Decomposing the Socio-economic Inequalities in Utilization of Full Antenatal Care in Jharkhand State, India

Abstract Antenatal Care (ANC) is one of the four pillars initiatives of the Safe Motherhood. Since MMR is high in rural areas of Bangladesh so to reduce MMR the uptake of ANC visit from trained provider is important. The objective of this study was to see the trends of 4+ ANC visit and identify the factors associated with the number of antenatal visits in rural areas.This study used the data generated from Bangladesh Demographic and Health Survey (BDHS) 2004-2014 to observe the trends and factors associated of 4+ ANC visit. The results of bivariate and multivariate analyses confirm that divisions, wealth, education and media exposure had strong influence on rural women’s 4 + ANC visit. Result of logistic regression model shows that poor and less educated women of rural areas were less likely to seek 4+ ANC visit than urban areas. This outcome of the paper suggests that rural women economic status and education has significant effect on 4+ ANC visit. The findings will help to design appropriate strategies, programs and policies for the improvement of rural women’s maternal healthcare seeking behaviour.

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Economic Status and Maternal Health: Analysis of the 2013-14 Zambia Demographic and Health Survey

Open Science Journal ◽

10.23954/osj.v2i2.863 ◽

2017 ◽

Vol 2 (2) ◽

Author(s):

Mulenga Chonzi Mulenga

Keyword(s):

Maternal Health ◽

Antenatal Care ◽

Health Outcomes ◽

Health Survey ◽

Economic Status ◽

Demographic And Health Survey ◽

Composite Measure ◽

Maternal Health Outcomes ◽

The Impact ◽

Status Of Women

With the current high maternal mortality rates prevailing in Zambia, it is imperative to analyze the effect that the economic status of women has on maternal health outcomes. It is hypothesized that wealth is positively linked to better health outcomes. As a result, maternal health outcomes will improve when the economic status of women improve. Using data for women from the 2013-14 Zambia Demographic and Health Survey, bivariate and multivariate analysis was used to ascertain the impact of wealth as a proxy for economic status and other variables based on five independent outcomes (Number of antenatal care visits, timing of first antenatal care visit, tetanus toxoid vaccination, iron tablet/syrup uptake, and place of delivery) and a composite measure of maternal health. The results revealed that women’s wealth and region were the only significant factor associated with all the five independent indicators and the composite measure of maternal health. However, for the composite measure, literacy and age of the mother were also found to be associated with maternal health. The study therefore concluded that economic status is an important factor in improving maternal health outcomes in Zambia. As a result, policy should be aimed at providing support to women within the lowest wealth quintiles so as to enable them access maternal health services.

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Utilization, Equity and Determinants of Full Antenatal Care in India: Analysis from the National Family Health Survey 4

10.21203/rs.2.11599/v2 ◽

2019 ◽

Author(s):

Gunjan Kumar ◽

Tarun Shankar Choudhary ◽

Akanksha Srivast ◽

Ravi Praksah Updhyay ◽

Sunita Taneja ◽

...

Keyword(s):

Antenatal Care ◽

Health Survey ◽

Tetanus Toxoid ◽

Maternal Education ◽

Family Health ◽

National Family Health Survey ◽

Multivariable Logistic Regression Model ◽

Factors Associated ◽

National Family ◽

Antenatal Visits

Abstract Objectives: We examined the utilisation, equity and determinants of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods: We analysed a sample of 190,898 women from India's National Family Health Survey 4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable logistic regression model was used to examine the factors associated with full ANC utilization. Results: In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Full ANC utilisation was inequitable across area of residence, caste and maternal education. Conclusions: Full ANC utilization in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program. Key words: Antenatal care, India, NFHS-4

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Factors associated with utilization of antenatal care services among rural women, Telangana, India

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20182476 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2807

Author(s):

Biranchi Narayan Das ◽

Seshasai Kanakamedala ◽

Mahesh kumar Mummadi

Keyword(s):

Health Care ◽

Antenatal Care ◽

Rural Women ◽

Cross Sectional ◽

Child Birth ◽

Factors Associated ◽

Care Services ◽

Telangana State ◽

The Government ◽

Antenatal Visits

Background: Antenatal care is the essential health care extended to pregnant women. Complete antenatal health care includes four antenatal visits, 2 TT injections, and consumption of 100 Iron and Folic acid tablets. In Telangana state the proportion of mothers received full ante natal care in rural area is only 37.3%. Hence, the present study conducted with an objective to assess the factors associated with utilization of antenatal care services among rural women in Telangana state.Methods: The study is a community based cross sectional study. It was conducted in villages of Moinabad Mandal of Telangana state. Sample size was calculated to 373.Out of 26 villages 20 villages were chosen randomly and from each village 20 houses were selected by stratified random method. Married women delivered at least one child during last five years were included. Pretested questionnaire was administered. The data were tabulated in MS Excel and analyzed by SPSS.Results: Among 373 participants, 89.3% mothers registered during 1st trimester, 92.8% confirmed their pregnancy in the Government sector, 81.3% mothers had four or more antenatal visits, nearly 87.7% mothers received two doses of TT and 77.2% had taken more than 100 Iron tablets. The factors identified to be having statistically significant (p< 0.05) association with better utilization of antenatal care were age at child birth >25 years, education10th class and above, Working mothers, first child birth, Socioeconomic class I- IV and early registration. On application of simple logistic regression predictors were found to be age, education, occupation, birth order, SES and early registration.Conclusions: Awareness should be made by the ASHA workers, ANMs and Anganwadi workers through better education and motivation of the target groups such as young mothers, homemakers, low socio-economic status groups and late registered mothers for better utilization.

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Family factors associated with immunization uptake in children aged between twelve and fifty-nine months: a household survey in Kakamega Central district, Western Kenya

Healthcare in Low-resource Settings ◽

10.4081/hls.2016.5447 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 1

Author(s):

Joram L. Sunguti ◽

Penny E. Neave ◽

Steve Taylor

Keyword(s):

Antenatal Care ◽

Economic Status ◽

Immunization Coverage ◽

Household Survey ◽

Cross Sectional Study ◽

Family Factors ◽

Cross Sectional ◽

Western Kenya ◽

Factors Affecting ◽

Factors Associated

In this study, we assessed immunization uptake and identified family factors associated with immunization in children aged between 12 and 59 months in Kakamega Central, Western Kenya. A cross sectional study was conducted in 13 sub-locations between June and July 2013. Data on 577 children were collected from their respective caregivers, by trained research assistants. The proportion of fully immunized children was 80.9% (95% confidence interval 76.9-85.3%). Immunization coverage was higher among caregivers who had completed secondary school (88%), those who had attended antenatal care clinics (81%) and children born in a health facility (85%). Some evidence was seen of increasing coverage with increasing socio-economic status. No evidence for a gender difference in coverage was seen. In the logistic regression model, the risk factors for incomplete immunization were: low educational level of the caregiver [adjusted odd ratio (AOR)=0.25; P<0.005], never attending any antenatal care (ANC) (AOR=0.14; P<0.05) and delivery outside of health facilities (AOR=0.40; P<0.005). Further inquiry is required into this area to fully comprehend the inextricable linkage between factors affecting immunization.

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Factors Associated with Anemia among Pregnant Women of Underprivileged Ethnic Groups Attending Antenatal Care at Provincial Level Hospital of Province 2, Nepal

Anemia ◽

10.1155/2021/8847472 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Umesh Kumar Yadav ◽

Prabesh Ghimire ◽

Archana Amatya ◽

Ashish Lamichhane

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Ethnic Groups ◽

Dietary Diversity ◽

Secondary Level ◽

Factors Associated ◽

Lower Education ◽

Level Hospital ◽

Antenatal Visits ◽

Prevalence Of Anemia

Background. This study aims at determining the factors associated with anemia among pregnant women of underprivileged ethnic groups attending antenatal care at the provincial level hospital of Province 2. Methods. A hospital-based cross-sectional study was carried out in Janakpur Provincial Hospital of Province 2, Southern Nepal. 287 pregnant women from underprivileged ethnic groups attending antenatal care were selected and interviewed. Face-to-face interviews using a structured questionnaire were undertaken. Anemia status was assessed based on hemoglobin levels determined at the hospital’s laboratory. Bivariate and multiple logistic regression analyses were used to identify the factors associated with anemia. Analyses were performed using IBM SPSS version 23 software. Results. The overall anemia prevalence in the study population was 66.9% (95% CI, 61.1–72.3). The women from most underprivileged ethnic groups (Terai Dalit, Terai Janajati, and Muslims) were twice more likely to be anemic than Madhesi women. Similarly, women having education lower than secondary level were about 3 times more likely to be anemic compared to those with secondary level or higher education. Women who had not completed four antenatal visits were twice more likely to be anemic than those completing all four visits. The odds of anemia were three times higher among pregnant women who had not taken deworming medication compared to their counterparts. Furthermore, women with inadequate dietary diversity were four times more likely to be anemic compared to women having adequate dietary diversity. Conclusions. The prevalence of anemia is a severe public health problem among pregnant women of underprivileged ethnic groups in Province 2. Being Dalit, Janajati, and Muslim, having lower education, less frequent antenatal visits, not receiving deworming medication, and having inadequate dietary diversity are found to be the significant factors. The present study highlights the need of improving the frequency of antenatal visits and coverage of deworming program in ethnic populations. Furthermore, promoting a dietary diversity at the household level would help lower the prevalence of anemia. The study findings also imply that the nutrition interventions to control anemia must target and reach pregnant women from the most-marginalized ethnic groups and those with lower education.

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Utilization, Equity and Determinants of Full Antenatal Care in India: Analysis from the National Family Health Survey 4

10.21203/rs.2.11599/v1 ◽

2019 ◽

Author(s):

Gunjan Kumar ◽

Tarun Shankar Choudhary ◽

Akanksha Srivast ◽

Ravi Praksah Updhyay ◽

Sunita Taneja ◽

...

Keyword(s):

Antenatal Care ◽

Health Survey ◽

Tetanus Toxoid ◽

Maternal Education ◽

Family Health ◽

National Family Health Survey ◽

Binary Logistic Regression Model ◽

Factors Associated ◽

National Family ◽

Antenatal Visits

Abstract Objectives We estimated the utilisation, determinants and equity of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods We used data from India’s National Family Health Survey-4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable binary logistic regression model was used to examine the factors associated with full ANC utilization. Results In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Full ANC utilisation was inequitable across area of residence, caste and maternal education. Conclusions Full ANC utilization in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program.

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Utilization, Equity and Determinants of Full Antenatal Care in India: Analysis from the National Family Health Survey 4

10.21203/rs.2.11599/v3 ◽

2019 ◽

Author(s):

Gunjan Kumar ◽

Tarun Shankar Choudhary ◽

Akanksha Srivast ◽

Ravi Praksah Updhyay ◽

Sunita Taneja ◽

...

Keyword(s):

Antenatal Care ◽

Health Survey ◽

Tetanus Toxoid ◽

Maternal Education ◽

Family Health ◽

National Family Health Survey ◽

Multivariable Logistic Regression Model ◽

Factors Associated ◽

National Family ◽

Antenatal Visits

Abstract Objectives: We examined the utilisation, equity and determinants of full antenatal care (ANC), defined as 4 or more antenatal visits, at least one tetanus toxoid (TT) injection and consumption of iron folic acid (IFA) for a minimum of 100 days, in India. Methods: We analysed a sample of 190,898 women from India's National Family Health Survey 4. Concentration curves and concentration index were used to assess equity in full ANC utilisation. Multivariable logistic regression model was used to examine the factors associated with full ANC utilization. Results: In India, 21% of pregnant women utilised full ANC, ranging from 2.3% - 65.9% across states. Overall, 51.6% had 4 or more ANC visits, 30.8% consumed IFA for atleast 100 days, and 91.1% had one or more doses of tetanus toxoid. Registration of pregnancy, utilisation of government’s Integrated Child Development Services (ICDS) and health insurance coverage were associated with higher odds of full ANC utilisation. Lower maternal education, lower wealth quintile(s), lack of father’s participation during antenatal visits, higher birth order, teenage and unintended pregnancy were associated with lower odds of full ANC utilisation. Full ANC utilisation was inequitable across area of residence, caste and maternal education. Conclusions: Full ANC utilization in India was inadequate and inequitable. Although half of the women did not receive the minimum recommended ANC visits, the utilisation of TT immunisation was almost universal. The positive association of full ANC with ICDS utilisation and child’s father involvement may be leveraged for increasing the uptake of full ANC. Strategies to address the socio-demographic factors associated with low and inequitable utilisation of full ANC are imperative for strengthening India’s maternal health program. Key words: Antenatal care, India, NFHS-4

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