Gender Analysis of Decision Making on Maternal Health Care among Rural Farmers in Southwestern Nigeria: Implications for Food Security

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Oluwatoyin J. Oluwasusi ◽  
Abolade O. Adeyemo ◽  
Funmilayo O. Bamigboye ◽  
Babatunde J. Olusipe
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Food Security ◽  
Rural Communities ◽  
Maternal Health ◽  
Maternal Health Care ◽  
Safe Motherhood ◽  
Rural Farmers ◽  
Significant Difference ◽  
Males And Females

Safe childbirth is crucial to farmers’ productivity and food security as farm labour plays a pivotal role for farming in most rural communities. Analysing gender roles on maternal health care (MHC) decision is of major concern in ensuring safe motherhood and poverty reduction in rural homes. Therefore, this study analysed gender concerns of MHC among rural farmers. Multistage sampling procedure was used to select 124 respondents for the study; data were collected using structured interview schedule, Focus Group Discussion, descriptive and inferential statistics. Respondents (χ = 29 years) were in their youthful and procreating stage with average family size of 4 members. Husbands (64.5%) mainly decided the MHC utilised for childbirth. More females (54.8%) belonged to cooperative society. About (56.5%) of males and females (53.2%), respectively were crop producers having average monthly earning of #19,000. Most predicating factors to MHC decision were family tradition ( χ= 2.21) and social capital (χ = 2.18). Males (61.3%) had high level of MHC decision unlike the females (54.8%) with low contribution to MHC decision. Monthly income (r=0.521), responsibility for decision making (r=0.668) were significantly related to respondents decision on MHC. There was a significant difference in the level of decision making between males and females (t=5.28, df =31). Hence, it is recommended that non-governmental organisation should collaborate with the government to aggressively sensitise rural communities on safe motherhood and men should sufficiently empower women to contribute and participate actively in decisions on maternal health care in rural families for sustainable food production and supply.

scholarly journals Social Determinant of Home Delivery among Ever-Married Women in Khyber Pakhtunkhwa Pakistan

2020 ◽  
Vol 20 (1) ◽  
pp. 55-72
Author(s):  
Dr. Hussain Ali
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Rural Women ◽  
Home Delivery ◽  
Married Women ◽  
Maternal Health Care ◽  
Decision Makers ◽  
Domestic Sphere ◽  
Khyber Pakhtunkhwa

The poor maternal health is one of the public health issues facing by rural women in Pakistan. There are various socio-demographic and cultural factors which confine women to domestic sphere. The main objective of this research is to study various social factors as determinants of home delivery among ever-married women in Khyber Pakhtunkhwa province of Pakistan. In the present study researchers used the quantitative research design in which the data are collected through household survey in the pakhtun society. The data are collected from 503 ever married women in District Malakand, from May 1, to November 30, 2016. The results show that nearly two third 62.3 percent men’s are key decision maker about antenatal care utilization, more than third forth 76 percent of the husbands are key decision makers about the home delivery due to their women subordinate position within household. The researchers concluded that men’s are key decision makers and their decision affect women maternal health care. In order to achieve Sustainable Development Goal No. 3, the study recommends mainstreaming women in the decision making process in domestic sphere as well as their involvement is decision making about accessing and utilizing of maternal health care services. Keywords: Home delivery, men’s decision, subordinate position, women

scholarly journals Two-fifths of women are not autonomous in maternal health service utilization: A community-based cross-sectional study

2021 ◽  
Author(s):  
Asmamaw Kassahun ◽  
Asrat Zewdie
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Maternal Health Care ◽  
Maternal Health Service ◽  
Health Care Decision ◽  
Care Decision

Abstract Background: Autonomy of women in health care decision-making is tremendously crucial for improved maternal health outcomes and women’s empowerment. Women with greater freedom of movement are more likely to receive maternal health services. However, little has been investigated about women’s autonomy in maternal health care decision-making and contributing factors in Ethiopia. The aim of this study was to assess decision-making autonomy on maternal health care services utilization and associated factors among women.Methods: A community-based cross-sectional study was conducted in Mettu rural Woreda, Ilu Aba Bor zone, southwest Ethiopia from June 19 to August 20, 2021. Data was collected using a pretested interviewer-administered questionnaire from 541 randomly selected women. The collected data was entered into Epi-Data version 3.1 and exported to SPSS version 22 for analysis. Bivariate and multivariate logistic regression was used to identify factors associated with women's decision-making autonomy on maternal health service utilization. The significance of association was declared by using the odds ratio with a 95% confidence interval and a p-value less than 0.05 in the multivariable model.Results: Out of 522 women included in the analysis, 322 (60.5%) (95% CI: 56.2%-64.7%) were found to be autonomous on maternal health service utilization. Age category from 30-39 years, AOR=4.27 (95%CI: 1.59-11.43), attending primary education and above, AOR=3.87 (95%CI: 2.15-6.99), greater than five family size, AOR=0.25 (95%CI: 0.15-0.41), and distance from the health facility, AOR=5.33 (95%CI: 2.50-11.33) were significantly associated with women's decision-making autonomy on maternal health care services utilization.Conclusion: Even though every woman has the right to participate in her own health care decision-making, around two fifths of them have no role in making health care decisions about their own health. Socio-demographic factors like age and education were found to influence women’s autonomy. Special attention has to be given to women living in rural areas in order to reduce their dependency through education.

scholarly journals Factors affecting the initiation and continuation of maternal health service utilization among women who delivered in the past one year in Enemay district, East Gojjam, Ethiopia

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Anguach Shitie ◽  
Zelalem Nigussie Azene
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Educational Status ◽  
Maternal Health Care ◽  
Health Care Decision ◽  
Maternal Health Care Services ◽  
Care Decision

Abstract Background Maternity continuum of care is the continuity of maternal healthcare services that a woman uses, which includes antenatal care (ANC 4+), skilled birth attendant (SBA), and postnatal care (PNC) within 48 h of delivery. It is one of the essential strategies for reducing maternal and newborn morbidity and mortality. Therefore, this study aimed to assess the prevalence and factors affecting the initiation and continuation of maternal health service utilization among women who delivered in the past one year in Enemay district, East Gojjam zone, Ethiopia. Methods A community-based cross-sectional study was conducted among six hundred twenty-one (621) women who gave birth in the last one year in Enemay district from February 25 to March 10, 2019. A simple random sampling technique was used to select the study participants. Data were collected by face-to-face interviewer-administered, pretested, and semi-structured questionnaire. Binary logistic regressions (bi-variable and multivariable) were fitted to identify statistically significant variables. Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) was used to declare statistically significant variables on the basis of p-value < 0.05 in the multivariable binary logistic regression. Results In this study, around 61% of women had antenatal care follow-up. Out of those women having ante natal care follow-up, about 77.5% (95% CI 73, 81.7%) had continued to receiving skilled birth delivery service. Age (AOR = 1.7 95% CI: (1.0, 2.88)), marital status (AOR = 1.6, 95% CI: (1.01, 2.76)), women’s educational status (AOR = 2.9, 95% CI: (1.30, 6.72)), autonomy for health care decision-making (AOR = 3.71, 95%CI: (2.36, 6.02)), exposure to media (AOR = 2.8, 95% CI: (1.78, 4.6)), wanted pregnancy (AOR = 3.6 95% CI: (2.2, 5.95)), and parity (AOR = 0.34, 95%CI: (0.16, 0.71)) were statistically significant variables associated with initiation of antenatal care, whereas educational status of women (AOR = 4.65, 95% CI: (1.37, 15.7)), autonomy for health care decision making (AOR = 2.62, 95% CI:(1.0, 6.82)), and had counseled during antenatal care (AOR = 2.88 95% CI: (1.21, 6.83)) were statistically significant variables associated with the continuation of maternal health care services. Conclusions This study demonstrated that the initiation and continuity of maternal health care services are low in the study area. Age, marital status, residence, women’s educational status, health care decision-making autonomy, exposure to media, wanted pregnancy, and parity were factors significantly affecting the initiation of antenatal care. Whereas, women’s educational status, health care decision-making autonomy, and counseling during antenatal care were predictors influencing the continuation of maternal health care services (antenatal care to skilled birth delivery).

Maternal health care decision-making process at the family level in Geita Region, Tanzania: A qualitative study

2020 ◽  
Author(s):  
Thecla W. Kohi ◽  
Jasintha S. Boniphace ◽  
Justine Dol
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Qualitative Study ◽  
Maternal Health Care ◽  
Health Care Facilities ◽  
Decision Making Process ◽  
Obstetric Danger Signs ◽  
Danger Signs ◽  
Family Level

Abstract Background : Most maternal deaths are preventable if a woman is able to identity danger signs and seek obstetric health care without delay. However, lack of knowledge on obstetric danger signs and a prolonged decision-making process at family level may contribute to the high maternal mortality. Currently, there is little known on how the process of decision-making at family level in seeking obstetric care is being made in Tanzania. Therefore, this study aimed to describe the process on decision-making at family level in seeking maternal health care during pregnancy, delivery and postpartum period in the Geita Region, Tanzania. Methods : A qualitative study using in-depth semi-structured interview was conducted at Chato District Hospital in the Geita Region with seven fathers and seven mothers who were attending the Reproductive Child Health Clinic.Participants were recruited using purposeful sampling and interviews were analyzed using content analysis. Results: Three themes emerged from this study, including recognition of danger signs, decision-making process, and perceived influencers for seeking maternal health care. Almost all participants were aware of obstetric danger signs, yet some gaps remained among husbands. The process of decision-making starts with the woman herself who then communicates to others for discussion but the final decision-making in seeking care is dominated by husbands, parents, or neighbors, rather than mothers alone. Observing danger signs and perceived quality of care available from the health facilities were the most predominate influencers for seeking maternal health care. Conclusion: While the process of decision-making in every family starts with the woman herself, others are consulted for discussion prior to reaching a decision about seeking maternal health care, resulting in delays in accessing care. It is positive that most of the decision makers had good understanding of obstetric danger signs and that observation of those danger signs encourage access of maternal health care. However, continued education on obstetric danger signs in the community is needed as well as quality care needs to be available and known to be provided at health care facilities to encourage early seeking of maternal health care. Keywords : maternal health; decision-making; Tanzania

scholarly journals A cross-sectional study of the role of men and the knowledge of danger signs during pregnancy in southern Mozambique

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Anna Galle ◽  
Malica De Melo ◽  
Sally Griffin ◽  
Nafissa Osman ◽  
Kristien Roelens ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Maternal Health ◽  
Antenatal Care ◽  
Financial Support ◽  
Maternal Health Care ◽  
Cross Sectional ◽  
Men And Women ◽  
Danger Signs ◽  
Knowledge Of Danger Signs

Abstract Background The role of the male partner and wider family in maternal health, especially in case of emergencies, has been receiving increasing attention over the last decade. Qualitative research has highlighted that women depend on others to access high quality maternity care. Currently little is known about these factors in relation to maternal health in Mozambique. Methods A cross sectional household survey was conducted with men and women in southern Mozambique about decision making, financial support and knowledge of danger signs. A multivariable logistic model was used to identify factors associated with knowledge of danger signs and Cohen’s kappa for agreement among couples. Results A total of 775 men and women from Marracuene and Manhica districts were interviewed. Maternal health care decisions were frequently made jointly by the couple (32–49%) and financial support was mainly provided by the man (46–80%). Parental and parent-in-law involvement in decision making and financial support was minimal (0–3%). The average number of danger signs respondents knew was 2.05 and no significant difference (p = 0.294) was found between men and women. Communication with the partner was a significant predictor for higher knowledge of danger signs for both men (p = 0.01) and women (p = 0.03). There was very low agreement within couples regarding decision making (p = 0.04), financial support (p = 0.01) and presence at antenatal care consultations (p = 0.001). Results suggest women and men have a high willingness for more male participation in antenatal care, although their understanding of what constitutes this participation is not clear. Conclusion The study findings highlight the important role men play in decision making and financial support for maternal health care issues. Strengthening male involvement in antenatal care services, by investing in counselling and receiving couples, could help accelerate gains in maternal health in Mozambique. Maternal health care studies should collect more data from men directly as men and women often report different views and behavior regarding maternal health care issues and male involvement.

scholarly journals Determinants of the Continuum of Maternal Health Care in Cambodia:  an analysis of the Cambodia Demographic Health Survey 2014

2021 ◽  
Author(s):  
Savina Chham ◽  
Emma Radovich ◽  
Veerle Buffel ◽  
Por Ir ◽  
Edwin Wouters
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Health Insurance ◽  
Maternal Health ◽  
Household Wealth ◽  
Maternal Health Care ◽  
Dropping Out ◽  
Demographic Health Survey ◽  
Household Decision ◽  
Household Decision Making

Abstract Introduction: Cambodia has achieved significant progress in maternal health, yet remains in the group of countries with the highest maternal mortality ratio in South-East Asia. Extra efforts are needed to improve maternal health through assessing the coverage of maternal health services as a continuum of care (CoC) and identifying the gaps. Our study aims to explore the coverage level of the Optimal CoC by (1) measuring the continuity of optimal antenatal care (ANC), skilled birth attendance (SBA) and optimal post-natal care (PNC), (2) identifying the determinants of dropping out from one service to another and (3) of not achieving the complete CoC. Method: The study employed data from the Cambodia Demographic Health Survey 2014. We restricted our analysis to married women who had a live birth in the five years preceding the survey (n=5678). Bi-variate and multivariate logistic regression were performed using STATA version 14. Results: Almost 50% of women had achieved the complete optimal CoC, while the remaining have used only one or two of the services. The result shows that the level of women’s education was positively associated with the use of optimal ANC, the continuation to using optimal PNC and achieving the complete CoC. More power of women in household decision making was also positively associated with receiving the complete CoC. The birth order was negatively associated with achieving the complete CoC, while exposure to the mass media and having health insurance increased the odds of achieving the complete CoC. Household wealth consequently emerged as an influential predictor of dropping out and not achieving the complete CoC. Receiving all different elements of ANC care improved the continuity of care from optimal ANC to SBA and from SBA to optimal ANC. Conclusion: The findings urge policy makers to approach maternal health care as a continuum of care with different determinants at each step. Household wealth was found to be the most influential factor, yet the study discovered also other barriers to optimal maternal health care which need to be addressed: future intervention should thus not only aim to increase wealth or health insurance coverage but also stimulate the education of women and empower women to claim power in household decision-making.

scholarly journals Multidimensional Socioeconomic Deprivations of Maternal Health Care Services Utilisation: Evidence from Bangladesh

2020 ◽  
Vol 27 (2) ◽  
pp. 15-33
Author(s):  
S. M. Mostafa Kamal ◽  
Md. Amanat Ullah ◽  
Masoumeh Tadayoni ◽  
Shahreen Noor ◽  
Md. Anisur Rahman
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Three Dimensions ◽  
Safe Motherhood ◽  
Multivariable Logistic Regression Analysis ◽  
Multivariate Statistical ◽  
Care Services ◽  
Maternal Health Care Services

 This paper examines the combined effect of three socioeconomic deprivations: education, wealth, and health on the utilisation of maternal health care services (MHCSs) among Bangladeshi women using the data of Bangladesh Demographic and Health Survey 2014. Both bivariate and multivariate statistical analyses were employed in this study. Multivariable logistic regression analysis is used to examine the effect of the multidimensional socioeconomic deprivations on the use of MHCSs. Of the women who had given at least one live birth in the three years preceding the survey, 43% were non-deprived by any dimension; 31% were deprived in one, 20% in two and 6% in all three dimensions. The prevalence of receiving four or more antenatal care (ANC) services was 31%; 38% used facility-based delivery (FBD) and 42% sought skilled birth assistance (SBA). When education and wealth deprivations were combined, women were significantly (P<0.01) least likely to seek assistance from SBA (OR=0.18, 95% CI: 0.14-0.24) and FBD (OR=0.17, 95% CI: 0.12-0.22); and when all three deprivations were combined women were less likely to receive ANC at least once (OR=0.16, 95% CI: 0.12-0.22) than those who were not deprived. Programmes should be undertaken to expand maternal health voucher schemes in more sub-districts and quality of care should be ensured for equal accessibility and availability of MHCSs targeting deprived and disadvantaged areas and women to ensure safe motherhood practices in Bangladesh. Our findings show that the situation of maternal health care in Bangladesh is not satisfactory.Antenatal care

scholarly journals Perceived Indigenous Perspectives of Maternal Health Care Services among Women of Marakwet, Kenya

2019 ◽  
pp. 1-14
Author(s):  
Solomon Kemoi Cheboi ◽  
Anastasiah Nyamilu Kimeu ◽  
Kenneth Kibaara Rucha
Keyword(s):  
Health Care ◽  
Social Interaction ◽  
Maternal Health ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Sexual Relationships ◽  
Reproductive Age ◽  
Safe Motherhood ◽  
Care Services ◽  
Maternal Health Care Services

Background: Recognition of the vulnerabilities and differentials in maternal indicator is a pressing concern throughout safe motherhood literature. Uptake of skilled delivery by women in Marakwet remain 44%, compared to the national rate of 68%. Accountability for improving maternal indicators calls for interrogation of indigenous practices to amend complex social causes. Methods: This was a qualitative study conducted in the thirteen patrilineal clans of Marakwet.  Discussants were women of reproductive age while key informants included cultural anthropologist, traditionalist and gatekeepers. The data was analyzed manually through a process of data reduction, organization and emerging patterns interpretation then sub categories. Results: Pregnancy and delivery are not just biomedical process but culturally biosocial practice. Discipline and socialization are critical elements. Adequate self, family and community care lead to noble pregnancy outcome. The community and midwife uses knowledge to jumpstart childbirth practices for expectant women for healthy prenatal period, delivery and postnatal running.  Holiness and hygiene, controlled sex and sexual relationships, artefacts and dressing, food ways and diet, social interaction, livelihoods and lifestyle are key pregnancy and childbirth social aetiology. Conclusion: cultural stimuli and remedies inform maternal health seeking behaviour and practices of women. Continued care, hygiene, geophagy, controlled food ways and social interaction as well as avoiding heavy duties and events that trigger emotions and pressure are sound indigenous ways of improving maternal and child health. However, norms such as visiting a midwife for pregnancy confirmation and massage as well as folk activities such as the use of charms and repertoires for protection and cleansing ceremonies provide false protection. Recommendation: the results suggest the relative value for indigenous maternal health care services in enhancing client centered delivery health services. Review of policies and programs to integrate harmless indigenous practices into maternity care services may promote quality, satisfaction and uptake of facility based childbirth services.

scholarly journals Knowledge and practices on maternal health care among mothers: A case study from Sewar Bansbot village of Dang district

2020 ◽  
pp. 13-27
Author(s):  
Ganga KC
Keyword(s):  
Health Care ◽  
Health Status ◽  
Maternal Health ◽  
Maternal Mortality ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
Reproductive Age ◽  
Safe Motherhood ◽  
Early Marriage ◽  
Significant Shift

Knowledge and practices regarding maternal health care among women has had a significant shift in Nepali culture. Understanding this ship can help to improve women's overall status. Nepal implemented a safe motherhood program, which slightly improved maternal health. Data, showed the maternal mortality ratio decreased during the period between 1996 and 2016 but still there is high ratio in maternal mortality. Conservative practices of maternal health are prevalent to this date. Health education is one of the crucial factors empowering women to be attentive of their rights and health status to get appropriate health services. Maternal health is a major burning issue in Nepal, which has been affected mainly due to early marriage, teenage pregnancy, superstition, low women literacy rate, and unhygienic behavioural practices. Women go through a rather depressing situation due to workload ignorance, lack of health facilities, economic, and social conditions. Despite the efforts from various types of private, government, and voluntary health agencies, there has not been a satisfactory improvement in maternal health status and safe motherhood. This study focuses on the knowledge and practices of maternal Health care. It also describes antenatal care, delivery care, and postnatal care. The study was conducted in Sewar Basbot village of ward no. 13, Ghorahi Sub-metropolitan city of Dang district that is situated near by district headquarters, Ghorahi. In total, 45 women of reproductive age (15-49 years) who were pregnant and having children below five years of age were purposively interviewed and completed the self-administered interview schedule.

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