scholarly journals Under-Utilization of Maternal-Child Healthcare Services and Adverse Outcomes of Unwanted Pregnancies in Urban and Rural Areas of Indonesia

2021 ◽  
Vol 30 ◽  
pp. 170-182
Author(s):  
Yunisa Astiarani ◽  
◽  
Maybelline . ◽  
Giovani I.G. Putri ◽  
Nur Fitriah ◽  
...  
Keyword(s):  
Child Health ◽  
Antenatal Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Unwanted Pregnancy ◽  
Healthcare Services ◽  
Maternal Child Health ◽  
Rural Settings ◽  
Child Healthcare ◽  
Maternal Child

The study examines the association of unwanted pregnancy and the utilization of maternal-child health services, and the adverse health outcomes in urban and rural settings. The study employed data from the 2017 Indonesia Demographic Health Survey that included 13,806 live births; the mothers were not pregnant at the interview and were married participants. The multiple logistic regression analysis concerning residential areas was conducted separately to compare outcomes related to unwanted pregnancy. Non-standard antenatal care visits (adjusted odds ratio [AOR]=1.7; 95% confidence interval [CI]=1.2–2.4), prolonged labor (AOR=1.6; 95% CI=1.2–2.1), the absence of child’s birth documentation (AOR=1.3; 95% CI=1.0–1.6), and smaller baby size (AOR=1.2; 95% CI=1.0–1.4) are associated with unwanted pregnancy in urban areas. In rural settings, on the other hand, unwanted pregnancy is associated with non-standard antenatal care (AOR=1.6; 95% CI=1.2–2.2). Therefore, in Indonesia, urban areas lack maternal-child healthcare services utilization and higher adverse events due to unwanted pregnancy than rural areas. An adjustment approach is required in maternal-child health-related programs in both areas, particularly for women living in urban.

scholarly journals How do community health actors explain their roles? Exploring the roles of community health actors in promoting maternal health services in rural Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Abebe Mamo ◽  
Sudhakar Morankar ◽  
Shifera Asfaw ◽  
Nicole Bergen ◽  
Manisha A. Kulkarni ◽  
...  
Keyword(s):  
Child Health ◽  
Health System ◽  
Community Health ◽  
Rural Areas ◽  
Maternal Child Health ◽  
Community Members ◽  
Health Extension Workers ◽  
Community Based ◽  
Rural Ethiopia ◽  
Rural Settings

Abstract Background Maternal and child morbidity and mortality remains one of the most important public health challenges in developing countries. In rural settings, the promotion of household and community health practices through health extension workers in collaboration with other community members is among the key strategies to improve maternal and child health. Little has been studied on the actual roles and contributions of various individuals and groups to date, especially in the rural areas of Ethiopia. In this study, we explored the role played by different actors in promoting ANC, childbirth and early PNC services, and mainly designed to inform a community based Information, Education & Communication intervention in rural Ethiopia. Methods An exploratory qualitative study was conducted on 24 in-depth interviews with health extension workers, religious leaders, women developmental army leaders, and selected community members; and 12 focus group discussions, six with female and six with male community members. Data was captured using voice recorders and field notes and transcribed verbatim in English, and analyzed using Atlas.ti software. Ethical approval for the fieldwork was obtained from Jimma University and the University of Ottawa. Results Participants described different roles and responsibilities that individuals and groups have in promoting maternal/child health, as well as the perceived roles of family members/husband. Commonly identified roles included promotion of health care services; provision of continuous support during pregnancy, labour and postnatal care; and serving as a link between the community and the health system. Participants also felt unable to fully engage in their identified roles, describing several challenges existing within both the health system and the community. Conclusions Involvement of different actors based on their areas of focus could contribute to community members receiving health information from people they trust more, which in turn is likely to increase use of services. Therefore, if our IEC interventions focus on overcoming challenges that limit actors’ abilities to engage effectively in promoting use of MCH services, it will be feasible and effective in rural settings, and these actors can become an epicenter in providing community based intervention in using ANC, childbirth and early PNC services.

Local Governance and Information Communication Technologies (ICTs) in Rural Kenya

2016 ◽  
pp. 175-183
Author(s):  
Alfred Akwala
Keyword(s):  
Child Health ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Health Knowledge ◽  
Child Health Services ◽  
Maternal Child Health ◽  
Information Communication ◽  
Participatory Communication ◽  
Sub Saharan ◽  
Maternal Child

Poor communication approaches in addition to other socio-economic factors in rural areas are the greatest contributors to infant and maternal mortality. Estimates show that sub-Saharan Africa and south Asia bear the greatest burden of maternal mortality. Traditional media has been seen to be ineffective in dissemination of maternal-child health information. However information communication technology (ICT) provides a variety of media platforms that can be appropriated in disseminating maternal-child health knowledge. The objective of this paper was to investigate how ICT can be appropriated in rural areas for campaigns in maternal-child health. One major issue emerged in this paper; that appropriate interactive and participatory communication through ICT influences the dissemination of maternal-child health knowledge among the rural population and thus influences utilisation of skilled maternal-child health services.

scholarly journals Access to maternal-child health and HIV services for women in North-Central Nigeria: A qualitative exploration of the male partner perspective

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243611
Author(s):  
Maryam Al-Mujtaba ◽  
Nadia A. Sam-Agudu ◽  
Nguavese Torbunde ◽  
Muktar H. Aliyu ◽  
Llewellyn J. Cornelius
Keyword(s):  
Decision Making ◽  
Child Health ◽  
Peer Support ◽  
Male Partner ◽  
Maternal Child Health ◽  
North Central ◽  
Health Decision Making ◽  
Health Decision ◽  
Child Healthcare ◽  
Maternal Child

Background In much of sub-Saharan Africa, male partners play influential roles in women's access to maternal-child healthcare, including prevention of mother-to-child transmission of HIV services. We explored male partner perspectives on women’s access to maternal-child healthcare in North-Central Nigeria. Methods Three focus groups were conducted with 30 men, purposefully-selected on the basis of being married, and rural or urban residence. Major themes explored were men’s maternal-child health knowledge, gender power dynamics in women’s access to healthcare, and peer support for pregnant and postpartum women. Data were manually analyzed using Grounded Theory, which involves constructing theories out of data collected, rather than applying pre-formed theories. Results Mean participant age was 48.3 years, with 36.7% aged <40 years, 46.7% between 41 and 60 years, and 16.6% over 60 years old. Religious affiliation was self-reported; 60% of participants were Muslim and 40% were Christian. There was consensus on the acceptability of maternal-child health services and their importance for optimal maternal-infant outcomes. Citing underlying patriarchal norms, participants acknowledged that men had more influence in family health decision-making than women. However, positive interpersonal couple relationships were thought to facilitate equitable decision-making among couples. Financial constraints, male-unfriendly clinics and poor healthcare worker attitudes were major barriers to women’s access and male partner involvement. The provision of psychosocial and maternal peer support from trained women was deemed highly acceptable for both HIV-positive and HIV-negative women. Conclusions Strategic engagement of community leaders, including traditional and religious leaders, is needed to address harmful norms and practices underlying gender inequity in health decision-making. Gender mainstreaming, where the needs and concerns of both men and women are considered, should be applied in maternal-child healthcare education and delivery. Clinic fee reductions or elimination can facilitate service access. Finally, professional organizations can do more to reinforce respectful maternity care among healthcare workers.

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 Selecting contextually appropriate performance indicators in a circumpolar context: a modified Delphi approach

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rebecca Rich ◽  
Thomsen D’Hont ◽  
Kellie E. Murphy ◽  
Jeremy Veillard ◽  
Susan Chatwood
Keyword(s):  
Child Health ◽  
Performance Measurement ◽  
Performance Indicators ◽  
Maternity Care ◽  
Cultural Safety ◽  
Determinants Of Health ◽  
Maternal Child Health ◽  
Modified Delphi ◽  
Delphi Approach ◽  
Maternal Child

Abstract Background Meaningful performance measurement requires indicators to be scientifically robust and strategically focused. For many circumpolar states, indicators aligned with national strategies may ignore the priorities of northern, remote, or Indigenous populations. The aim of this project was to identify contextually appropriate performance indicators for maternity care in circumpolar regions. Methods Fourteen maternity care and health systems experts participated in a modified Delphi consensus process. The list of proposed indicators was derived from a previously published scoping review. Fourteen participants rated each proposed indicator according to importance, circumpolar relevance, validity, and reliability and suggested additional indicators for consideration. Results Consensus was achieved after two rounds, as measured by a Cronbach’s alpha of 0.87. Eleven indicators, many of which represented physical health outcomes, were ranked highly on all four criteria. Twenty-nine additional indicators, largely focused on social determinants of health, health care responsiveness, and accessibility, were identified for further research. Travel for care, cultural safety and upstream structural determinants of health were identified as important themes. Conclusions This study identified the important gaps between current performance measurement strategies and the context and values that permeate maternal-child health in circumpolar regions. The indicators identified in this study provide an important foundation for ongoing work. We recommend that future work encompass an appreciation for the intersectoral nature of social, structural, and colonial determinants of maternal-child health in circumpolar regions.

Genetic Testing, Genetic Information, and the Role of Maternal-Child Health Nurses in Israel

2006 ◽  
Vol 38 (3) ◽  
pp. 219-224 ◽  
Author(s):  
Sivia Barnoy ◽  
Dorit Appel ◽  
Chava Peretz ◽  
Hana Meiraz ◽  
Mally Ehrenfeld
Keyword(s):  
Genetic Testing ◽  
Child Health ◽  
Genetic Information ◽  
Maternal Child Health ◽  
Maternal Child

scholarly journals DETERMINANTS OF USE OF MATERNAL–CHILD HEALTH SERVICES IN RURAL GHANA

2000 ◽  
Vol 32 (1) ◽  
pp. 1-15 ◽  
Author(s):  
ISAAC ADDAI
Keyword(s):  
Child Health ◽  
Child Health Services ◽  
Multivariate Techniques ◽  
Maternal Child Health ◽  
Place Of Delivery ◽  
Level Of Education ◽  
Religious Background ◽  
Rural Ghana ◽  
Region Of Residence ◽  
Maternal Child

This study uses data from the Ghana Demographic and Health Survey (GDHS) of 1993 to examine factors determining the use of maternal–child health (MCH) services in rural Ghana. The MCH services under study are: (1) use of a doctor for prenatal care; (2) soliciting four or more antenatal check-ups; (3) place of delivery; (4) participation in family planning. Bivariate and multivariate techniques are employed in the analyses. The analyses reveal that the use of MCH services tends to be shaped mostly by level of education, religious background and region of residence, and partially by ethnicity and occupation. The implications of these results are discussed.

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