted from public to private facilities for their antenatal care visits and delivery. To increase the health service utilization and promote good health, maternal health care programs should pay particular attention to young, multiparous women, of low socio-economic status, or with poorly educated husbands. Clinical trial registration ISRCTN69491836; https://www.isrctn.com/. Registered on December 06, 2018. Retrospectively registered.

scholarly journals Individual and community-level determinants of poor tetanus toxoid immunization among pregnant women in Ethiopia using data from 2016 Ethiopian demographic and health survey; multilevel analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Alemneh Mekuriaw Liyew ◽  
Hiwotie Getaneh Ayalew
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tetanus Toxoid ◽  
Logistic Regression Model ◽  
Community Level ◽  
Multilevel Logistic Regression ◽  
Care Visit ◽  
Multilevel Logistic Regression Model ◽  
Tetanus Toxoid Immunization

Abstract Background Tetanus is a vaccine-preventable disease that can occur in all populations, with neonates and pregnant women being at the most risk. Ethiopia has the highest maternal and neonatal tetanus morbidity and mortality rates. Besides, only 49% of mothers get vaccinated with adequate tetanus toxoid in Ethiopia which is below the world health organization recommendation. To date, there is limited evidence on the individual and community level determinants of poor tetanus toxoid (TT) immunization. Therefore, this study aimed to assess individual and community-level factors associated with poor TT immunization coverage in Ethiopia. Method Secondary data analysis was conducted using the 2016 Ethiopian demographic and health survey. A total of 7043 pregnant women were included in the current study. A multilevel logistic regression model was used to identify individual and community level determinants of poor tetanus toxoid immunization. Finally, the adjusted odds ratio with a 95% confidence interval was reported. Results In the multilevel logistic regression model adjustment, having no Antenatal care visit (AOR = 5.64; 95% CI:2.48,7.30) and having one to three antenatal care visit (AOR = 1.50; 95% CI: 1.19–1.82); poor wealth index (AOR = 1.26; 95% CI: 1.03, 1.54); not being exposed to media (AOR = 1.29; 95% CI: 1.10, 1.51); maternal unemployment (AOR = 1.15; 95% CI: 1.10, 1.31); rural residence (AOR = 1.13; 95% CI: 1.08, 1.72); and high community illiteracy (AOR = 1.28; 95% CI: 1.03, 1.58) were associated with higher odds of poor tetanus toxoid immunization. Whereas, iron uptake during pregnancy (AOR = 0.59; 95% CI: 0.51, 0.68), was associated with lower odds of poor tetanus toxoid immunization. Conclusion In this study tetanus toxoid (TT) vaccine utilization was affected by both community and individual-level factors. Therefore, focusing on antenatal care services especially encouraging pregnant women to have at least four visits, consulting women to be exposed to media, improving community literacy and maternal employment will help to minimize TT underutilization.

scholarly journals Awareness and Its Associated Factors of Obstetrics Fistula among Antenatal Care Attendees in Injibara Town Health Institutions, Awi Zone, North West, Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Wondu Feyisa Balcha ◽  
Azezu Asres Nigussie ◽  
Fentahun Yenealem Beyene ◽  
Azimeraw Arega Tesfu
Keyword(s):  
Logistic Regression ◽  
Confidence Interval ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Associated Factors ◽  
Obstetric Fistula ◽  
Multivariate Logistic Regression Analysis ◽  
Public Health Issue ◽  
Multivariate Logistic Regression ◽  
Health Institution

Background. Obstetric fistula is abnormal passageway between the vagina and bladder or rectum, and it has the most devastating effects on physical, social, and economic levels and represents a major public health issue of thousands of women, which failed to provide accessible and appropriate intrapartum care for women within a developing country, particularly in Ethiopia. Therefore, we tried to assess the awareness and its associated factors of obstetrics fistula among pregnant mothers attending antenatal care clinics. Methods. A health institutional-based cross-sectional study was employed from March 4 to 29/2019 among 413 pregnant women. Data was collected by a systematic random sampling technique and entered into a computer using Epi data 3.5, edited and analyzed using Statistical Package of Social Sciences 23.0 version. Bivariate and multivariate logistic regression analyses were employed to estimate the crude and adjusted odds ratio with a confidence interval of 95% and p value of less than 0.05 considered statically significant. Result. This study identified that 39.5% with 95% confidence interval (34.6-44.6%) of pregnant women had good awareness about obstetrics fistula. Multivariate logistic regression analysis showed that living in urban [AOR=1.98, 95% CI=1.07−3.69], attending formal education [AOR=2.11, 95% CI=1.06−4.12], having history antenatal care [AOR=3.87, 95% CI=1.60−9.68], and childbirth at health institution [AOR=7.10, 95% CI=2.52−2.02] were significantly associated with awareness of obstetrics fistula. Conclusion and recommendation. This study showed that awareness of obstetrics fistula was low. Residency, education, and occupation of the women, having history of antenatal care and childbirth at health institution was significantly associated with awareness of obstetrics fistula. Still, there is a gap on awareness of obstetrics fistula; therefore, it is good to emphasize on providing information on maternal health care issues, particularly about obstetrics fistula.

scholarly journals The determinant of Antenatal Care Visits among Pregnant Women in Ethiopia

2019 ◽  
Author(s):  
Setegn Muche Fenta
Keyword(s):  
Health Care ◽  
Mass Media ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Rural Women ◽  
Sub Saharan Africa ◽  
World Health ◽  
Antenatal Care Visit ◽  
Care Visit ◽  
Pregnant Mothers

Abstract Background Health care services during a pregnancy and after delivery are important for the survival and well being of both the mother and the infant. The World Health Organization recommends a minimum of four antenatal care visits during a pregnancy. In Ethiopia, only 38% of women aged 15-49 with a live birth received at least one-time antenatal care visits from a skilled provider. This value is much more below the average rates of least developed countries and Sub-Saharan Africa. This study aimed to identify the determinant factor of antenatal care service visits among pregnant women in EthiopiaMethod The national-level cross-sectional Ethiopian Demographic and Health 2016 survey data were accessed and used for the analysis. A total of 7913 pregnant women were included in the study. Zero-inflated Poisson regression models were employed to identify the determinant of antenatal care visits.Results Only 35.5% of the pregnant mothers have visited at least four times and 64.5% of the pregnant mothers have visited less than four times during their periods of pregnancy. The study revealed that rich women (IRR 1.077, 95% CI: 1.029,1.127), having access to mass media (IRR=1.086, 95% CI: 1.045, 1.128), having pregnancy complications (IRR=1.203, 95% CI: 1.165, 1.242), secondary or above-educated women (IRR=1.112, 95% CI:1.052, 1.176), husband's having secondary or above level of education (IRR=1.085, 95% CI: 1.031, 1.142), being married (IRR = 1.187; 95% CI: 1.087,1.296) and women age >30 years (IRR=1.067, 95% CI: 1.024, 1.111) were strongly positively associated with the antenatal care visit. Rural pregnant women less antenatal visits (IRR=0.884, 95% CI: 0.846, 0.924) had also a statistically significant association with antenatal care visits.Conclusion This study was revealed rural women, poor women, uneducated mothers, uneducated husbands, not having access to mass media, unmarried women, have not pregnancy a complication was significantly associated with less number of antenatal care visit. Therefore, efforts are needed to advance the socioeconomic status of women, increasing the educational level of women and their husbands. The concerned body also should be made maternal health-care programs should be stretched and intensified in rural areas.

scholarly journals FACTORS THAT INFLUENCING THE AWARENESS OF THE FIRST ANTENATAL VISIT

2021 ◽  
Vol 4 (3) ◽  
pp. 264
Author(s):  
Maria Magdalena Awi ◽  
Dwi Purwanti ◽  
Reny I’tishom ◽  
Ninik Darsini
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Family Support ◽  
Dominant Factor ◽  
P Value ◽  
Antenatal Visit ◽  
Test Results ◽  
Multivariate Test ◽  
Antenatal Care Visit ◽  
Care Visit

ABSTRACTBackground : K1 antenatal care visits at gestational age less than 13 weeks has a very important meaning for pregnant women as well as maternal and child health programs because of their contribution to the prevention of maternal deaths. Coverage of K1 in Puskesmas Watukapu  still has a gap of 28.05%.This study aims to determine the factors that influence the K1 antenatal care visit. Methode : The research method was analytic observational with cross sectional design. The sample in this study were all pregnant women trimesters 2 and 3 who came to visit the POLI KIA Puskesmas Watukapu.The sample size of 70 respondents was taken by non-probability sampling technique with consecutive sampling.The independent variable was K1 antenatal care visit, while the dependent variable were age, knowledge, education, parity, attitude, husband's support and family support.Research instrument with questionnaire. Bivariate data analysis used chi square test and multivariate test used  multiple logistic regression  test.  Results:this study found that the proportion of K1 antenatal care visits was 62.4%. Bivariate statistical test results knowledge P = 0,000 (p <0,005), attitude P = 0,135 (P> 0,005), husband support P = 0,000 (P <0,005), family support P = 0,004 (P <0,005), age P = 0,331 (P> 0.005), education P = 0.004 (P <0.005), parity P = 0.015 (P <0.05).  Multivariate test results with  P value <0.005 was  parity with a P value of 0.017.Conclusion: There is a correlation between knowledge, education, parity, husband's support and family support to the awareness of K1 antenatal care visits with the most dominant factor is parity.  

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