scholarly journals Association of Antenatal Care Visit with Utilization of Institutional Delivery Care Services in Afghanistan: Intersections Between Education, Wealth, and Household Decision-Making Autonomy

2021 ◽  
Author(s):  
Mostafizur Rahman ◽  
Priom Saha ◽  
Jalal Uddin
Keyword(s):  
Decision Making ◽  
Social Status ◽  
Institutional Delivery ◽  
Skilled Birth Attendant ◽  
Safe Motherhood ◽  
Care Utilization ◽  
Delivery Care ◽  
Household Decision ◽  
Care Services ◽  
Statistical Interactions

Abstract Background: The importance of antenatal visits in safe motherhood and childbirth is well documented. However, less is known how social determinants of health interact with antenatal care (ANC) visits in shaping the uptake of professional delivery care services in low-income countries. This study examines the association of ANC visits with institutional delivery care utilization outcomes in Afghanistan. Further, we assess the extent to which ANC visits intersect with education, wealth, and household decision-making autonomy in predicting two outcomes of delivery care utilization- delivery at a health facility and delivery assisted by a skilled birth attendant.Methods: We used data from the Afghanistan Demographic and Health Survey (AfDHS) 2015. The analytic sample included 15,581 women of reproductive age (15-49). We assessed the associations using logistic regression models, estimated the predicted probability of delivery care outcomes using statistical interactions, and presented estimates in margins plot. Results: Regression analyses adjusted for socioeconomic and demographic covariates suggest that women who had 4 or more ANC visits were 5.7 times (95% CI= 4.78, 7.11, P<0.001) more likely to use delivery care at a health facility and 6.5 times (95% CI= 5.23, 8.03; P<0.001) more likely to have a delivery assisted by a skilled birth attendant compared to women who had no ANC visit. Estimates from models with statistical interactions between ANC, education, wealth, and decision-making autonomy suggest that women with higher social status were more advantageous in utilizing institutional delivery care services compared to women with lower levels of social status. Conclusion: Our findings suggest that the association of ANC visit with institutional delivery care services is stronger among women with higher social status. The results have implications for promoting safe motherhood and childbirth through improving women’s social status.

scholarly journals Safe Delivery Care: Policy, Practice and Gaps in Nepal

2013 ◽  
Vol 52 (192) ◽  
Author(s):  
Tulsi Ram Bhandari ◽  
Ganesh Dangal
Keyword(s):  
Maternal Mortality ◽  
Institutional Delivery ◽  
Maternal Mortality Ratio ◽  
Skilled Birth Attendant ◽  
Safe Motherhood ◽  
Delivery Care ◽  
Care Policy ◽  
Safe Delivery ◽  
Policy Practice ◽  
Mortality Ratio

Delivery care is regarded as safe when it is attended by a skilled birth attendant either at health facility or home. Childbirth practices differ from place to place and are determined by availability and accessibility of health services. After National Health Policy (1991), Nepal has focused on safe motherhood policies and programmes. Maternal mortality ratio decreased nearly fourfold between the years 1990 to 2011. The country is likely to achieve the Millennium Development Goal (MDG) 5. However, indicators of the MDG 5: skilled care at birth and institutional delivery rates are very far from the targets. From the initial findings of limited studies, safe delivery incentive programme has been successful for increasing the skilled care at birth and institutional delivery and reducing the maternal mortality twofold between the years 1990 to 2011. In spite of numerous efforts there is a wide difference in the utilization of skilled care at birth among the women by area of residence, ecological regions, wealth quintiles, education status, age and parity of women, caste ethnicity and so forth. This difference indicates that current policies and programmes are not enough for addressing the low utilization of safe delivery care throughout the country.  Keywords: delivery practices; gaps; Nepal; place of delivery; safe delivery care policy.    

scholarly journals Maternity Care Services Utilization and Factors Associated with Institutional Delivery Among Postpartum Women in Dabat Demographic and Health Survey Site, Northwest Ethiopia: A Community Based Baseline Survey for MNCH Surveillance

2021 ◽  
Author(s):  
Abebaw Addis Gelagay ◽  
Abebaw Gebeyehu Worku ◽  
Debrework Tesgera Bashah ◽  
Nigusie Birhan Tebeje ◽  
Mignote Hailu Gebrie ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Postnatal Care ◽  
Institutional Delivery ◽  
Care Utilization ◽  
Postpartum Women ◽  
Community Based ◽  
Services Utilization ◽  
Care Services ◽  
Care Visit ◽  
Antenatal Care Utilization

Abstract Background Maternal continuum of care is identified to have a greatest impact on maternal and child survival. However, there is a wide variation in maternal health services utilization from place to place in Ethiopia. Therefore, knowing antenatal care, labor and delivery, and postnatal care uptake has paramount importance to take interventions. Methods A community-based cross-sectional survey was conducted among 1626 postpartum women. Descriptive statistics were done to characterize the study population and utilization of antenatal care, institutional delivery, and postnatal care services. Logistic regression analysis was employed to identify factors associated with institutional delivery. Results Nearly eighty percent, (79.7%, 95% CI: 77.7, 81.6), of women attended at least one antenatal care visit at any health facility. However, only less than one third (31.4%) used all the recommended antenatal care (ANC). About half, 820 (49.2%: 95% CI: 46.7, 51.8) women delivered their child in health institution. About half, 822 (50.6%, 95% CI: 48.2, 52.9) of postpartum women who participated in this study had at least one postnatal care (PNC) visit at health facilities. Being urban resident (AOR=8.18, 95%CI: 4.69, 14.26)), respondents of higher educational status (AOR= 4.99, 95%CI: 2.51, 9.90), being Orthodox Christian (AOR= 2.35, 95%CI: 1.15, 4.79), getting TT vaccination during pregnancy (AOR=1.54, 95%CI: 1.06, 2.23), and antenatal care utilization (AOR=2.97, 95%CI: 2.06, 4.27) were predictors for health facility/institutional delivery. Conclusions Though a significant proportion of the study participants initiated antenatal care, utilization of all the recommended antenatal care visits, facility delivery, and postnatal care services were low. Health professionals need to use the first antenatal care visit as a golden opportunity to attract and maintain pregnant women for the subsequent maternal health care services.

scholarly journals Practices and Women’s Perceptions of Childbirth in Western Nepal: A Qualitative Study

2020 ◽  
Vol 18 (1) ◽  
pp. 64-69
Author(s):  
Tulsi Ram Bhandari ◽  
Shreejana Wagle ◽  
Ganesh Dangal
Keyword(s):  
Institutional Delivery ◽  
Health Workers ◽  
Cultural Beliefs ◽  
Home Delivery ◽  
Labor Pain ◽  
Delivery Care ◽  
Local Health ◽  
Care Services ◽  
Study Results ◽  
Women’S Perceptions

Background: Despite continuous efforts to increase the utilization of institutional delivery care services nearly two-fifths women deliver their babies at home without the assistance of skilled birth attendants (SBA) in Nepal. The skilled care at birth can reduce the high maternal and neonatal mortality. This study explored childbirth practices and women’s perceptions of childbirth and its associated factors.Methods: An exploratory study was conducted in three purposively selected remote villages of Kapilvastu district, from March to May 2017. Face-to-face in-depth interviews were conducted with women who had an under-one year child. We performed a thematic analysis to draw the findings of the study. Results: Women sought institutional delivery care either for long labor-pain or obstructed-delivery. Despite various incentives, people still preferred home for normal deliveries. There was also practiced skilled birth attendant (SBA) assisted home delivery care. Some of the local health workers also advised pregnant-women for assisted home delivery care. People considered childbirth as a normal process. Due to cultural beliefs and norms, people were also reluctant to pursue institutional delivery care services. Financial constraints, poor access to services and expensive transportation services were other underlining causes of home delivery practices. Conclusions: Despite various incentives for institutional delivery care; the study did not spectacle an encouraging reaction. It pointed to the very basic and strong relationship between women’s position in the household and the society and education with childbirth practices. There were limits to how far financial incentives can overcome these obstacles. So, the improvement of the socio-economic conditions of the women would be the viable way-out of the problem.Keywords: Childbirth practices; home delivery; institutional delivery; women’s perception

scholarly journals ANTENATAL HEALTH CARE;

2017 ◽  
Vol 24 (04) ◽  
pp. 495-499
Author(s):  
Muhammad Asim ◽  
Saira Siddiqui ◽  
Nazia Malik ◽  
Waseem Nawaz ◽  
Farman Ali
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Health Care Services ◽  
Relevant Literature ◽  
Health Care Facilities ◽  
Easy Access ◽  
Care Utilization ◽  
Household Decision ◽  
Care Services ◽  
Maternal Morbidity And Mortality

Background: Prenatal and postnatal health care utilization services areimperative strategy to decrease maternal morbidity and mortality. One in 38 Pakistani womendies from pregnancy related causes as compared to 1 in 230 women in Sri Lanka. Objectives:The objective of the present study is to know about the pattern and trends of utilization ofantenatal and postnatal health care services by mothers in Pakistan. Study design: Descriptivesystematic literature review. Material and methods: The relevant literature was systematicallysearched through different key words related to antenatal and postnatal health care utilizationservices in Pakistan through different online research engines to accomplish this study.Results: Twenty five research articles were included in this review article. It was found thatlast two decades, we cannot achieve the optimum progress towards antenatal and postnatalhealth care utilization services. The problem is much severe in rural areas of across the country,where a number of socio-cultural and program factors hinders women to utilize the basic healthservices. Mother’s education, household income, autonomous at household decision makingand birth order are the significant factors that to utilize the antenatal and postnatal care inPakistan. Conclusion: There should be need to aware the mother about the importance ofprenatal and postnatal visits. In rural areas, government should give some economic incentivefor prenatal and postnatal visits. Furthermore, government should take necessary steps totackle the problem by providing the easy access to the health care facilities.

scholarly journals Effect of Women’s Role on Household Decision Making on Institutional Delivery of the recent Child in Nepal

2015 ◽  
Vol 26 ◽  
pp. 51-61
Author(s):  
Ramesh Adhikari
Keyword(s):  
Decision Making ◽  
Institutional Delivery ◽  
Comparison Group ◽  
Multivariate Logistic Regression Analysis ◽  
Well Being ◽  
Maternal Health Services ◽  
Household Decision ◽  
Household Decision Making ◽  
The Family ◽  
Women's Role

Nepalese women are behind than men in many areas, such as educational attainment, participation in decision-making and health service utilization, all of which have an impact on reproductive health outcomes. This paper explores effect of women's role on household decision making on institutional delivery of the child in Nepal Data as drawn from the Nepal Demographic and Health Survey, 2011. The analysis is confined to women who had given birth in the five years preceding the survey (n=4,148). The net effect of women’s role on household decision making on institutional delivery after controlling for the effect of other predictors has been measured through multivariate logistic regression analysis. The findings indicate that institutional delivery was still very low in Nepal. Only two in five of the women (40%) had delivered their last child with health facilities. Notably, higher level of women’s role on household decision was associated with higher level of institutional delivery [adjusted odds ratio (aOR=1.20)] than their comparison group. It can be concluded that programs should aim to increase use of maternal health services by improving women’s role on household decision making so that the overall well-being of the family can be maintained and enhanced.

scholarly journals Female Community Health Volunteers’ (FCHVs) Involvement in Improving Maternal Health, Nepal

2019 ◽  
Vol 2 (3) ◽  
pp. 250-252 ◽  
Author(s):  
Prakash Shahi
Keyword(s):  
Maternal Health ◽  
National Policy ◽  
Family Health ◽  
Emergency Obstetric Care ◽  
Skilled Birth Attendant ◽  
Neonatal Morbidity ◽  
Obstetric Care ◽  
Safe Motherhood ◽  
Care Services ◽  
Policies And Programs

Improving maternal health was one of the eight millennium development goals (MDGs) in 2000 and later included in SDG as a major agenda in 2015 which was adopted by the international community.  In Nepal, the first elected democratic government developed Health Policy in 1991 and revised in 2014 which has identified safe motherhood as a priority program and institutionalized safe motherhood as a primary health care. In order to effectively address maternal and neonatal morbidity and mortality, the Family Health Division, Department of Health Services (DoHS) developed National Safe Motherhood Long Term Plan 2002- 2017 (revised in 2006) which aimed to establish basic and comprehensive emergency obstetric care services in all districts. To complement this plan, the National Policy on SBA (2006) was developed with the aim of increasing the percentage of births assisted by a skilled birth attendant (as internationally defined) to 60 percent by 2015. Table 1 explains some historical shifts in maternal health policies and programs in Nepal.

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