birth attendance
Recently Published Documents


TOTAL DOCUMENTS

228
(FIVE YEARS 122)

H-INDEX

19
(FIVE YEARS 5)

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261161
Author(s):  
Anbrasi Edward ◽  
Younghee Jung ◽  
Grace Ettyang ◽  
Chhea Chhorvann ◽  
Casey Risko ◽  
...  

Background The coverage for reproductive care continuum is a growing concern for communities in low- income economies. Adolescents (15–19 years) are often at higher odds of maternal morbidity and mortality due to other underlying factors including biological immaturity, social, and economic differences. The aim of the study was to examine a) differences in care-seeking and continuum of care (4 antenatal care (ANC4+), skilled birth attendance (SBA) and postnatal care (PNC) within 24h) between adult (20–49 Years) and adolescents and b) the effect of multilevel community-oriented interventions on adolescent and adult reproductive care-seeking in Cambodia, Guatemala, Kenya, and Zambia using a quasi-experimental study design. Methods In each country, communities in two districts/sub-districts received timed community health worker (CHW) household health promotion and social accountability interventions with community scorecards. Two matched districts/sub-districts were selected for comparison and received routine healthcare services. Results Results from the final evaluation showed that there were no significant differences in the care continuum for adolescents and adults except for Kenya (26.1% vs 18.8%, p<0.05). SBA was significantly higher for adolescents compared to adult women for Guatemala (64% vs 55.5%, p<0.05). Adolescents in the intervention sites showed significantly higher ANC utilization for Kenya (95.3% vs 84.8%, p<0.01) and Zambia (87% vs 72.7%, p<0.05), ANC4 for Cambodia (83.7% vs 43.2%, p<0.001) and Kenya (65.9% vs 48.1%, p<0.05), SBA for Cambodia (100% vs 88.9%, p<0.05), early PNC for Cambodia (91.8% vs 72.8%, p<0.01) and Zambia (56.5% vs 16.9%, p<0.001) compared to the comparison sites. However, the findings from Guatemala illustrated significantly lower care continuum for intervention sites (aOR:0.34, 95% CI 0.28–0.42, p<0.001). The study provides some evidence on the potential of multilevel community-oriented interventions to improve adolescent healthcare seeking in rural contexts. The predictors of care continuum varied across countries, indicating the importance of contextual factors in designing interventions.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Prem Shankar Mishra ◽  
Debashree Sinha ◽  
Pradeep Kumar ◽  
Shobhit Srivastava

Abstract Background Despite a significant increase in the skilled birth assisted (SBA) deliveries in India, there are huge gaps in availing maternity care services across social gradients - particularly across states and regions. Therefore, this study applies the spatial-regression model to examine the spatial distribution of SBA across districts of India. Furthermore, the study tries to understand the spatially associated population characteristics that influence the low coverage of SBA across districts of India and its regions. Methods The study used national representative cross-sectional survey data obtained from the fourth round of National Family Health Survey, conducted in 2015-16. The effective sample size was 259,469 for the analysis. Moran’s I statistics and bivariate Local Indicator for Spatial Association maps were used to understand spatial dependence and clustering of deliveries conducted by SBA coverage in districts of India. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of deliveries conducted by SBA. Results Moran’s I value for SBA among women was 0.54, which represents a high spatial auto-correlation of deliveries conducted by SBA over 640 districts of India. There were 145 hotspots for deliveries conducted by SBA among women in India, which includes almost the entire southern part of India. The spatial error model revealed that with a 10% increase in exposure to mass media in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Interestingly, also with the 10% increase in the four or more antenatal care (ANC) in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Again, if there was a 10% increase of women with first birth order in a particular district, then the deliveries conducted by SBA significantly increased by 6.1%. If the district experienced an increase of 10% household as female-headed, then the deliveries conducted by SBA significantly increased by 1.4%. Conclusion The present study highlights the important role of ANC visits, mass media exposure, education, female household headship that augment the use of an SBA for delivery. Attention should be given in promoting regular ANC visits and strengthening women’s education.


Author(s):  
Clara Lindberg ◽  
Tryphena Nareeba ◽  
Dan Kajungu ◽  
Atsumi Hirose

Abstract Objective Monitoring essential health services coverage is important to inform resource allocation for the attainment of the Sustainable Development Goal 3. The objective was to assess service, effective and financial coverages of maternal healthcare services and their equity, using health and demographic surveillance site data in eastern Uganda. Methods Between Nov 2018 and Feb 2019, 638 resident women giving birth in 2017 were surveyed. Among them, 386 were randomly sampled in a follow-up survey (Feb 2019) on pregnancy and delivery payments and contents of care. Service coverage (antenatal care visits, skilled birth attendance, institutional delivery and one postnatal visit), effective coverage (antenatal and postnatal care content) and financial coverage (out-of-pocket payments for antenatal and delivery care and health insurance coverage) were measured, stratified by socio-economic status, education level and place of residence. Results Coverage of skilled birth attendance and institutional delivery was both high (88%), while coverage of postnatal visit was low (51%). Effective antenatal care was lower than effective postnatal care (38% vs 76%). Financial coverage was low: 91% of women made out-of-pocket payments for delivery services. Equity analysis showed coverage of institutional delivery was higher for wealthier and peri-urban women and these women made higher out-of-pocket payments. In contrast, coverage of a postnatal visit was higher for rural women and poorest women. Conclusion Maternal health coverage in eastern Uganda is not universal and particularly low for postnatal visit, effective antenatal care and financial coverage. Analysing healthcare payments and quality by healthcare provider sector is potential future research.


2021 ◽  
Author(s):  
Quraish Sserwanja ◽  
Linet M. Mutisya ◽  
Lilian Nuwabaine ◽  
Kassim Kamara ◽  
Ronald K Mutebi ◽  
...  

Abstract IntroductionGlobally, Sierra Leone has some of the worst maternal and child health indicators. The situation is worsened by a dearth of evidence about the level of continuum of care, an evidence-based intervention aimed at reducing maternal and perinatal morbidity and mortality. Hence this study aimed to fill this gap in evidence in the level of and factors associated with continuum of maternal and newborn care.MethodThe study employed data from the 2019 Sierra Leone Demographic Health Survey (SLDHS). Analysis was restricted to women who had a live birth in the five years preceding the survey (n = 7,326). Bi-variable and multivariable logistic regression were performed using SPSS software version 25.ResultsOnly 17.9% (95% CI: 17.4-19.1) of the women utilized complete continuum of care (CoC) for maternal and newborn health services in Sierra Leone. About 22% (95% CI: 21.3-23.1) utilized 8 or more antenatal care (ANC) contacts, 88% (95% CI: 87.9-89.4) had skilled birth attendance (SBA) while 90.7% (95% CI: 90.2-91.5) and 90.4% (95% CI: 89.9-91.2) of mothers and neonates utilized postnatal care (PNC) respectively. Having started ANC within first trimester (aOR 1.71, 95% CI: 1.46-2.00), belonging to the Southern region (aOR 1.85, 95% CI: 1.23-2.80), belonging to richer wealth quintile (aOR 1.76, 95% CI: 1.27-2.44), using internet (aOR 1.49, 95% CI: 1.12-1.98) and having no big problems seeking permission to access healthcare (aOR 1.34, 95% CI: 1.06-1.69) were significantly associated with utilization of CoC.ConclusionThe overall completion of continuum of maternal care is low, with ANC being the lowest utilized component of continuum of care. The study findings further call for urgent attention for maternal health stakeholders to develop and implement tailored interventions prioritizing women empowerment, access to affordable internet services, timely initiation of ANC contacts, women in developed regions such as the Western and those from poor households.


2021 ◽  
Vol 6 (4) ◽  
pp. 26
Author(s):  
Yayi Alfred ◽  
Omona Kizito

Background: Traditional and complementary medicine is globally accepted and steadily gaining popularity among populations. The practices of conventional health care workers toward it vary from one country or setting to another. Limited literature exists on practices of health workers towards this form of medicine in low income settings especially in Africa where it is widely used with limited collaboration, integration and regulation.Purpose: To determine the prevalence and determinants of traditional and complementary medicine practices as well as health problems and reasons for its use among nurses and midwives in North Western Uganda.Materials & Methods: We used a descriptive and analytical cross-sectional design. Data was collected using self-administered structured questionnaires that were distributed to a sample of 300 nurses and midwives drawn from 6 hospitals. Descriptive statistics, chi squared and multiple binary logistic regression analysis were used for analysis.Results: Of all the respondents, 147 (54.9%) had personally ever used traditional and complementary medicine, 69 (25.7%) had personally used it in the past 12 months, 84 (31.3%) had ever recommended use of TCM. The most commonly used therapies were: herbalism (78.2%), traditional birth attendance (67.3%), nutritional supplements (67.3%), body massage (53.1%), spiritualism (24.5%), traditional dentistry (21.1%) and traditional bone setting (14.3%). Traditional and complementary medicine was mainly used for pain management (53.1%) followed by acute diseases (49.6%). The commonest reasons given for use were the fact that it is readily available, accessible and cheap. Chi square analysis showed statistically significant associations between TCM practices (personal use and recommendation to others) and respondents religion (p=0.046), location of hospital (p=0.002), presence of a family member who is a TCM provider (p=0.001), attendance of training on TCM in the years of work (p=0.001), provision of TCM as a business and duration of years served as a health professional (p=0.029).Conclusions: There is need to improve traditional and complementary medicine practices amongst nurses, midwives and other health care professionals. This will avert the negative/undesired effects in the community.


2021 ◽  
Vol 1 (1) ◽  
pp. 30-38
Author(s):  
Alex Darteh Afrifa ◽  
James Kojo Prah ◽  
Kwasi Sobre Nkrumah

Background: Access to a doctor, nurse, or a midwife during childbirth is key to the global effort to reduce maternal mortality ratios. Ghana has recorded significant improvements in maternal care over the past three decades. However, despite many policies aimed at improving health care for pregnant women such as the free maternal care policy, many Ghanaian women still deliver without a skilled birth attendant present. This systematic review, therefore, sought to identify the various factors affecting utilisation of skilled birth attendance in Ghana. Methods: PubMed Central, African Journals Online (AJOL), CINAHL Plus with Full Text (EBSCO), and Science Direct were searched for studies from January 2010 to December 2020. A broad range of search terms was used. Studies included had diverse designs, were conducted among Ghanaian pregnant women, and had skilled delivery as an outcome of interest. The quality of studies was assessed. Due to the diversity of types of studies included in this systematic review (including qualitative, descriptive, and evaluative studies that ranged from simple bivariate analyses to complex multivariate modelling), a meta-analysis was neither possible nor appropriate. We, therefore, conducted a narrative synthesis of the search findings. Results: Twenty-four (24) studies met our inclusion criteria for this review. Included studies comprised sixteen (16) cross-sectional studies and eight (8) qualitative studies. The sample size of the included studies cumulatively was 86,998 participants. The emerging themes were: health system factors (10); maternal and family factors (5); and sociodemographic factors (9). Conclusion: In general, health system factors; maternal and family factors; and sociodemographic factors were found to influence skilled delivery services in Ghana. Therefore, in order to ensure that there is a skilled birth attendant present at every birth, efforts should aim at addressing social and cultural factors which have been identified as key determinants to utilisation of skilled delivery in Ghana.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eugene Budu ◽  
Vijay Kumar Chattu ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Aliu Mohammed ◽  
...  

Abstract Background Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. Methods Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. Results Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. Conclusion Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Aseye Kpodotsi ◽  
Elizabeth Aku Baku ◽  
Jo Hunter Adams ◽  
Olufunke Alaba

Abstract Background Equitable access to skilled birth attendance during delivery is vital for reducing global maternal deaths to 70 deaths per 100, 000 to achieve the Sustainable Development Goals (SDGs) by 2030. Although several initiatives have been implemented to reduce maternal mortality in Ghana, inequalities in access to skilled birth attendance during delivery still exist among women of different socioeconomic groups. This study assesses the socioeconomic inequalities in access and use of skilled birth attendants during delivery in Ghana. Methods Research was conducted through literature reviews and document reviews, and a secondary data analysis of the 2014 Ghana Demographic and Health Survey (GDHS), a nationally representative survey. A total of 1305 women aged 15–49 years, who had a live birth the year before to the survey in the presence of a skilled birth attendant were analysed using concentration indices and curves. The indices were further decomposed to identify the major socioeconomic factors contributing most to the inequalities. Results The results found that access to skilled birth attendants was more among women from rich households showing a pro-rich utilization. The decomposition analysis revealed that household wealth index, educational level of both mother and husband/partner, area of residence and mother’s health insurance coverage were the major contributing factors to socioeconomic inequalities in accessing skilled birth attendants during child delivery among Ghanaian women. Conclusion This study confirms that a mother’s socioeconomic status is vital to reducing maternal deaths. Therefore, it is worthy to focus attention on policy interventions to reduce the observed inequalities as revealed in the study.


2021 ◽  
Vol 6 (12) ◽  
pp. e006453
Author(s):  
Muhammad Ashar Malik ◽  
Lara Riedige Rohm ◽  
Pieter van Baal ◽  
Eddy van Doorslaer van Doorslaer

IntroductionPakistan is a country with high maternal and infant mortality. Several large foreign funded projects were targeted at improving maternal, neonatal and child health. The Norway-Pakistan Partnership Initiative (NPPI) was one of these projects. This study aims to evaluate whether NPPI was successful in improving access and use of skilled maternal healthcare.MethodsWe used data from three rounds (2009–2010, 2011–2012 and 2013–2014) of the Pakistan Social and Living Standards Measurement Survey (PSLM). A difference-in-difference regression framework was used to estimate the effectiveness of NPPI and its different programme components with respect to maternal healthcare seeking behaviour of pregnant women. Various parts of the PSLM were combined to examine the healthcare seeking behaviour response of pregnant women to exposure to NPPI.ResultsTrends in maternal care seeking behaviour of pregnant women were similar in districts exposed to NPPI and control districts. Consequently, only a weak and insignificant impact of NPPI on maternal care seeking behaviour was found. However, women in districts which used vouchers or which implemented contracting were more likely to seek skilled assistance with their delivery.ConclusionWe conclude that the objective to improve access to and use of skilled care was not achieved by NPPI. The small effects identified for vouchers and contracts on skilled birth attendance hold some promise for further experimentation.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Hee sang Yoon ◽  
Chong-Sup Kim

Abstract Background El Salvador is recognized as a country that has effectively reduced its Maternal Mortality Ratio (MMR). While health indicators, such as total fertility rate, adolescent fertility rate, skilled birth attendance, and health expenditures, have improved in El Salvador, this improvement was unremarkable compared to advancements in other developing countries. How El Salvador could achieve an outstanding decrease in MMR despite unexceptional improvements in health and non-health indicators is a question that deserves deep research. We used quantitative methods and an observational case study to show that El Salvador could reduce its MMR more than expected by instituting health policies that not only aimed to reduce the (adolescent) fertility rate, but also provide safe birthing conditions and medical services to pregnant women through maternity waiting homes. Methods We ran pooled ordinary least squares regression and panel regression with fixed effects using MMR as the dependent variable and health and non-health factors as the independent variables. We conducted residual analysis, calculated the predicted value of MMR, and compared it with the observed value in El Salvador. To explain the change in MMR in El Salvador, we carried out an observational case study of maternity waiting homes in that country. Results El Salvador could reduce MMR by improving health factors such as fertility rate skilled birth attendance and non-health factors, such as gross domestic product (GDP) per capita and female empowerment. However, even while considering these factors, the MMR of El Salvador decreased by more than expected. We confirmed this by analyzing the residuals of the regression model. This improvement in MMR, which is larger than expected from the regression results, can be attributed partly to government measures such as maternity waiting homes. Conclusions The reason for the unexplained reduction in El Salvador’s MMR seems to be attributed in part to health policies that not only aim to reduce the fertility rate but also to provide safe birthing conditions and medical services to pregnant women through maternity waiting homes.


Sign in / Sign up

Export Citation Format

Share Document