scholarly journals Women’s retention on the Continuum of Maternal Care Pathway in West Gojjam Zone, Ethiopia: Multilevel Analysis

2020 ◽  
Author(s):  
Amanu Aragaw Emiru ◽  
Getu Degu Alene ◽  
Gurmesa Tura Debelew
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Service Utilization ◽  
Maternal Care ◽  
Health Service Utilization ◽  
Continuum Of Care ◽  
Maternal Health Service ◽  
West Gojjam ◽  
The Continuum

Abstract Background: The continuum of maternal care has been one of the effective approaches for improving the health of mothers and newborns. Although large numbers of Ethiopian women do not use maternal health services, points of drop out along the continuum are not understood well. Understanding of a particular point of maternal care dropout on the continuum, however, helps governments make effective interventions. This study aimed to assess the extent of women’s service utilization and the factors affecting retention on the continuum of care in West Gojjam Zone, Ethiopia. Methods: A community-based study linked to health facility data was conducted in June 2018. Data were obtained from 1281 mothers who gave birth to their last baby within the preceding 12 months from a two-stage cluster sampling. Data were collected via face-to-face interviews using a pretested questionnaire. Multilevel logistic regression models were used to examine the effects of individual and cluster-level factors on key elements of the continuum of care. The measure of fixed effects was expressed as Odds Ratio with 95 % confidence interval. Results: The study revealed that only 12.1% of women completed the continuum of care (ANC4+, SBA, PNC within 48 hours after birth); while 25.1% reported not having care at any stage for their most recent birth. There were commonalities and differences in the predictors of the three indicators of maternal health service utilization. Variables related to services received during antenatal care such as early initiation of ANC (AOR=7.53, 95%CI, 2.94, 19.29) and receiving proper contents (AOR=3.31, 95%CI, 1.08, 10.16) were among the predictors significantly associated with the completion of the continuum of care. Conclusions: The continuum of maternal care completion rate was extremely low, indicating that women were not getting the maximum possible health benefit from existing health services. The results also revealed that maternal health service utilization was influenced by factors operating at various levels-individual, household, community, and health facility. Since antenatal care is considered an entry point for the subsequent use of maternal services, strategies that aimed to improve maternal health service utilization should target early initiation and antenatal care quality

scholarly journals Women’s retention on the Continuum of Maternal Care Pathway in West Gojjam Zone, Ethiopia: Multilevel Analysis

2019 ◽  
Author(s):  
Amanu Aragaw Emiru ◽  
Getu Degu Alene ◽  
Gurmesa Tura Debelew
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Maternal Care ◽  
Health Service Utilization ◽  
Continuum Of Care ◽  
Maternal Health Service ◽  
West Gojjam ◽  
West Gojjam Zone ◽  
The Continuum

Abstract Background The continuum of maternal care has been one of the effective approaches for improving the health of mothers and newborns. Although a large numbers of Ethiopian women do not use maternal health services, points of drop out along the continuum are not understood well. Understanding of a particular point of maternal care dropout on the continuum, however, helps governments make effective interventions. This study aimed to assess the extent of women’s service use and the factors affecting retention on the continuum of care in West Gojjam Zone, Ethiopia. Methods A community based survey linked to health facility data was conducted in June 2018. Data were obtained from 1281 mothers who gave birth to their last baby within the preceding 12-18 months from a two-stage cluster sampling. Data were collected via face-to-face interviews using a pretested questionnaire. Multilevel logistic regression models were used to examine the effects of individual and cluster-level factors on key elements of the continuum of care. The measure of fixed effects was expressed as Odds Ratio with 95% confidence interval.Results The study revealed that only 12.1% of women completed the continuum of care (ANC4+, SBA, PNC within 48 hours after birth); while, 25.1% reported not having care at any stage for their most recent birth. There were commonalities and differences in the predictors of the three indicators of maternal health service utilization. Variables related to services received during antenatal care such as early initiation of ANC (AOR=7.53, 95%CI, 2.94, 19.29) and receiving proper contents (AOR=3.31, 95%CI, 1.08, 10.16) were among the predictors significantly associated with the completion of the continuum of care. Conclusions The continuum of maternal care completion rate was extremely low, indicating that women were not getting the maximum possible health benefit from existing health services. Factors influencing each of the three indicators of maternal care service revealed to operate at various levels - individual, household, community, and facility. Since antenatal care is one of the basic gateways for subsequent use of maternal services, strategies that aimed to improve maternal health service utilization should target early initiation and antenatal care quality.

scholarly journals Women’s retention on the Continuum of Maternal Care Pathway in West Gojjam Zone, Ethiopia: Multilevel Analysis

2019 ◽  
Author(s):  
Amanu Aragaw Emiru ◽  
Getu Degu Alene ◽  
Gurmesa Tura Debelew
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Maternal Care ◽  
Health Service Utilization ◽  
Continuum Of Care ◽  
Maternal Health Service ◽  
West Gojjam ◽  
West Gojjam Zone ◽  
The Continuum

Abstract Background: The continuum of maternal care has been one of the effective approaches for improving the health of mothers and newborns. Although a large numbers of Ethiopian women do not use maternal health services, points of drop out along the continuum are not understood well. Understanding of a particular point of maternal care dropout on the continuum, however, helps governments make effective interventions. This study aimed to assess the extent of women’s service use and the factors affecting retention on the continuum of care in West Gojjam Zone, Ethiopia. Methods: A community based survey linked to health facility data was conducted in June 2018. Data were obtained from 1281 mothers who gave birth to their last baby within the preceding 12 months from a two-stage cluster sampling. Data were collected via face-to-face interviews using a pretested questionnaire. Multilevel logistic regression models were used to examine the effects of individual and cluster-level factors on key elements of the continuum of care. The measure of fixed effects was expressed as Odds Ratio with 95 % confidence interval. Results: The study revealed that only 12.1% of women completed the continuum of care (ANC4+, SBA, PNC within 48 hours after birth); while, 25.1% reported not having care at any stage for their most recent birth. There were commonalities and differences in the predictors of the three indicators of maternal health service utilization. Variables related to services received during antenatal care such as early initiation of ANC (AOR=7.53, 95%CI, 2.94, 19.29) and receiving proper contents (AOR=3.31, 95%CI, 1.08, 10.16) were among the predictors significantly associated with the completion of the continuum of care. Conclusions: The continuum of maternal care completion rate was extremely low, indicating that women were not getting the maximum possible health benefit from existing health services. Factors influencing each of the three indicators of maternal care service revealed to operate at various levels - individual, household, community, and facility. Since antenatal care is one of the basic gateways for subsequent use of maternal services, strategies that aimed to improve maternal health service utilization should target early initiation and antenatal care quality.

WOMEN’S EDUCATION AND UTILIZATION OF MATERNAL HEALTH SERVICES IN AFRICA: A MULTI-COUNTRY AND SOCIOECONOMIC STATUS ANALYSIS

2017 ◽  
Vol 50 (6) ◽  
pp. 725-748 ◽  
Author(s):  
Zacharie Tsala Dimbuene ◽  
Joshua Amo-Adjei ◽  
Dickson Amugsi ◽  
Joyce Mumah ◽  
Chimaraoke O. Izugbara ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Service Utilization ◽  
Women's Education ◽  
Health Service Utilization ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Care Visit ◽  
Socioeconomic Strata

SummaryThere is an abundant literature on the relationship between women’s education and maternal and child outcomes, including antenatal and postnatal care, onset of antenatal care and skilled birth attendance. However, few studies have adopted the ‘equity’ lens, despite increasing evidence that inequities between rich and poor are increasing although maternal and child mortality is declining. This study examined the differential effects of women’s education within different socioeconomic strata in Africa. The most recent Demographic and Health Surveys (DHS) conducted in the Democratic Republic of the Congo, Egypt, Ghana, Nigeria and Zimbabwe were used. In each country, the original sample was stratified into three socioeconomic groups: poor, middle and rich. For each maternal health service utilization variable, the gross and net effects of women’s education, controlling for age, parity, religion, marital status, health insurance, access to health facilities, partner’s education and current place of residence, were estimated using logistic regression, taking into account the complex sampling design of the DHS. The findings revealed country-specific variations in maternal health service utilization, and for most indicators there was a clear gradient among socioeconomic strata: women living in better-off households exhibited greater access to, and utilization of, maternal health services. Multivariate analyses revealed that women’s education had a positive association with type of antenatal care provider, timing and frequency of antenatal care visits, place of delivery and presence of a skilled birth attendant at delivery. Many other factors were found to be significantly associated with maternal health service utilization. For instance, parity had a negative and significant association with timing of first antenatal care visit. Likewise, partner’s education was positively and statistically associated with timing of first antenatal care visit. It is argued that an over-generalization of the association between women’s education and maternal health service utilization can be misleading. Efforts to improve maternal health service utilization in Africa must adopt an ‘equity’ approach, taking into account the specific needs of sub-populations.

scholarly journals Women’s autonomy and maternal health service utilization among the women’s having less than two years age children in Rautahat district, Nepal

2021 ◽  
Vol 7 (9) ◽  
pp. 427
Author(s):  
Sanjaya Kumar Shah ◽  
Neelima Yadav ◽  
Richa Shah ◽  
Ramesh Bhatta ◽  
Rajesh Karki ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Maternal Health Service ◽  
Cross Sectional ◽  
Care Visit

<p class="abstract"><strong>Background:</strong> Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Despite various attempts and schemes made by government. maternal mortality remains as one of the biggest public health challenges in Nepal. The aim of the study was to assess the association of women autonomy with maternal health service utilization among the women having 2 years children in Paroha municipality ward no. 3 and 4, Rautahat, Nepal.</p><p class="abstract"><strong>Methods:</strong> Cross sectional study was conducted. Simple random sampling was used to select respondents. Data were collected through face to face interview. Data were entered in Epi data and analyzed using SPSS. Chi square test was applied to test the significance of association at 95% confidence interval.  </p><p class="abstract"><strong>Results:</strong> Majority (76.8%) of the respondents had antenatal care visit and more than half of them had four or more antenatal care visits. similarly, overwhelming majority (88.4%) of the birth were institutional delivery. Almost (91%) of the women had postnatal care visit for their last child. The study indicates that almost (95.5%) of the decisions were made without the involvement of the women. Most of women had medium level autonomy in all aspect (score= 17-32). Autonomy was positively associated with use of maternal health services i.e.; ANC visit (p=0.000), place of delivery (p=0.036), PNC visit (p=0.045).</p><p class="abstract"><strong>Conclusions:</strong> Findings of the study show that if women autonomy will be higher, there will be increase in maternal service utilization. Whereas autonomy has link with better education and employment opportunity of the women.</p>

scholarly journals Understanding how distance to facility and quality of care affect maternal health service utilization in Kenya and Haiti: A comparative geographic information system study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Xing Gao ◽  
David Wayne Kelley
Keyword(s):  
Quality Of Care ◽  
Maternal Health ◽  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Geographic Information ◽  
Maternal Health Service ◽  
Rural Regions ◽  
Urban Regions

In 2000, the United Nations established eight Millennium Development Goals (MDG) to combat worldwide poverty, disease, and lack of primary education. Goal number five aimed to reduce the maternal mortality ratio by three quarters and provide universal access to reproductive healthcare services by 2015. While there has been some progress, MDG 5 fell far short of target goals, highlighting the necessity of further improvement in global maternal health. Using Geographic Information Systems (GIS), this study aims to understand how distance to facility and quality of care, which are components of access, affect maternal service utilization in two of the world’s poorest countries, Haiti and Kenya. Furthermore, this study examines how this relationship may change or hold between urban and rural regions. Data from the United States Agency for International Development Demographic and Health Survey and Service Provision Assessment were linked spatially in a GIS model, drawing comparisons among distance to facility, quality of care, and maternal health service utilization. Results show that in both rural and urban regions, access to maternal health service and maternal health service utilization share a similar spatial pattern. In urban regions, pockets of maternal health disparities exist despite close distance to facility and standard quality of care. In rural regions, there are areas with long distances to facilities and low quality of care, resulting in poor maternal service usage. This study highlights the usefulness of GIS as a tool to evaluate disparities in maternal healthcare provision and usage.

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