scholarly journals Factors Associated With Inadequate Receipt of Components and Non-use of Antenatal Care Services in India: A Regional Analysis

2022 ◽  
Author(s):  
Nilu Nagdev ◽  
Felix Akpojene Ogbo ◽  
Mansi Dhami ◽  
Thierno Diallo ◽  
David Lim ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Multinomial Logistic Regression ◽  
Regional Analysis ◽  
Significant Risk ◽  
Family Health ◽  
Reproductive Age ◽  
Indian Government ◽  
Factors Associated ◽  
North East ◽  
At Home

Abstract BackgroundFailure to use antenatal care (ANC) and inadequate receipt of components of ANC pose a significant risk for both the pregnant woman and baby. This study aimed to examine a regional analysis of factors associated with no or inadequate receipt of components of ANC services among Indian women.MethodInformation on 184,628 women of reproductive age 15-49 years from the 2015-16 India National Family Health Survey (NFSH-4) was used. Survey multinomial logistic regression analyses that adjust for cluster and survey weights were conducted to assess the socio-demographic and other factors associated with no or receipt of inadequate receipt of components of ANC in the six regions in India.ResultsAcross regions in India, 18% of women reported no ANC, and the prevalence of inadequate and adequate receipt of components of ANC in all six regions ranged from 16% to 43% and 34% to 81%, respectively. Our analyses revealed that in all six regions, poor households reported increased odds of receiving no or inadequate receipts of components of ANC. In all six regions, inadequate receipts of components of ANC was significantly higher among women who had limited knowledge about pregnancy complications and post-delivery complications. In all the six regions except the East region, women who delivered their babies at home reported higher odds of receiving no or inadequate receipts of components of ANC and women who had no postnatal checkup after delivery reported higher odds of receiving no or inadequate receipts of components of ANC in all regions except South, West and North East regions. Low levels of women's education and women who delivered their babies at home were associated with increased odds of receiving no or inadequate receipts of components of ANC in all six regions except North and East regions.ConclusionA better understanding of the factors associated and incorporating them into the short- and long-term intervention strategies, including free financial support from the Indian government to encourage pregnant women from lower socioeconomic groups to use health services across all regions.

scholarly journals Country compliance with WHO-recommended antenatal care guidelines: equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

2020 ◽  
Vol 5 (12) ◽  
pp. e002169
Author(s):  
Ngatho Samuel Mugo ◽  
Kyaw Swa Mya ◽  
Camille Raynes-Greenow
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Adolescent Mothers ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Multinomial Logistic Regression ◽  
Wealth Quintile ◽  
Adjusted Risk ◽  
Factors Associated

IntroductionEarly access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar.MethodsWe examined data from 2943 mothers aged 15–49 years whose most recent birth occurred in the last 5 years prior to the 2015–2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC.ResultsApproximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30–39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84).ConclusionThe 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas.

scholarly journals Factors associated with small- and large-for-gestational-age in socioeconomically vulnerable individuals in the 100 Million Brazilian Cohort

2021 ◽  
Author(s):  
Ila R Falcão ◽  
Rita de Cássia Ribeiro-Silva ◽  
Marcia Furquim de Almeida ◽  
Rosemeire L Fiaccone ◽  
Natanael J Silva ◽  
...  
Keyword(s):  
Gestational Age ◽  
Multinomial Logistic Regression ◽  
Mixed Race ◽  
Sociodemographic Factors ◽  
Reproductive Age ◽  
Large For Gestational Age ◽  
Maternal Characteristics ◽  
Factors Associated ◽  
Study Population ◽  
Brazilian Populations

ABSTRACT Background Evidence points to diverse risk factors associated with small- (SGA) and large-for-gestational-age (LGA) births. A more comprehensive understanding of these factors is imperative, especially in vulnerable populations. Objectives To estimate the occurrence of and sociodemographic factors associated with SGA and LGA births in poor and extremely poor populations of Brazil. Methods The study population consisted of women of reproductive age (14–49 y), whose last child was born between 2012 and 2015. INTERGROWTH 21st consortium criteria were used to classify weight for gestational age according to sex. Multinomial logistic regression modeling was performed to investigate associations of interest. Results Of 5,521,517 live births analyzed, SGA and LGA corresponded to 7.8% and 17.1%, respectively. Multivariate analysis revealed greater odds of SGA in children born to women who self-reported as black (OR: 1.21; 95% CI: 1.19, 1.22), mixed-race (parda) (OR: 1.08; 95% CI: 1.07, 1.09), or indigenous (OR: 1.11; 95% CI: 1.06, 1.15), were unmarried (OR: 1.08; 95% CI: 1.07, 1.08), illiterate (OR: 1.47; 95% CI: 1.42, 1.52), did not receive prenatal care (OR: 1.57; 95% CI: 1.53, 1.60), or were aged 14–20 y (OR: 1.21; 95% CI: 1.20, 1.22) or 35–49 y (OR: 1.12; 95% CI: 1.10, 1.13). Considering LGA children, higher odds were found in infants born to women living in households with ≥3 inadequate housing conditions (OR: 1.11; 95% CI: 1.10, 1.12), in indigenous women (OR: 1.22; 95% CI: 1.19, 1.25), those who had 1–3 y of schooling (OR: 1.18; 95% CI: 1.17, 1.19), 1–3 prenatal visits (OR: 1.16; CI 95%: 1.14, 1.17), or were older (OR: 1.26; 95% CI: 1.25, 1.27). Conclusions In poorer Brazilian populations, socioeconomic, racial, and maternal characteristics are consistently associated with the occurrence of SGA births, but remain less clearly linked to the occurrence of LGA births.

scholarly journals Exploring Attitudes About the Legality of Self-Managed Abortion in the US: Results from a Nationally Representative Survey

2021 ◽  
Author(s):  
Sarah Raifman ◽  
M. Antonia Biggs ◽  
Lauren Ralph ◽  
Katherine Ehrenreich ◽  
Daniel Grossman
Keyword(s):  
Multinomial Logistic Regression ◽  
Public Attitudes ◽  
The United States ◽  
Public Affairs ◽  
Policy Implications ◽  
Reproductive Age ◽  
Factors Associated ◽  
The Us ◽  
The Law ◽  
Nationally Representative

Abstract Introduction Twenty-four states have at least one law in place that could be used to prosecute people for self-managed abortion (SMA), or the termination of a pregnancy outside of the formal healthcare system. We investigated factors associated with public attitudes about SMA legality and legal access to abortion more generally. Methods In August 2017, we surveyed a nationally representative sample of English- and Spanish-speaking women ages 18–49 years in the United States (US) using Ipsos Public Affairs’ KnowledgePanel. Unadjusted and adjusted multinomial logistic regression estimates identify characteristics associated with believing that SMA should not be against the law, compared to should be against the law, with weighting to account for sampling into the panel. Results Overall, 76% (95% CI: 74.3%-77.1%) and 59% (95% CI: 57.3%-60.4%) of participants (n = 7,022, completion rate 50%) reported that abortion and SMA, respectively, should not be against the law; 1% and 19% were unsure. Among those living in a state with at least one law that could be used to prosecute an individual for SMA, the majority (55%, 95% CI: 52.7%-57.9%) believed SMA should not be against the law. Factors associated with believing SMA should not be against the law, compared to should be against the law, included prior abortion experience and higher levels of education and income. Conclusion Most reproductive age women in the US believe that SMA should not be criminalized. There is more uncertainty about SMA legality than about the legality of abortion more generally. Policy Implications US laws that criminalize SMA are not supported by the majority of the people living in their jurisdictions.

scholarly journals Factors associated with the compliance of recommended first postnatal care services utilization among reproductive age women in Benin Republic: an analysis of 2011/2012 BDHS data

2017 ◽  
Vol 6 (4) ◽  
pp. 1161 ◽  
Author(s):  
Justin Dansou ◽  
Adeyemi O. Adekunle ◽  
Ayodele O. Arowojolu
Keyword(s):  
Postnatal Care ◽  
Multinomial Logistic Regression ◽  
Household Wealth ◽  
Reproductive Age ◽  
Special Focus ◽  
Wealth Status ◽  
Services Utilization ◽  
Factors Associated ◽  
To Receive ◽  
Benin Republic

Background: High maternal and neonatal mortality persist in Benin republic. Rates of decline are slow and factors influencing PNC services utilization are not well known. This study aims to assess factors associated with PNC services utilization among mothers and their newborns with special focus on the recommendation 2 of WHO guidelines on postnatal care of the mother and the newborn.Methods: This study analysed Benin’s 2011/2012 DHS data. A total of 16,599 women were interviewed where 8,275 eligible for the present study. Multinomial logistic regression was applied.Results: While 68.42% of mothers and their newborns received at least one PNC visit over postnatal period, the percent of newborns and their mothers with appropriate first PNC check-up was low, 19.95%. Factors explaining PNC uptake were place of residence, ethnic group, occupation, ANC attendance, place of delivery, baby birth size, household wealth status, mass media use, and to a lesser extent education attainment. Accessibility, number of living children followed by the birth order number, and desire for pregnancy appeared to be specific determinants to appropriate first PNC check-up. Mothers who attended more frequently ANC services were more likely to receive PNC check-ups. Mothers who delivered at private health facility were more likely to receive PNC check-ups.Conclusions: To increase the achievement of the recommended WHO PNC frequency, there is a need to: address unmet needs for Family Planning in Benin; to expend health education and counselling to encourage ANC attendance supervise by skilled personnel.

scholarly journals What influences home delivery among women who live in urban areas? Analysis of 2014 Ghana Demographic and Health Survey data

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244811
Author(s):  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
Ebenezer Agbaglo ◽  
Francis Appiah ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Survey ◽  
Rural Areas ◽  
Urban Areas ◽  
Wealth Quintile ◽  
Home Delivery ◽  
Northern Region ◽  
Demographic And Health Survey ◽  
Factors Associated ◽  
At Home

Background In Ghana, home delivery among women in urban areas is relatively low compared to rural areas. However, the few women who deliver at home in urban areas still face enormous risk of infections and death, just like those in rural areas. The present study investigated the factors associated with home delivery among women who live in urban areas in Ghana. Materials and methods Data for this study was obtained from the 2014 Ghana Demographic and Health Survey. We used data of 1,441 women who gave birth in the 5 years preceding the survey and were dwelling in urban areas. By the use of Stata version 14.2, we conducted both descriptive and multivariable logistic regression analyses. Results We found that 7.9% of women in urban areas in Ghana delivered at home. The study revealed that, compared to women who lived in the Northern region, women who lived in the Brong Ahafo region [AOR = 0.38, CI = 0.17–0.84] were less likely to deliver at home. The likelihood of home delivery was high among women in the poorest wealth quintile [AOR = 2.02, CI = 1.06–3.86], women who professed other religions [AOR = 3.45; CI = 1.53–7.81], and those who had no antenatal care visits [AOR = 7.17; 1.64–31.3]. Conversely, the likelihood of home delivery was lower among women who had attained secondary/higher education [AOR = 0.30; 0.17–0.53], compared to those with no formal education. Conclusion The study identified region of residence, wealth quintile, religion, antenatal care visits, and level of education as factors associated with home delivery among urban residents in Ghana. Therefore, health promotion programs targeted at home delivery need to focus on these factors. We also recommend that a qualitative study should be conducted to investigate the factors responsible for the differences in home delivery in terms of region, as the present study could not do so.

scholarly journals Birth preparedness and complication readiness among women of reproductive age in Kenya and Tanzania: a community-based cross-sectional survey

2020 ◽  
Author(s):  
James Orwa ◽  
Samwel Maina Gatimu ◽  
Michaela Mantel ◽  
Stanley Luchters ◽  
Micheal A. Mugerwa ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Reproductive Age ◽  
Birth Preparedness ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Complication Readiness ◽  
Level Of Education ◽  
Factors Associated ◽  
Danger Signs

Abstract Background: Delayed health-seeking continues to contribute to preventable maternal and neonatal deaths in low resource countries. Some of the strategies to avoid the delay include early preparation for the birth and detection of danger signs. We aimed to assess the level of practice and factors associated with birth preparedness and complication readiness (BPCR) in Kenya and Tanzania.Methods: We conducted community-based multi-stage cross-sectional surveys in Kilifi and Kisii counties in Kenya and Mwanza region in Tanzania and included women who delivered two years preceding the survey (2016–2017). A woman who mentioned at least three out of five BPCR components was considered well-prepared. Bivariate and multivariable proportional odds model were used to determine the factors associated with the BPCR. The STROBE guidelines for cross-sectional studies informed the design and reporting of this study.Results: Only 11.4% (59/519) and 7.6% (31/409) of women were well-prepared for birth and its complications in Kenya and Tanzania, respectively, while 39.7% and 30.6% were unprepared, respectively. Level of education (primary: adjusted odds ratio (aOR): 1.59, 95% CI: 1.14–2.20, secondary: aOR: 2.24, 95% CI: 1.39–3.59), delivery within health facility (aOR: 1.63, 95% CI: 1.15–2.29), good knowledge of danger signs during pregnancy (aOR: 1.28, 95% CI: 0.80–2.04), labour and childbirth (aOR: 1.57, 95% CI: 0.93–2.67), postpartum (aOR: 2.69, 95% CI: 1.24–5.79), and antenatal care were associated with BPCR (aOR: 1.42, 95% CI: 1.13–1.78).Conclusion: Overall, most pregnant women were not prepared for birth and its complications in Kilifi, Kisii and Mwanza region. Improving level of education, creating awareness on danger signs during preconception, pregnancy, childbirth, and postpartum period, and encouraging antenatal care and skilled birth care among women and their male partners/families are recommended strategies to promote BPCR practices and contribute to improved pregnancy outcomes in women and newborns.

scholarly journals Tetanus Toxoid Immunization Status and Associated Factors among Mothers in Hawzen, Eastern Zone of Tigray, Ethiopia, 2019

2020 ◽  
Vol 13 (1) ◽  
pp. 281-288
Author(s):  
Meresa Berwo Mengesha ◽  
Desta Abraha Weldegeorges ◽  
Natnael Etsay Assefa ◽  
Senait Gebreslasie Gebremeskel ◽  
Hagos Degefa Hidru ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Tetanus Toxoid ◽  
Immunization Coverage ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Factors Associated ◽  
Immunization Status ◽  
Eastern Zone ◽  
Future Fertility ◽  
Tetanus Toxoid Immunization

Background: Neonatal tetanus remains a significant avertable cause of morbidity and mortality in neonates. Adequate vaccination strategies, including at least two doses of tetanus toxoid for reproductive age women, can decrease neonatal mortality. In Ethiopia, a few numbers of neonates were protected at birth through this proactive intervention. Therefore, this study aimed to determine factors associated with the low coverage of tetanus toxoid immunization. Objective: This study aimed to determine the status of Tetanus Toxoid immunization coverage and factors associated with it. Methods: Community-based cross-sectional study design was implemented among 515 mothers in Hawzen, Eastern zone of Tigray. The data were entered into Epi data manager version 3.5.1 and exported to Statistical Package for Social Science version 20 software for analysis. Bivariate and multivariate logistic regression was used to identify factors significantly associated with tetanus toxoid immunization coverage. Results: Two hundred and seven (40.2%) mothers were protected against tetanus at last birth. Mothers whose age was less than 20 years [AOR 0.19(0.10, 0.32), had no future plan for fertility [AOR 0.30(0.17, 0.53)], mothers attended once for antenatal care visits [AOR 0.38(0.18, 0.82)] and who got information from media [AOR 4.49(1.82, 11.07] were independent predictors of tetanus toxoid immunization status of mothers. Conclusion: More than half of the mothers were not protected against tetanus at the time of last birth. This study found the age of mothers, future fertility plans, numbers of antenatal care visits and mothers who got information from media; these were significant factors associated with the likelihood of tetanus toxoid immunization of mothers.

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

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

scholarly journals Risk Factors Associated with Under-Five Stunting, Wasting, and Underweight Based on Ethiopian Demographic Health Survey Datasets in Tigray Region, Ethiopia

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Berhanu Teshome Woldeamanuel ◽  
Tigist Tigabie Tesfaye
Keyword(s):  
Risk Factors ◽  
Drinking Water ◽  
Antenatal Care ◽  
Significant Risk ◽  
Wealth Index ◽  
Household Wealth ◽  
Binary Logistic Regression Analysis ◽  
Under Five ◽  
Factors Associated ◽  
Tigray Region

Background. Stunting, wasting, and underweight among children are major problems in most regions of Ethiopia, including the Tigray region. The main objective of this study was to assess the risk factors associated with stunting, wasting, and underweight of children in the Tigray region. Methods. The information collected from 1077 children born 5 years before the survey was considered in the analysis. Multivariable binary logistic regression analysis was fitted to identify significant risk factors associated with stunting, wasting, and underweight. Results. Male children and rural born were having a higher burden of both severe and moderate stunting, wasting, and underweight than females and urban born. Among male children, 27.6%, 4.10%, and 14.2% of them were stunted, wasted, and underweight, respectively. Protected drinking water (odds ratio (OR) = 0.68; 95% confidence interval (CI): (0.50, 0.92)) was associated with stunting. Maternal age at birth less than 20 years (OR = 0.66; 95% CI: (0.45, 0.97)) and being male (OR = 2.04; 95% CI: (1.13, 3.68)) were associated with high risk of underweight. No antenatal care follow-up (OR = 2.20; 95% CI: (1.04, 4.64)) was associated with wasting, while the poor wealth index, diarrhea, low weight at birth (<2.5 kg), lower age of a child, and 3 or more under-five children in a household were significantly associated with stunting, wasting, and underweight. Conclusions. Being born in rural, being male, unprotected drinking water, smaller weight at birth, no antenatal follow-ups, diarrhea, and poor household wealth were factors associated with increased stunting, wasting, and underweight. Thus, interventions that focus on utilization of antenatal care services, improving household wealth, and improving access to protected drinking water were required by policymakers to decrease stunting, wasting, and underweight more rapidly.

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