scholarly journals Maternal and community factors associated with postnatal care checkups in Ethiopia: A multi-level analysis

2020 ◽  
Author(s):  
Afework Tadele ◽  
Masrie Getinet
Keyword(s):  
Cesarean Section ◽  
Health Facility ◽  
Postnatal Care ◽  
Household Wealth ◽  
Community Level ◽  
Maternal Factors ◽  
Community Factors ◽  
Factors Associated ◽  
Care Services ◽  
Multi Level

Abstract Background Maternal mortality remained a public health issue, especially in developing countries. Although the first two days after birth was a critical time in which the highest maternal death recorded, it was the most neglected period of maternal health services. Therefore, this study aims to determine the maternal and community-level factors of postnatal check-ups in Ethiopia Methods Demographic and Health Survey (DHS) in 2016 was utilized. A total of 3,948 women aged 15-49 giving birth in the two years before the survey were included. The response variables were post-natal check-ups in the first two days after birth, dichotomized into no check-ups in the first two days and check-ups within two days after giving birth. The explanatory variables were individual maternal characteristics such as education, household wealth, perceived distance to a health facility to get medical help, employment status, antenatal care (ANC), delivery by cesarean section, birth order and place of delivery, and selected community characteristics such as community literacy, community socioeconomic status, community ANC coverage, community perception of distance to a health facility, and regional states. A multi-level mixed-effects logistic regression model was employed. Result Only 17% of the women had a postnatal check-up within 2 days of giving birth in Ethiopia. Institutional delivery AOR 2.14 [95% C.I 1.70, 2.0] and giving birth by cesarean section AOR 1.66 [95% CI 1.10, 2.50] were found to be maternal factors, whereas administrative regions(Oromia 69%, Somali 56%, Benishangul 55%, SNNPR 43%, Gambela 66%, Afar 50% and Dire Dawa 55% which less likely to utilize postnatal care utilization as compared to Addis Ababa city administrative area), Higher community-level wealth AOR 1.44 [95% C.I 1.08, 1.2], ANC coverage AOR 1.52 [95% C.I 1.19, 1.96] and perceived distance of the health facility as a big problem AOR 0.78[95% C.I 0.60, 0.99] were the community factors associated with postnatal check-ups in Ethiopia. Conclusion Both maternal factors and community factors are found to be a significant association with postnatal care services utilization, however, based on the ICC maternal factors prevail the community-level factors. Increasing access to postnatal care services to the remote areas of Ethiopia was recommended.

scholarly journals Family planning utilization and associated factors among postpartum women in Addis Ababa, Ethiopia, 2018

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245123
Author(s):  
Lema Tafa ◽  
Yoseph Worku
Keyword(s):  
Family Planning ◽  
Antenatal Care ◽  
Sexual Activity ◽  
Health Facility ◽  
Postnatal Care ◽  
Associated Factors ◽  
Addis Ababa ◽  
Postpartum Women ◽  
Factors Associated ◽  
Care Services

Background Pregnancies that occur in the first year after birth can result in adverse outcomes for the mothers and their babies. Postpartum family planning (PPFP) can save lives of many mothers and children. Only few data are available about the magnitude of PPFP use and its determinants in Addis Ababa, Ethiopia. Objective To assess PPFP utilization and associated factors in Addis Ababa, Ethiopia. Method A facility-based cross-sectional study was conducted from April to June 2018. A total of 625 women were enrolled in the study. Statistical Package for the Social Sciences (SPSS) software was used to analyze the data. Binary logistic regression model with adjusted odd ratio (AOR) and 95% confidence interval (CI) was used to identify the factors associated with PPFP use. A p-value less than 0.05 was considered as significant. Result The magnitude of PPFP utilization in Addis Ababa was 71.8%. Previous family planning (FP) information (AOR = 13.2; 95% CI: (1.96, 88.07)), FP information from health facility visit (AOR = 2.23; 95% CI: (1.45, 3.43)), antenatal care (AOR = 4.96; 95% CI: (1.58, 15.64)), counseling on FP at postnatal care (AOR = 1.97; 95% CI: (1.27, 3.05)), menses resumption after birth (AOR = 1.75; 95% CI: (1.11, 2.76)), and commencing sexual activity after birth (AOR = 9.34; 95% CI: (5.39, 16.17)) were the factors associated with PPFP use. Conclusion and recommendation Though the magnitude of PPFP use is encouraging, still three out of the ten postpartum women did not use PPFP. The determinants of PPFP use were having FP information, having FP information from health facility visit, antenatal care, counseling about FP during postnatal care, menses resumption after birth, and commencing sexual activity after birth. The health system in the City and the healthcare providers should strive to reach every woman who is not accessing the PPFP services and antenatal care services, and improve counseling services on PPFP during delivery and postnatal care services.

scholarly journals Factors associated with maternity waiting home use among women in Jimma Zone, Ethiopia: a multilevel cross-sectional analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e028210 ◽  
Author(s):  
Jaameeta Kurji ◽  
Lakew Abebe Gebretsadik ◽  
Muluemebet Abera Wordofa ◽  
Morankar Sudhakar ◽  
Yisalemush Asefa ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Facility ◽  
Household Wealth ◽  
Community Level ◽  
Cross Sectional ◽  
Factors Associated ◽  
Cross Sectional Analysis ◽  
Jimma Zone ◽  
Maternity Waiting Home ◽  
Sectional Analysis

ObjectiveTo identify individual-, household- and community-level factors associated with maternity waiting home (MWH) use in Ethiopia.DesignCross-sectional analysis of baseline household survey data from an ongoing cluster-randomised controlled trial using multilevel analyses.SettingTwenty-four rural primary care facility catchment areas in Jimma Zone, Ethiopia.Participants3784 women who had a pregnancy outcome (live birth, stillbirth, spontaneous/induced abortion) 12 months prior to September 2016.Outcome measureThe primary outcome was self-reported MWH use for any pregnancy; hypothesised factors associated with MWH use included woman’s education, woman’s occupation, household wealth, involvement in health-related decision-making, companion support, travel time to health facility and community-levels of institutional births.ResultsOverall, 7% of women reported past MWH use. Housewives (OR: 1.74, 95% CI 1.20 to 2.52), women with companions for facility visits (OR: 2.15, 95% CI 1.44 to 3.23), wealthier households (fourth vs first quintile OR: 3.20, 95% CI 1.93 to 5.33) and those with no health facility nearby or living >30 min from a health facility (OR: 2.37, 95% CI 1.80 to 3.13) had significantly higher odds of MWH use. Education, decision-making autonomy and community-level institutional births were not significantly associated with MWH use.ConclusionsUtilisation inequities exist; women with less wealth and companion support experienced more difficulties in accessing MWHs. Short duration of stay and failure to consider MWH as part of birth preparedness planning suggests local referral and promotion practices need investigation to ensure that women who would benefit the most are linked to MWH services.

scholarly journals Individual and community level factors associated with delayed first postnatal care attendance among reproductive age group women in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Achamyeleh Birhanu Teshale ◽  
Getayeneh Antehunegn Tesema ◽  
Yigizie Yeshaw ◽  
Ayenew Kassie Tesema ◽  
Adugnaw Zeleke Alem ◽  
...  
Keyword(s):  
Health Facility ◽  
Postnatal Care ◽  
Community Level ◽  
Reproductive Age ◽  
Multilevel Logistic Regression ◽  
Age Group ◽  
Individual Level ◽  
Factors Associated ◽  
Multilevel Logistic Regression Analysis ◽  
Reproductive Age Group

Abstract Background Postnatal care (PNC) visits provide a huge benefit for ensuring appropriate breastfeeding practices, to monitor the overall health status of the newborn, to timely diagnose and intervene birth-related complications, and to plan future family planning options. Despite delayed PNC attendance have a great impact on the survival of the mother and the newborn it still receives less emphasis. As a result, most mothers do not receive PNC services early. We, therefore, aimed to determine individual and community level factors associated with delayed first Postnatal Care attendance among reproductive age group women in Ethiopia. Methods We used the most recent Ethiopian Demographic and Health Survey (EDHS 2016) data to determine associated factors of delayed first PNC in Ethiopia. A weighted sample of 4308 women with a live birth in the two years preceding the survey was included. A multilevel logistic regression analysis was used to analyze the data. Variables with p-value < 0.05 in the multivariable multilevel logistic regression analysis were declared significantly associated with delayed first PNC attendance. Results In this study, both individual level and community level factors were associated with delayed PNC attendance. Among the individual level factors: having four or more antenatal care visit [Adjusted Odd Ratio (AOR) = 0.73; 95% CI: 0.59, 0.92], delivery at a health facility [AOR = 0.04; 95% CI: 0.03, 0.05], and perceiving distance from the health facility as not a big problem [AOR = 0.73; 95% CI: 0.58, 0.91] were associated with lower odds of delayed first PNC attendance. Of community level factors: being in Oromia [AOR = 2.31; 95% CI: 1.38, 3.83] and Gambela [AOR = 2.01; 95% CI: 1.13, 3.56] regions were associated higher odds of delayed first PNC attendance. Conclusions Both individual level and community level factors were found to be associated with delayed PNC attendance. Strengthening antenatal care utilization, institutional delivery, and appropriate distributions of maternal health services in each region and areas far apart from the health facility are recommended.

scholarly journals Facility delivery and postnatal care services use among mothers who attended four or more antenatal care visits in Ethiopia: further analysis of the 2016 Demographic and Health Survey

2018 ◽  
Author(s):  
Gedefaw Abeje Fekadu ◽  
Fentie Ambaw Getahun ◽  
Seblewongiel Ayenalem Kidanie
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Postnatal Care ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Factors Associated ◽  
Content Of Care ◽  
Care Services ◽  
At Home

AbstractIntroductionIn Ethiopia, many mothers who attend the recommended number of antenatal care visits fail to use facility delivery and postnatal care services. This study identifies factors associated with facility delivery and use of postnatal care among mothers who had four or more antenatal care visits, using data from the 2016 Ethiopian Demographic and Health Survey (EDHS).MethodsTo identify factors associated with facility delivery, we studied background and service-related characteristics among 2,415 mothers who attended four or more antenatal care visits for the most recent birth. In analyzing factors associated with postnatal care within 42 days after delivery, the study included 1,055 mothers who attended four or more antenatal care visits and delivered at home. We focused on women who delivered at home because women who deliver at a health facility are more likely also to receive postnatal care as well. A multivariable logistic regression model was fitted for each outcome to find significant associations between facility delivery and use of postnatal care.ResultsFifty-six percent of women who had four or more antenatal care visits delivered at a health facility, while 44% delivered at home. Mothers with secondary or above level of education, urban residents, women in the richest wealth quintile, and women who were working at the time of interview had higher odds of delivering in a health facility. High birth order was associated with a lower likelihood of health facility delivery. Among women who delivered at home, only 8% received postnatal care within 42 days after delivery. Quality of antenatal care as measured by the content of care received during antenatal care visits stood out as an important factor that influences both facility delivery and postnatal care. Among mothers who attended four or more antenatal care visits and delivered at home, the content of care received during ANC visits was the only factor that showed a statistically significant association with receiving postnatal care.ConclusionsThe more antenatal care components a mother receives, the higher her probability of delivering at a health facility and of receiving postnatal care. The health care system needs to increase the quality of antenatal care provided to mothers because receiving more components of antenatal care is associated with increased health facility delivery and postnatal care. Further research is recommended to identify other reasons why many women do not use facility delivery and postnatal care services even after attending four or more antenatal care visits.

scholarly journals Less than one-fifth of the mothers practised exclusive breastfeeding in the emerging regions of Ethiopia: a multilevel analysis of the 2016 Ethiopian demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tsegaye Gebremedhin ◽  
Demiss Mulatu Geberu ◽  
Asmamaw Atnafu
Keyword(s):  
Health Survey ◽  
Exclusive Breastfeeding ◽  
Household Wealth ◽  
Community Level ◽  
Wealth Status ◽  
Individual Level ◽  
Factors Associated ◽  
Breastfeeding Practices ◽  
The Individual ◽  
Low Coverage

Abstract Background The burden of low coverage of exclusive breastfeeding (EBF) has a significant impact on the health of a newborn and also on the family and social economy in the long term. Even though the prevalence of EBF practices in Ethiopia is low, the practices in the pastoral communities, in particular, are significantly low and affected by individual and community-level factors. Besides, its adverse outcomes are mostly unrecognised. Therefore, this study aimed to assess the individual and community-level factors of low coverage of EBF practices in the emerging regions of Ethiopia. Methods In this analysis, data from 2016 Ethiopian Demographic and Health Survey (EDHS) were used. A two-stage stratified sampling technique was used to identify 1406 children aged 0 to 23 months in the emerging regions of Ethiopia. A multilevel mixed-effect binary logistic regression analysis was used to determine the individual and community level factors associated with exclusive breastfeeding practices. In the final model, variables with a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were found to be statistically significant factors that affect exclusive breastfeeding practices. Results Overall, 17.6% (95% CI: 15.6–19.6) of the children aged 0 to 23 months have received exclusive breastfeeding. Employed mothers (AOR: 0.33, 95% CI: 0.21–0.53), richer household wealth status (AOR: 0.39, 95% CI: 0.16–0.96), mothers undecided to have more children (AOR: 2.29, 95% CI: 1.21–4.29), a child with a history of diarrhoea (AOR: 0.31, 95% CI: 0.16–0.61) were the individual-level factors, whereas Benishangul region (AOR: 2.63, 95% CI: 1.44–4.82) was the community-level factors associated with the exclusive breastfeeding practices. Conclusions Less than one-fifth of the mothers have practised exclusive breastfeeding in the emerging regions of Ethiopia. The individual-level factors such as mother’s employment status, household wealth status, desire for more children, presence of diarrhoea and community-level factors such as region have contributed to the low coverage of exclusive breastfeeding. Therefore, the federal and regional health bureaus and other implementers should emphasise to those emerging regions by creating awareness and strengthening the existing community-based health extension program to enhance exclusive breastfeeding practices.

scholarly journals Population attributable risk estimates for factors associated with non-use of postnatal care services among women in Nigeria

BMJ Open ◽  
2016 ◽  
Vol 6 (7) ◽  
pp. e010493 ◽  
Author(s):  
K E Agho ◽  
O K Ezeh ◽  
A I Issaka ◽  
A I Enoma ◽  
S Baines ◽  
...  
Keyword(s):  
Postnatal Care ◽  
Population Attributable Risk ◽  
Attributable Risk ◽  
Factors Associated ◽  
Care Services ◽  
Risk Estimates

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 Levels of and changes in socioeconomic inequality in delivery care service: A decomposition analysis using Bangladesh Demographic Health Surveys

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242325
Author(s):  
Mohammad Habibullah Pulok ◽  
Gowokani Chijere Chirwa ◽  
Jacob Novignon ◽  
Toshiaki Aizawa ◽  
Marshall Makate
Keyword(s):  
Health Facility ◽  
Socioeconomic Inequality ◽  
Care Service ◽  
Skilled Birth Attendance ◽  
Household Wealth ◽  
Facility Delivery ◽  
Delivery Care ◽  
Health Facility Delivery ◽  
Care Services ◽  
Birth Attendance

Background Socioeconomic inequality in maternity care is well-evident in many developing countries including Bangladesh, but there is a paucity of research to examine the determinants of inequality and the changes in the factors of inequality over time. This study examines the factors accounting for the levels of and changes in wealth-related inequality in three outcomes of delivery care service: health facility delivery, skilled birth attendance, and C-section delivery in Bangladesh. Methods This study uses from the Bangladesh Demographic and Health Survey of 2011 and 2014. We apply logistic regression models to examine the association between household wealth status and delivery care measures, controlling for a wide range of sociodemographic variables. The Erreygers normalised concentration index is used to measure the level of inequalities and decomposition method is applied to disentangle the determinants contributing to the levels of and changes in the observed inequalities. Results We find a substantial inequality in delivery care service utilisation favouring woman from wealthier households. The extent of inequality increased in health facility delivery and C-section delivery in 2014 while increase in skilled birth attendance was not statistically significant. Wealth and education were the main factors explaining both the extent of and the increase in the degree of inequality between 2011 and 2014. Four or more antenatal care (ANC4+) visits accounted for about 8% to 14% of the observed inequality, but the contribution of ANC4+ visits declined in 2014. Conclusion This study reveals no progress in equity gain in the use of delivery care services in this decade compared to a declining trend in inequity in the last decade in Bangladesh. Policies need to focus on improving the provision of delivery care services among women from poorer socioeconomic groups. In addition, policy initiatives for promoting the completion of quality education are important to address the stalemate of equity gain in delivery care services in Bangladesh.

scholarly journals Assessing the Contextual Effect of Community in the Utilization of Postnatal Care Services in Ghana

2021 ◽  
Author(s):  
Emmanuel Dankwah ◽  
Wu Zeng ◽  
Cindy Feng ◽  
Shelley Kirychuck ◽  
Rein Lepnrum ◽  
...  
Keyword(s):  
Postnatal Care ◽  
Northern Region ◽  
Community Level ◽  
Scan Statistics ◽  
Contextual Effect ◽  
Health Seeking ◽  
Poverty Level ◽  
Individual Level ◽  
Care Services ◽  
Poor Women

Abstract BackgroundInequalities in the use of postnatal care services (PNC) in Ghana have been linked to poor maternal and neonatal health outcomes. This has ignited a genuine concern that PNC interventions with a focus on influencing solely individual-level risk factors do not achieve the desired results. This study aimed to examine the community-level effect on the utilization of postnatal care services. Specifically, the research explored clusters of non-utilization of PNC services as well as the effect of community-level factors on the utilization of PNC services, with the aim of informing equity-oriented policies and initiatives.MethodsThe 2014 Ghana Demographic and Health Survey GDHS dataset was used in this study. Two statistical methods were used to analyze the data; spatial scan statistics were used to identify hotspots of non-use of PNC services and second two-level mixed logistic regression modeling was used to determine community-level factors associated with PNC services usage. ResultsThis study found non-use of PNC services to be especially concentrated among communities in the Northern region of Ghana. Also, the analyses revealed that community poverty level, as well as community secondary or higher education level, were significantly associated with the utilization of PNC services, independent of individual-level factors. In fact, this study identified that a woman dwelling in a community with a higher concentration of poor women is less likely to utilize of PNC services than those living in communities with a lower concentration of poor women (Adjusted odds ratio (AOR) = 0.60, 95%CI: 0.44 - 0.81). Finally, 24.0% of the heterogeneity in PNC services utilization was attributable to unobserved community variability.ConclusionThe findings of this study indicate that community-level factors have an influence on women’s health-seeking behavior. Community-level factors should be taken into consideration for planning and resource allocation purposes to reduce maternal health inequities. Also, high-risk communities of non-use of obstetric services were identified in this study which highlights the need to formulate community-specific strategies that can substantially shift post-natal use in a direction leading to universal coverage.

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