scholarly journals Effects of continuum of care in maternal health services on adverse birth outcome in Northwest Ethiopia: a prospective follow up study

2021 ◽  
Author(s):  
Muluwas Amentie Zelka ◽  
Alemayehu Worku Yalew ◽  
Gurmesa Tura Debelew
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Birth Outcomes ◽  
Perinatal Death ◽  
Birth Outcome ◽  
Maternal Health Services ◽  
Northwest Ethiopia ◽  
Adverse Birth Outcomes ◽  
Follow Up Study

Abstract Background Globally, around 4 million of babies were died within the first month and more than 3 million were stillbirth. Of them, 99% of newborn deaths and 98% of stillbirth occur in developing countries. Despite give a priority for maternal health services, adverse birth outcomes are still major public health problems and big challenge in Ethiopia particularly in study area. Hence, to overcome those challenges, a continuum of care (COC) is core key strategies. Despite that study conduct on effectiveness of COC in maternal health services was scare in developing countries and not done in study area. We aimed to assess effectiveness of continuity of care on reduction of adverse events and determinants of adverse birth outcomes. Methods Community and health facility linked prospective follow-up study design was employed from March 2020 to January 2021 in Northwest Ethiopia. A multistage sampling technique was used to recruit 2,198 pregnant women. Data were collected by using semi-structured and pretested interviewer questionnaire. Collected data were coded, entered, cleaned and analyzed by using STATA 14. Mixed-effect model was used to identify community and individual level factors of adverse birth outcomes. Finally, propensity score matching (PSM) was applied to determine effectiveness of COC in maternal health services. Results Magnitude of adverse birth outcome was 26.8%: stillbirth (2.7%), neonatal mortality rate (3.1%) and neonatal morbidity (6.8%). Risk factors significantly associated were being poor household wealth index (AOR = 3.3), pregnant related complication during pregnancy (AOR = 3.29), labour and childbirth (AOR = 6.08), immediately after childbirth (AOR = 5.24), offensive odder amniotic fluid (AOR = 3.04) and history of stillbirth (AOR = 4.2). Whereas, women receive IFA during pregnancy (AOR = 0.44), initiate BF within 1hour (AOR = 0.22) and immunizing newborn within postnatal period (AOR = 0.33) were protective factors. As treatment effect, completion of COC in MHS via time dimension (β = -0.03), completion of key services of MHS (β = -0.04) and completion of COC in MHS via space dimension (β = -0.02) were associated with a significant reduction in the likelihood of perinatal death Conclusions The results suggested that neonatal and perinatal mortality rate were high as compared with national and international target. Completion of COC in MHS is an effective strategy in reduction perinatal death. Efforts should be made to strengthening COC of MHS and also encourage IFA supplementation, immunizing and early initiation of BF for newborn were strongly recommended.

scholarly journals Determinants of adverse birth outcome in Tigrai region, North Ethiopia: Hospital-based case-control study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Helen Tsehaye Hailemichael ◽  
Gurmesa Tura Debelew ◽  
Haileselasie Berhane Alema ◽  
Meresa Gebremedhin Weldu ◽  
Kebede Haile Misgina
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Birth Outcomes ◽  
Birth Outcome ◽  
Public Hospitals ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Dietary Counseling ◽  
Planning Methods

Abstract Background Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia. Methods Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05. Result The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15–13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92–36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35–17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89–13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83–14.01] were significantly associated with adverse birth outcomes. Conclusion and recommendation The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes.

scholarly journals Adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia: Systematic review and meta-analysis

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241811
Author(s):  
Demeke Mesfin Belay ◽  
Wubet Alebachew Bayih ◽  
Abebaw Yeshambel Alemu ◽  
Aklilu Endalamaw Sinshaw ◽  
Demewoz Kefale Mekonen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Birth Outcomes ◽  
Associated Factors ◽  
Birth Outcome ◽  
Meta Analysis ◽  
Adverse Birth Outcome ◽  
Adverse Birth Outcomes ◽  
Pooled Prevalence ◽  
History Of

Background The magnitude of adverse birth outcome among diabetic pregnant women is high in low-and-middle income countries, like Ethiopia. Precise epidemiological evidence is necessary to plan, evaluate and improve effective preventive measures. This systematic review and meta-analysis is the first to estimate the pooled prevalence of adverse birth outcome and associated factors among diabetic pregnant women in Ethiopia. Methods PubMed, Cochrane Library, Google Scholar, SCOPUS, Web of Science and PsycINFO, and article found in University online repository were accessed. Observational studies such as cross-sectional, case-control and prospective cohort reported using English language was involved. I2 statistic was used to check heterogeneity. Egger’s test and funnel plot were used to measure publication bias. Weighted inverse variance random effects model was also performed. Results Seven studies with 1,225 study participants were retrieved to estimate the pooled prevalence of adverse birth outcome and associated factors. The pooled prevalence of adverse birth outcome among diabetic pregnant women was 5.3% [95% CI; 1.61, 17.41]. Fasting blood glucose level above 100 mg/dl [Adjusted Odds ratio (AOR) = 10.51; 95% Confidence Interval (CI) = 5.90, 15.12], two hour post prandial glucose level above 120 mg/dl [AOR = 8.77; 95% CI = 4.51, 13.03], gestational age <37 completed week [AOR = 9.76; 95% CI = 5.29, 14.23], no ANC follow-up [AOR = 10.78; 95% CI = 6.12, 15.44], history of previous adverse outcomes [AOR = 3.47; 95% CI = 1.04, 5.90], maternal age < 30 years [AOR = 3.47; 95% CI = 1.04, 5.90], and illiteracy [AOR = 2.89; 95% CI = 0.81,4.97)] were associated factors of adverse birth outcome. Conclusions The pooled prevalence of adverse birth outcomes among diabetic pregnant women in Ethiopia was high. Child born from mothers who were illiterate, maternal age < 30 years, gestational age < 37 completed weeks, history of previous adverse birth outcomes and no ANC follow-up increased the risk of adverse birth outcome. Trial registration It is registered in PROSPERO data base: (PROSPERO 2020: CRD42020167734).

scholarly journals Improving maternal health services through social accountability interventions in Nepal: an analytical review of existing literature

2020 ◽  
Vol 41 (1) ◽  
Author(s):  
Adweeti Nepal ◽  
Santa Kumar Dangol ◽  
Anke van der Kwaak
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Maternal Health Services ◽  
Policy Formulation ◽  
Social Accountability ◽  
The Social ◽  
The Government ◽  
The Impact

Abstract Background The persistent quality gap in maternal health services in Nepal has resulted in poor maternal health outcomes. Accordingly, the Government of Nepal (GoN) has placed emphasis on responsive and accountable maternal health services and initiated social accountability interventions as a strategical approach simultaneously. This review critically explores the social accountability interventions in maternal health services in Nepal and its outcomes by analyzing existing evidence to contribute to the informed policy formulation process. Methods A literature review and desk study undertaken between December 2018 and May 2019. An adapted framework of social accountability by Lodenstein et al. was used for critical analysis of the existing literature between January 2000 and May 2019 from Nepal and other low-and-middle-income countries (LMICs) that have similar operational context to Nepal. The literature was searched and extracted from database such as PubMed and ScienceDirect, and web search engines such as Google Scholar using defined keywords. Results The study found various social accountability interventions that have been initiated by GoN and external development partners in maternal health services in Nepal. Evidence from Nepal and other LMICs showed that the social accountability interventions improved the quality of maternal health services by improving health system responsiveness, enhancing community ownership, addressing inequalities and enabling the community to influence the policy decision-making process. Strong gender norms, caste-hierarchy system, socio-political and economic context and weak enforceability mechanism in the health system are found to be the major contextual factors influencing community engagement in social accountability interventions in Nepal. Conclusions Social accountability interventions have potential to improve the quality of maternal health services in Nepal. The critical factor for successful outcomes in maternal health services is quality implementation of interventions. Similarly, continuous effort is needed from policymakers to strengthen monitoring and regulatory mechanism of the health system and decentralization process, to improve access to the information and to establish proper complaints and feedback system from the community to ensure the effectiveness and sustainability of the interventions. Furthermore, more study needs to be conducted to evaluate the impact of the existing social accountability interventions in improving maternal health services in Nepal.

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