Access to sexual and reproductive health commodities in East and Southern Africa: a cross-country comparison of availability, affordability and stock-outs in Kenya, Tanzania, Uganda and Zambia

Ooms, Gaby I; Kibira, Denis; Reed, Tim; Ham, Hendrika A. van den; Mantel‐Teeuwisse, Aukje K.; Buckland-Merrett, Gemma

doi:10.1186/s12889-020-09155-w

Cited by 29 publications

(21 citation statements)

References 34 publications

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“…The black dots refer to outliers. # P-value from the Mann-Whitney test comparing the median knowledge scores between midwives in hospitals and those in PHCs; and between physicians in hospitals and those in PHCs supplies in public facilities, whereas others reported a higher availability in private facilities [47][48][49][50]. For instance, a study in Kenya, Uganda and Zambia reported a higher availability of magnesium sulfate and of calcium gluconate in public than in private facilities [48].…”

Section: Discussionmentioning

confidence: 99%

Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo

Nkamba

Vangu

Elongi

et al. 2020

BMC Health Serv Res

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Background Hypertensive disorders in pregnancy are the second most common cause of maternal mortality in the Democratic Republic of Congo (DRC), accounting for 23% of maternal deaths. This study aimed to assess facility readiness, and providers’ knowledge to prevent, diagnose, and treat pre-eclampsia. Methods A facility-based cross-sectional study was conducted in 30 primary health centres (PHCs) and 28 referral facilities (hospitals) randomly selected in Kinshasa, DRC. In each facility, all midwives and physicians involved in maternal care provision (n = 197) were included. Data on facility infrastructure and providers’ knowledge about pre-eclampsia were collected using facility checklists and a knowledge questionnaire. Facility readiness score was defined as the sum of 13 health commodities needed to manage pre-eclampsia. A knowledge score was defined as the sum of 24 items about the diagnosis, management, and prevention of pre-eclampsia. The score ranges from 0 to 24, with higher values reflecting a better knowledge. The Mann-Witney U test was used to compare median readiness scores by facility type and ownership; and median knowledge scores between midwives in hospitals and in PHCs, and between physicians in hospitals and in PHCs. Results Overall, health facilities had 7 of the 13 commodities, yielding a median readiness score of 53.8%(IQR: 46.2 to 69.2%). Although all provider groups had significant knowledge gaps about pre-eclampsia, providers in hospitals demonstrated slightly more knowledge than those in PHCs. Midwives in public facilities scored higher than those in private facilities (median(IQR): 8(5 to 12) vs 7(4 to 8), p = 0.03). Of the 197 providers, 91.4% correctly diagnosed severe pre-eclampsia. However, 43.9 and 82.2% would administer magnesium sulfate and anti-hypertensive drugs to manage severe pre-eclampsia, respectively. Merely 14.2 and 7.1% of providers were aware of prophylactic use of aspirin and calcium to prevent pre-eclampsia, respectively. Conclusion Our study showed poor availability of supplies to diagnose, prevent and treat pre-eclampsia in Kinshasa. While providers demonstrated good knowledge regarding the diagnosis of pre-eclampsia, they have poor knowledge regarding its prevention and management. The study highlights the need for strengthening knowledge of providers toward the prevention and management of pre-eclampsia, and enhancing the availability of supplies needed to address this disease.

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Section: Discussionmentioning

confidence: 99%

Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo

Nkamba

Vangu

Elongi

et al. 2020

BMC Health Serv Res

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“…Our study showed that contraceptive utilization in Zambia is lower than that of the sub-Saharan region average, Europe, Latin America and United States of America (USA) [9,10,[21][22][23] and higher than that in Uganda [17], Chad and Benin [9]. The higher prevalence in Europe and United States of America (USA) can be attributed to the easier access of contraceptives, increased funding of policies, and interventions being implemented by these governments compared to Zambia [22,24]. Furthermore, the higher gender equality in Europe compared to Zambia empowers women to make decisions regarding contraceptive use [22,25,26].…”

Section: Resultsmentioning

confidence: 99%

Rural-urban Correlates of Modern Contraceptives Utilization Among Adolescents in Zambia: a National Cross-sectional Survey

Sserwanja¹,

Musaba

Mutisya

et al. 2021

Preprint

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Background: Modern contraceptive use among adolescents is low despite the adverse effects of adolescent pregnancies and births. Understanding the predictors of modern contraceptive use in different settings is key to design effective context-specific interventions. We aimed to determine factors associated with modern contraceptives use among adolescents in rural and urban settings of Zambia. Methods: We analyzed data from 2018 Zambia demographic and health survey (ZDHS) focusing on adolescent girls aged 15–19 years. We conducted multilevel logistic regression using SPSS version 25 to examine rural-urban variations in factors associated with modern contraceptive utilization.Results: Overall, 12.0% (360/3000, 95% CI: 10.9-13.2) of adolescents in Zambia were using modern contraceptives. Use of modern contraceptives was higher in rural areas at 13.7% (230/1677, 95% CI: 12.1-15.3) compared to 9.8% (130/1323, 95% CI: 8.3-11.6) in urban areas. In the rural areas, having a child (aOR = 13.46; 95% CI 8.28 to 21.90), marriage (aOR = 1.97; 95% CI 1.25 to 3.08), older age (being 19 years) (aOR = 3.97; 95% CI 1.51 to 10.1) and belonging to the richest wealth quintile (aOR = 3.01; 95% CI 1.06 to 8.58) were positively associated with contraceptive utilization. In the urban areas, older age (being 19 years) (aOR = 4.80; 95% CI 1.55 to 14.84) and having a child (aOR = 18.52; 95% CI 9.50 to 36.14) were the only factors positively associated with modern contraceptive utilization.Conclusions: Having shown that some factors (age and having a child) were associated with modern contraceptive use in both rural and urban areas while some were only significant in rural areas (province, marital status and wealth index), indicates that the urban-rural differences in modern contraceptives use are both due to differences in the levels and nature or type of determinants. Therefore, interventions aiming to increase contraceptive utilization should be context specific.

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“…Early models in Kenya projected that disruption of care during the COVID-19 pandemic could lead to as many as 2,120 additional child deaths and 196 additional maternal deaths during each month of the pandemic, 1 and there have been lawsuits and tragic deaths related to the implementation of COVID-19 restrictions. [32][33][34] In the MomCare experience, digital interventions communicated vital health information and promoted care-seeking behaviors during a pandemic, helping to maintain consistency in care and encourage progress toward lowering maternal and infant deaths in the region.…”

Section: Discussionmentioning

confidence: 99%

Maintaining Continuity of Care for Expectant Mothers in Kenya During the COVID-19 Pandemic: A Study of MomCare

Sanctis

Etiebet

Janssens

et al. 2022

Glob Health Sci Pract

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The outbreak of coronavirus disease (COVID-19) challenged the care-seeking behavior of expectant mothers and their access to quality health care. MomCare, a digital care bundle that links mothers-to-be with care providers and payers, quickly adapted and provided a suite of support services throughout the pandemic.n Maintaining or improving care-seeking behaviors and quality of care for MomCare platform users shows how public health practitioners can promote interactive, patient-driven technology that can quickly link payments with patients and providers to support and empower mothers-to-be in times of crisis.

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Access to sexual and reproductive health commodities in East and Southern Africa: a cross-country comparison of availability, affordability and stock-outs in Kenya, Tanzania, Uganda and Zambia

Cited by 29 publications

References 34 publications

Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo

Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo

Rural-urban Correlates of Modern Contraceptives Utilization Among Adolescents in Zambia: a National Cross-sectional Survey

Maintaining Continuity of Care for Expectant Mothers in Kenya During the COVID-19 Pandemic: A Study of MomCare

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