scholarly journals Inequality in institutional delivery of the recent birth among married women in Nepal: a trend analysis

2020 ◽  
Author(s):  
Ramesh Adhikari ◽  
Aakriti Wagle
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Rural Women ◽  
Institutional Delivery ◽  
Maternal Mortality Ratio ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Demographic And Health Surveys ◽  
Chi Square ◽  
Safe Delivery

Abstract Background The huge discrepancy in health statistics between developed and developing countries occur in the area of maternal mortality, with developing countries contributing most of the figures. Nepal has higher maternal mortality ratio than its South Asian neighbors. This study assesses the trend of institutional delivery of recent birth and compared the inequalities with associated factors that affect institutional delivery in Nepal.Methods The data for this study was obtained from three sequential Nepal Demographic and Health Surveys [NDHS] of 2006, 2011, and 2016. The information was collected from mothers having a child within last five years preceding the survey years. The total number of such mothers was 4066, 4148, and 3998 respectively in the survey of 2006, 2011, and 2016.The association between institutional delivery and the explanatory variables was assessed via bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression).Results The utilization of health service during delivery stepped up from 21% in 2006 to 62% in 2016.Although the proportion of delivery in health facility increased among poorest over the period of 10 years, the disparity between richest and poorest still persisted from 2006 to 2016 and the association was highly significant in all the surveys. Although, government of Nepal has launched the maternity incentive scheme through safe delivery incentive program in 2005, poor women are still deprived from utilizing the service. Poorest and poorer women were 78 percent (aOR=0.22, 95% CI 0.17-0.27) and 71 Percent (aOR=0.23, 95%CI 0.23-0.35) respectively less likely to have institutional delivery than the richest women after controlling the other socio-demographic and culture factors. Furthermore, this study found that education, place of residence, women’s autonomy, religion, number of ANC visits, exposure to newspaper and TV were significant predicators for place of delivery. Conclusion Although there has been three-fold increment in utilization of health services during delivery over the period of 10 years, the discrepancy between rich and poor, educated and uneducated and urban and rural area is highly evident. Overall, our study highlights the necessity of interventions to promote institutional delivery with greater focus on poor, uneducated, and rural women.

scholarly journals Inequality in institutional delivery of the recent birth among married women in Nepal: a trend analysis

2020 ◽  
Author(s):  
Ramesh Adhikari ◽  
Aakriti Wagle
Keyword(s):  
Developing Countries ◽  
Maternal Mortality ◽  
Rural Women ◽  
Institutional Delivery ◽  
Maternal Mortality Ratio ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Demographic And Health Surveys ◽  
Chi Square ◽  
Safe Delivery

Abstract Background The huge discrepancy in health statistics between developed and developing countries occur in the area of maternal mortality, with developing countries contributing most of the figures. Nepal has higher maternal mortality ratio than its South Asian neighbors.This study assesses the trend of institutional delivery of recent birth and compared the inequalities with associated factors that affect institutional delivery in Nepal.Methods The data for this study was obtained from three sequential Nepal Demographic and Health Surveys [NDHS] of 2006, 2011, and 2016. The information was collected from mothers having a child within last five years preceding the survey years.The total number of such mothers was 4066, 4148, and 3998 respectively in the survey of 2006, 2011, and 2016.The association between institutional delivery and the explanatory variables was assessed via bivariate analysis (chi-square test) and multivariate analysis (binary logistic regression).Results The utilization of health service during delivery stepped up from 21% in 2006 to 62% in 2016.Although the proportion of delivery in health facility increased among poorest over the period of 10 years, the disparity between richest and poorest still persisted from 2006 to 2016 and the association was highly significant in all the surveys. Although, government of Nepal has launched the maternity incentive scheme through safe delivery incentive program in 2005, poor women are still deprived from utilizing the service. Poorest and poorer women were 78 percent (aOR = 0.22, 95% CI 0.17–0.27) and 71 Percent (aOR = 0.23, 95%CI 0.23–0.35) respectively less likely to have institutional delivery than the richest women after controlling the other socio-demographic and culture factors. Furthermore, this study found that education, place of residence, women’s autonomy, religion, number of ANC visits, exposure to newspaper and TV were significant predicators for place of delivery.Conclusion Although there has been three-fold increment in utilization of health services during delivery over the period of 10 years, the discrepancy between rich and poor, educated and uneducated and urban and rural area is highly evident. Overall, our study highlights the necessity of interventions to promote institutional delivery with greater focus on poor, uneducated, and rural women.

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 Analysis Determinants of Postpartum Maternal Mortality at Sidoarjo Regency in 2012

2014 ◽  
Vol 2 (1) ◽  
pp. 105
Author(s):  
Puspita Rahmawati ◽  
Santi Martini ◽  
Chatarina Umbul Wahjuni
Keyword(s):  
Multivariate Analysis ◽  
Maternal Mortality ◽  
Univariate Analysis ◽  
Maternal Mortality Ratio ◽  
Observational Research ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Mortality Case ◽  
Mortality Ratio ◽  
Chi Square Test

ABSTRACTThe maternal mortality ratio (MMR) in Indonesia remains high, i.e approximately 359 per 100.000 life birth (IDHS 2012). MMR is an indicator of mother’s health, especially the risk of being death for a mother while pregnant and delivery. Mostly the majority of maternal mortality (MMR) is occurring in the first two days after delivery and care after giving birth services required to manage complication. Sidoarjo regency has high postpartum maternal mortality case, so it is necessary to study determinants influencing postpartum maternal mortality in that regency. This research aimed to analyze the determinants that influence postpartum maternal mortality. This research was an observational research using case control study. Number of samples was 21 cases and 43 controls. Data were analyzed by univariate analysis, bivariate analysis with chi-square test, and multivariate analysis with multiple logistic regressions. The result showed that the determinants which influence postpartum maternal mortality according to multivariate analysis were pre-eclampsia/eclampsia (OR = 20,98; 95%CI : 2,250 – 323,416; p = 0,008) and delivery complication (OR = 5,47; 95%CI : 1,356 – 22,022; p = 0,017). Probability of mother to have risk of postpartum maternal mortality with all those risk factors above was 92,9%. This research recommended are need to detect early sign of pregnancy, delivery, and post delivery complication, especially danger sign of pre-eclampsia/eclampsia, referral preparation, and pregnancy planning. Keywords :  postpartum maternal mortality, determinants, pre-                                     eclampsia/eclampsia, delivery complication.

scholarly journals Analysis Determinants of Postpartum Maternal Mortality at Sidoarjo Regency in 2012

2014 ◽  
Vol 2 (1) ◽  
pp. 105
Author(s):  
Puspita Rahmawati ◽  
Santi Martini ◽  
Chatarina Umbul Wahjuni
Keyword(s):  
Multivariate Analysis ◽  
Maternal Mortality ◽  
Univariate Analysis ◽  
Maternal Mortality Ratio ◽  
Observational Research ◽  
Bivariate Analysis ◽  
Chi Square ◽  
Mortality Case ◽  
Mortality Ratio ◽  
Chi Square Test

ABSTRACTThe maternal mortality ratio (MMR) in Indonesia remains high, i.e approximately 359 per 100.000 life birth (IDHS 2012). MMR is an indicator of mother’s health, especially the risk of being death for a mother while pregnant and delivery. Mostly the majority of maternal mortality (MMR) is occurring in the first two days after delivery and care after giving birth services required to manage complication. Sidoarjo regency has high postpartum maternal mortality case, so it is necessary to study determinants influencing postpartum maternal mortality in that regency. This research aimed to analyze the determinants that influence postpartum maternal mortality. This research was an observational research using case control study. Number of samples was 21 cases and 43 controls. Data were analyzed by univariate analysis, bivariate analysis with chi-square test, and multivariate analysis with multiple logistic regressions. The result showed that the determinants which influence postpartum maternal mortality according to multivariate analysis were pre-eclampsia/eclampsia (OR = 20,98; 95%CI : 2,250 – 323,416; p = 0,008) and delivery complication (OR = 5,47; 95%CI : 1,356 – 22,022; p = 0,017). Probability of mother to have risk of postpartum maternal mortality with all those risk factors above was 92,9%. This research recommended are need to detect early sign of pregnancy, delivery, and post delivery complication, especially danger sign of pre-eclampsia/eclampsia, referral preparation, and pregnancy planning. Keywords :  postpartum maternal mortality, determinants, pre-                                     eclampsia/eclampsia, delivery complication.

scholarly journals Determinants of safe delivery utilization among Indonesian women in eastern part of Indonesia

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 332
Author(s):  
Ferry Efendi ◽  
Susy Katikana Sebayang ◽  
Erni Astutik ◽  
Setho Hadisuyatmana ◽  
Eka Mishbahatul Mar'ah Has ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Economic Status ◽  
Full Range ◽  
Unwanted Pregnancy ◽  
Secondary Data ◽  
Binary Logistic Regression ◽  
Wealth Quintile ◽  
Cross Sectional ◽  
Safe Delivery ◽  
Chi Squared

Background: Improving maternal health and reducing maternal mortality are part of the United Nations global Sustainable Development Goals for 2030. Ensuring every woman’s right to safe delivery is critical for reducing the maternal mortality rate. Our study aimed to identify determinants of safe delivery utilization among women in the eastern Indonesia. Methods: This study was cross-sectional and used a secondary data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 2,162 women who had their last child in the five years preceding the survey and lived in the eastern part of Indonesia were selected as the respondents. Chi-squared test and binary logistic regression were used to understand the determinants of safe delivery. Results: Higher child rank and interval ≤2 years (OR: 0.30, 95% CI: 0.19-0.47), unwanted pregnancy at time of becoming pregnant (OR: 1.48, 95% CI: 1.05-2.08), richest wealth quintile (OR: 5.59, 95% CI: 3.37-9.30), more than four antenatal care visits (OR: 3.62, 95% CI: 2.73-4.79), rural residence, good composite labor force participation, and a good attitude towards domestic violence were found to be significantly associated with delivery at health facility. Higher child rank and interval ≤2 years (OR: 0.49, 95% CI: 0.29-0.83), husband/partner having completed secondary or higher education (OR: 2.18, 95% CI: 1.48-3.22), being in the richest wealth quintile, and four other factors were found to be significantly associated with the assistance of skilled birth attendants. Conclusions: This research extends our knowledge on the determinants of safe delivery among women in the eastern part of Indonesia. This study revealed that the economic status of household remains an important issue in improving safe delivery among women in eastern part of Indonesia. An open innovation and partnership process to improve safe delivery program that engages the full range of stakeholders should be developed based on economic situation.

scholarly journals Born Too Soon; Implications in a Tertiary Health Facility in Enugu State Nigeria

2021 ◽  
Vol 11 (6) ◽  
pp. 190-196
Author(s):  
Nwoga Hope Obiageli ◽  
Ajuba Miriam Obinwanne ◽  
Igweagu Chukwuma Paulinus
Keyword(s):  
Caesarean Section ◽  
Health Facility ◽  
Preterm Delivery ◽  
Tertiary Education ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
Enugu State

Background: Preterm birth (PTB) is a complex complication of pregnancy with multiple etiologies. This results in long term medical burdens to the families and health care system at large. The objective of the study was to determine the socio-demographic and obstetric characteristics that affect preterm delivery. Methods: The study was a prospective cohort study conducted at the Obstetrics and Gynecology Department of a tertiary health facility in Nigeria. Data for the study were retrieved from the ante-natal and delivery card of the women that delivered at the unit within the time of data collection. Data was analyzed using SPSS version 25 and variables were presented as frequencies, percentages, means, and standard deviation. Bivariate analysis was done using chi-square test. The level of significance was set at p value ≤ 0.05. Binary logistic regression was used to determine factors that predicted preterm delivery. Results: Majority of them were married 746(96.9%), Igbos 763(99.1) and Christians 766(99.5%). Most of the women were civil servants 429(55.7%), while about 31.3% of them were unemployed 241(31.3%). Majority of the women 484(62.9%) had tertiary education. About 48% of them delivered through caesarean section while 53.9% booked within 14-28weeks gestation. Delivering through caesarean section and gestational age at booking predicted preterm delivery. Un-booked mothers have about 7times odds of having PTB when compared to those that booked at ≥28 week’s gestation. Conclusion: The prevalence of PTB is still high in Nigeria. Booking status of the mother and C/S delivery were found to be strongly associated with preterm delivery. Key words: Enugu State, Nigeria, Preterm delivery, Prevalence, Tertiary health facility.

scholarly journals Sub-regional disparities in the use of antenatal care service in Mauritania: findings from nationally representative demographic and health surveys (2011–2015)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gebretsadik Shibre ◽  
Betregiorgis Zegeye ◽  
Bright Opoku Ahinkorah ◽  
Dina Idriss-Wheeler ◽  
Mpho Keetile ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Statistical Significance ◽  
Maternal Mortality Ratio ◽  
Population Attributable Risk ◽  
Population Attributable Fraction ◽  
Regional Disparities ◽  
World Health ◽  
Demographic And Health Surveys ◽  
Mortality Ratio

Abstract Background Skilled antenatal care (ANC) has been identified as a proven intervention to reducing maternal deaths. Despite improvements in maternal health outcomes globally, some countries are signaling increased disparities in ANC services among disadvantaged sub-groups. Mauritania is one of sub-Saharan countries in Africa with a high maternal mortality ratio. Little is known about the inequalities in the country’s antenatal care services. This study examined both the magnitude and change from 2011 to 2015 in socioeconomic and geographic-related disparities in the utilization of at least four antenatal care visits in Mauritania. Methods Using the World Health Organization’s Health Equity Assessment Toolkit (HEAT) software, data from the 2011 and 2015 Mauritania Multiple Indicator Cluster Surveys (MICS) were analyzed. The inequality analysis consisted of disaggregated rates of antenatal care utilization using four equity stratifiers (economic status, education, residence, and region) and four summary measures (Difference, Population attributable risk, Ratio and Population attributable fraction). A 95% Uncertainty Interval was constructed around point estimates to measure statistical significance. Results Substantial absolute and relative socioeconomic and geographic related disparities in attending four or more ANC visits (ANC4+ utilization) were observed favoring women who were richest/rich (PAR = 19.5, 95% UI; 16.53, 22.43), educated (PAF = 7.3 95% UI; 3.34, 11.26), urban residents (D = 19, 95% UI; 14.50, 23.51) and those living in regions such as Nouakchott (R = 2.1, 95% UI; 1.59, 2.56). While education-related disparities decreased, wealth-driven and regional disparities remained constant over the 4 years of the study period. Urban-rural inequalities were constant except with the PAR measure, which showed an increasing pattern. Conclusion A disproportionately lower ANC4+ utilization was observed among women who were poor, uneducated, living in rural areas and regions such as Guidimagha. As a result, policymakers need to design interventions that will enable disadvantaged subpopulations to benefit from ANC4+ utilization to meet the Sustainable Development Goal (SDG) of reducing the maternal mortality ratio (MMR) to 140/100, 000 live births by 2030.

scholarly journals Perception of disaster preparedness and participation in training are associated with disaster preparedness among health workers

2019 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
I Made Dwie Pradnya Susila ◽  
Pande Putu Januraga ◽  
Ni Wayan Arya Utami
Keyword(s):  
Disaster Management ◽  
Disaster Preparedness ◽  
Health Workers ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Continuous Training ◽  
Cross Sectional Survey ◽  
Chi Square ◽  
Cross Sectional ◽  
Disaster Training

Background and purpose: Disaster preparedness is crucial for health workers in order to provide relief to communities affected by disasters quickly and precisely. However currently there are only few health workers who are prepared to face disasters. This study aims to determine the association between knowledge, perception, participation in training and experience in disaster management with disaster preparedness in health workers.Methods: A cross sectional survey was conducted among health workers at Petang and Abiansemal public health centres (PHCs). Of the six PHCs, four were randomly selected consisting of one PHC in Petang Sub-district and three PHCs in Abiansemal Sub-district. All health workers (271 people) in the four PHCs were selected as respondents. Individual face-to-face interviews were conducted by the first author during April 2018 in the workplaces of each respondent using a pre-tested questionnaire. Data collected consisted of socio-demographic characteristics, knowledge, perceptions, participation in training, experiences in disaster management and disaster preparedness. Questions consisted of three components namely knowledge (12 items), perception (32 items) and disaster preparedness (25 items). Bivariate analysis was conducted with chi square test and multivariate analysis with binary logistic regression to determine the association between knowledge, perception, participation in training and experience in disaster management with disaster preparedness.Results: The results showed that 70.9% of respondents had attended disaster training, 40.6% had good knowledge, 24.7% had participated in disaster management and 49.1% had a high level of disaster preparedness. The variables significantly associated with disaster preparedness were perceptions (AOR=6.40; 95%CI: 3.71-10.99) and participation in disaster training (AOR=2.68; 95%CI: 1.44-4.97).Conclusion: Perception and participation in training are significantly associated with disaster preparedness. Continuous training is needed to increase disaster preparedness among health workers.

scholarly journals Determinants of safe delivery utilization among Indonesian women in eastern part of Indonesia

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 332
Author(s):  
Ferry Efendi ◽  
Susy Katikana Sebayang ◽  
Erni Astutik ◽  
Setho Hadisuyatmana ◽  
Eka Mishbahatul Mar'ah Has ◽  
...  
Keyword(s):  
Maternal Mortality ◽  
Full Range ◽  
Unwanted Pregnancy ◽  
Binary Logistic Regression ◽  
Wealth Quintile ◽  
Cross Sectional ◽  
Safe Delivery ◽  
Skilled Assistance ◽  
Chi Squared ◽  
Development Goals

Background: Improving maternal health and reducing maternal mortality are part of the United Nations global Sustainable Development Goals for 2030. Ensuring every woman’s right to safe delivery is critical for reducing the maternal mortality rate, especially in Indonesia. Our study aimed to identify determinants of safe delivery utilization among women in the eastern Indonesia. Methods: This study was cross-sectional and used data from the 2017 Indonesian Demographic and Health Survey (IDHS). A total of 2,162 women who had their last child in the five years preceding the survey and lived in the eastern part of Indonesia were selected as the respondents. Chi-squared test and binary logistic regression were used to understand the determinants of safe delivery. Results: Higher child rank and interval ≤2 years (OR: 0.30, 95% CI: 0.19-0.47), unwanted pregnancy at time of becoming pregnant (OR: 1.48, 95% CI: 1.05-2.08), richest wealth quintile (OR: 5.59, 95% CI: 3.37-9.30), more than four antenatal care visits (OR: 3.62, 95% CI: 2.73-4.79), rural residence (OR: 0.49, 95% CI: 0.36-0.66), good composite labor force participation (OR: 1.47, 95% CI: 1.15-1.89), and a good attitude towards domestic violence (OR: 1.33, 95% CI: 1.04-1.69) were found to be significantly associated with facility-based delivery. Higher child rank and interval ≤2 years (OR: 0.49, 95% CI: 0.29-0.83), husband/partner having completed secondary or higher education (OR: 2.18, 95% CI: 1.48-3.22), husband/partner having a non-agricultural occupation (OR: 1.35, 95% CI: 1.00-1.81), being in the richest wealth quintile (OR: 15.69, 95% CI: 5.53-44.50), and three other factors were found to be significantly associated with skilled assistance delivery. Conclusions: Safe delivery and facility-based delivery among women in the eastern part of Indonesia were determined by several individual and household factors. An open innovation and partnership process that engages the full range of stakeholders should be developed based on local needs.

scholarly journals Analysis of Anxiety-Related Factors amongst Frontline Dental Staff during the COVID-19 Pandemic in Yichang, China

2020 ◽  
Author(s):  
Suli Zhao ◽  
Jing Cao ◽  
Rongcan Sun ◽  
Lin Zhang ◽  
Beibei Liu
Keyword(s):  
Anxiety Disorders ◽  
General Public ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Anxiety State ◽  
Chi Square ◽  
Related Factors ◽  
Protective Measures ◽  
Dental Staff ◽  
Potential Factors

Abstract Background: Dental staff were characterized with the tolerance of enduring stress and they are at a high risk to respiratory infectious disease. This study compared the anxiety level of the frontline dental staff (FDS) to the general public in Yichang during the coronavirus disease of 2019 (COVID-19) pandemic and examined potential explanatory factors to the differences.Methods: Two online questionnaires were used separately to collect data from FDS and the general public. The Chinese version of Beck Anxiety Inventory (BAI) was included for the assessment of anxiety. Firstly, a Chi-square test was conducted to compare the anxiety state between these two groups. Then, a bivariate analysis using Cramer’s V and Eta squared was conducted to find the potential factors. Lastly, a binary logistic regression was performed to examine the association between potential factors and the anxiety state of FDS.Results: In general, FDS were 4.342 (95% CI: 2.427-7.768) times more likely to suffer from anxiety disorders than the general public. The bivariate analysis showed that age, Level Three Protective Measures (PM-3), conflicts with patients and/or colleagues were moderately associated with the anxiety state of FDS. But the knowledge of COVID-19, the treatment to suspected or confirmed cases both had a weak association with the anxiety among FDS. Conversely, workload, the exposure to potential infectious substance and conducting aerosol generated performance were not significantly related to the anxiety of FDS. As the model indicated, an elder age and PM-3 protective measures could lower the anxiety state of FDS, whereas the conflict with patients or/and colleagues would worsen it.Conclusions: During the COVID-19 pandemic, FDS were more likely to suffer from anxiety disorders than the general public. An elder age, sufficient personal protective measures and good relationships with colleagues and patients would help them to maintain good mental health.

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