scholarly journals Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

2021 ◽  
Vol 13 (4(J)) ◽  
pp. 17-30
Author(s):  
Ruth Atuhaire ◽  
Robert Wamala ◽  
Leonard. K. Atuhaire ◽  
Elizabeth Nansubuga
Keyword(s):  
Antenatal Care ◽  
Community Health ◽  
Health Facility ◽  
Maternal Education ◽  
Health Workers ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Care Health

This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.

Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

2021 ◽  
Author(s):  
Ruth Atuhaire ◽  
Robert Wamala ◽  
Leonard K Atuhaire
Keyword(s):  
Community Health ◽  
Health Facility ◽  
Postnatal Care ◽  
Maternal Education ◽  
Health Workers ◽  
Media Exposure ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Care Health

Abstract BackgroundMaternal health equality is an ultimate goal for a better world. Early maternal healthcare service utilization is hindered by numerous social and economical barriers, along with widespread inequalities in utilization of existing services. To better understand variations existing in Uganda, we assessed differences in early antenatal care, health facility delivery and early postnatal care among women in selected sub regions. The differences were decomposed into components attributed to variation in women's characteristics and the effects of coefficients.MethodsWe used a sample of 1,521 women of reproductive ages (15-49), who delivered a child five years prior to the 2016 Uganda Demographic and Health Survey. Non-linear Oaxaca’ Blinder Multivariate Decomposition method and STATA 13.0 software were used.ResultsSignificant differences in early ANC, health facility delivery and EPNC among women in Eastern and Western sub regions were attributed to both variation in women’s characteristics and effects of coefficients. Overall gap in early ANC (57.39%), health facility delivery (63.88%) and EPNC (59.06%) was attributed to differences in women's characteristics, whereas differences in effects of coefficients attributed 42.61% variations in early ANC, 36.12% in health facility delivery, and 40.94% in EPNC.Specifically, overall gap in early ANC would reduce if differences in availability of community health workers (31.6%) and media exposure (34.7%) were to disappear. Furthermore, the gap would increase by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth differences respectively. Overall gap in health facility delivery would reduce if differences in community health worker availability (24.6%) and media exposure (37.2%) were to disappear, and increase by 54.9% in the absence of variations in effects of maternal education. The overall gap in EPNC would reduce if differences in maternal education (18.5%) and community health worker availability (17.17%) were to disappear and increase by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth quintile respectively.ConclusionProgress towards equitable maternal health should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Postpartum Care ◽  
Reproductive Age ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results: Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion: Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services. Keywords: Antenatal care, health facility delivery, postpartum care, Mwanza, Tanzania

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: a cross-sectional baseline survey

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania. Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables. Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups. Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Improving maternal health by reducing maternal morbidity and mortality relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables.Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups.Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

scholarly journals Sociodemographic inequalities in utilizing maternal healthcare services in Cambodia

2020 ◽  
Author(s):  
Donghua Zhou ◽  
Zhonghe Zhou ◽  
Cheng Yang ◽  
Lu Ji ◽  
Bishwajit Ghose ◽  
...  
Keyword(s):  
Health Facility ◽  
Postnatal Care ◽  
Unwanted Pregnancy ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Demographic And Health Surveys ◽  
Sample Population ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Cambodia is a Southeast Asian country and has one the highest rates of maternal and child mortality with inadequate use of maternal healthcare services in the region. The present study aimed to analyse the progress made in terms of using maternal healthcare services since 2000.Methods Two rounds of Demographic and Health Surveys (DHS 2000 and DHS 2014) were used in the study. Sample population consisted 11,961 women aged between 15-49 years. The outcome measures were: Timing of first ANC attendance, adequacy of ANC attendance, place of delivery and postnatal checkup. WHO guidelines were used to set the cut-off/define these measures.Results Findings indicated that the overall prevalence of making the first ANC visit in the first trimester was 64.19% [95%CI=62.22,66.11], and that of having at least four ANC visits was 43.80% [95%CI=41.89,45.73]. Prevalence of health facility delivery was 48.76% [46.62,50.90] and that of postnatal checkup was 71.14% [95%CI=69.21,73.01]. Between 2000 and 2014, the percentage of timely and adequate use of ANC increased by respectively 61.8% and 65.3%, while that of health facility delivery and postnatal care increased by respectively 74.5% and 43.9%. Important demographic, socioeconomic and geographic disparities were observed in the utilization of ANC, health facility delivery and postnatal care services. Urban residency, having better educational status, white collar job, access to electronic media showed positive association, whereas higher parity (having >2 children) and unwanted pregnancy showed negative association with the use of maternal healthcare services. Having at least four ANC visits was associated with significantly increased higher odds of using health facility delivery and postnatal care.Conclusion There has a been a remarkable increase in the prevalence of women who are using the maternal healthcare services since 2000. Although the data are cross-sectional that precludes assuming any causal relationship, the current findings provide important insights regarding the pattern of sociodemographic inequalities in the use of maternal healthcare services in Cambodia.

scholarly journals Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

2019 ◽  
Author(s):  
James Orwa ◽  
Michaela Mantel ◽  
Micheal Mugerwa ◽  
Sharon Brownie ◽  
Eunice Siaity Pallangyo ◽  
...  
Keyword(s):  
Health Facility ◽  
Urban Areas ◽  
Healthcare Services ◽  
Facility Delivery ◽  
Reproductive Age ◽  
Baseline Survey ◽  
Antenatal Visit ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Cross Sectional

Abstract Background Improving maternal health by reducing maternal morbidity and mortality relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables.Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups.Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

scholarly journals Effects of antenatal care visits and health facility delivery on women's choice to circumcise their daughters in sub-Saharan Africa: evidence from demographic and health surveys

2021 ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu ◽  
Carolyne Njue
Keyword(s):  
Antenatal Care ◽  
Health Facility ◽  
Healthcare Service ◽  
Facility Delivery ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Service Utilisation ◽  
Health Facility Delivery ◽  
Maternal Healthcare ◽  
Sub Saharan

Abstract Background This study examines the association between maternal healthcare service utilisation and circumcision of daughters in sub-Saharan Africa (SSA). Methods This study is based on a cross-sectional study design that draws on analysis of pooled data from current demographic and health surveys conducted between 2010 and 2019 in 12 countries in SSA. Both bivariate and multivariable binary logistic regression models were employed. Results Mothers who had four or more antenatal care visits were less likely to circumcise their daughters compared with those who had zero to three visits. Mothers who delivered at a health facility were less likely to circumcise their daughters than those who delivered at home. With the covariates, circumcision of daughters increased with increasing maternal age but decreased with increasing wealth quintile and level of education. Girls born to married women and women who had been circumcised were more likely to be circumcised. Conclusions This study established an association between maternal healthcare service utilisation and circumcision of girls from birth to age 14 y in SSA. The findings highlight the need to strengthen policies that promote maternal healthcare service utilisation (antenatal care and health facility delivery) by integrating female genital mutilation (FGM) information and education in countries studied.

Interrelationships Between Maternal Health Services in Uganda: A Structural Equation Analysis

2019 ◽  
Author(s):  
Ruth Atuhaire
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Health Facility ◽  
Structural Equation ◽  
First Trimester ◽  
Maternal Health Services ◽  
Facility Delivery ◽  
Health Facility Delivery ◽  
Mediating Factor

Abstract Background Maternal health care and treatment services have a bearing on maternal mortality. Direct and Indirect factors affecting Maternal health outcomes therefore require understanding to enable well targeted interventions. This study, therefore, assessed the interrelationships between early antenatal care, health facility delivery and early postnatal care.Methods We investigated Maternal Health services using utilizing Antenatal care (ANC) within three months of pregnancy, Health facility delivery and utilizing postnatal care (PNC) within 48 hours after childbirth. The 2016 Uganda Demographic and Health Survey data was used. During analysis, a Generalized Structural Equation Model using logistic link and binomial family option was used. The interrelated (Endogenous) outcomes were timely ANC, health facility delivery and timely PNC.Results Timely ANC (aOR=1.04; 95% CI=0.95-1.14) and(aOR=1.1; 95% CI=1.00-1.26) was directly related to increased odds of health facility delivery and timely PNC respectively. Factors that increased the odds of timely ANC as a mediating factor for health facility delivery and timely PNC were women age 35-39 (aOR=1.18; 95% CI=0.99-1.24) compared to women age 15-19, completing primary seven (aOR=1.68; 95% CI=1.58-1.81) compared to some primary, available health workers (aOR=1.06; 95% CI=0.97-1.18), complications (aOR=2.04; 95% CI=1.89-2.26) and desire for pregnancy(aOR=1.15; 95% CI=1.03-1.36). Factors that reduced the odds of timely ANC were being married (aOR=0.93; 95% CI=0.89-1.20), distance and cost of service being problematic (aOR=0.97; 95% CI=0.85-1.1) (aOR=0.5; 95% CI=0.37-0.82) respectively. Factors that significantly influenced health facility delivery through timely ANC were; unmarried (OR=1.03; (=1.04*0.99)), distance being problematic ((aOR=1.0; (=1.04*0.97)) and complications (aOR=2.02; (=1.04*1.94)). Factors that significantly influenced timely PNC through timely ANC were; women age 35-39 (aOR=1.3; (=1.18*1.1)) compared to 15-19, completing primary seven (aOR=1.68; (=1.68*1.1))compared to some primary and service cost being problematic (aOR=0.55; (=0.5*1.1)). Surprisingly, health facility delivery was not statistically significant as a mediator for timely PNC.Conclusion Attending antenatal care within first trimester was a mediating factor for health facility delivery and early postnatal care. Interventions in maternal health should focus on factors that increase antenatal care first trimester attendance in resource limited settings. Furthermore, Government should reduce on costs of attaining all maternal health services and emphasize girl education completion.

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