Antenatal Care among Women in Rural Nepal: A Community-based Study

Dhakal, Sulochana; Teijlingen, Edwin Roland Van; Stephens, Jane; Dhakal, Keshar Bahadur; Simkhada, Padam; Raja, Edwin Amalraj; Chapman, Glen N.

doi:10.14574/ojrnhc.v11i2.20

Cited by 10 publications

(16 citation statements)

References 15 publications

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“…34 The combination of all or some of these factors implies that women have limited capacity to demand biomedical services from their husbands or mothers-in-law, and therefore follow traditional practices, including giving birth without a skilled birth attendant or not using maternity services. 35,39,48,54 Ethnicities and religions Studies conducted in Bhaktapur and Kavre (Hill districts) found that women of privileged ethnicities (Newar/Brahmin/Chhetri) had higher use of maternity services, 61,71 a finding that was consistent with a study in the Brahmin of the Terai. 58 Similarly, the continuity and quality of ANC services received by women from advantaged ethnicities were high.…”

Section: Wealth Statussupporting

confidence: 68%

Social determinants of health affecting utilisation of routine maternity services in Nepal: a narrative review of the evidence

Khatri

Karkee

2018

Reproductive Health Matters

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Nepal has one of the highest maternal and neonatal mortality rates among low-and middleincome countries. Nepal's health system focuses on life-saving interventions provided during the antenatal to postpartum period. However, the inequality in the uptake of maternity services is of major concern. This study aimed to synthesise evidence from the literature regarding the social determinants of health on the use of maternity services in Nepal. We conducted a structured narrative review of studies published from 1994 to 2016. We searched five databases: PubMed; CINAHL; EMBASE; ProQuest and Global Index Medicus using search terms covering four domains: access and use; equity determinants; routine maternity services and Nepal. The findings of the studies were summarised using the World Health Organization's Social Determinants of Health framework. A total of 59 studies were reviewed. A range of socio-structural and intermediary-level determinants was identified, either as facilitating factors, or as barriers, to the uptake of maternity services. These determinants were higher socioeconomic status; education; privileged ethnicities such as Brahmins/Chhetris, people following the Hindu religion; accessible geography; access to transportation; family support; women's autonomy and empowerment; and a birth preparedness plan. Findings indicate the need for health and non-health sector interventions, including education linked to job opportunities; mainstreaming of marginalised communities in economic activities and provision of skilled providers, equipment and medicines. Interventions to improve maternal health should be viewed using a broad 'social determinants of health' framework.

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Section: Wealth Statussupporting

confidence: 68%

Social determinants of health affecting utilisation of routine maternity services in Nepal: a narrative review of the evidence

Khatri

Karkee

2018

Reproductive Health Matters

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“…Similar result was found in a study in rural Nepal that the majority of the women attended for Antenatal care were younger age of 20 -24 years. 9 Most of the mothers 83.42% were house wife and educated up to Secondary level (33.16%) and primary level (28.64%). Md.…”

Section: Resultsmentioning

confidence: 99%

“…This result is consistent with the study done in rural Nepal. 9 Another study in Bangladesh found that 55% received two antenatal visits, 33% received three to four visits, and 12% received five or more than five visits. 8 Regarding antenatal care service provider majority 55.03% from doctor and 25.39% from specialized doctor.…”

Section: Resultsmentioning

confidence: 99%

“…Most women received suggestions for a nutritious diet (84%), while only 27% got advice on danger signs in pregnancy. 9 Pregnant women may find it difficult to travel long distance for taking antenatal care in rural areas especially when the condition of the roads is poor. In our study among those who attended ANC, 46.56% respondents said health care centre within walking distance and 53.44% respondents had to go there by vehicle.…”

Section: Resultsmentioning

confidence: 99%

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Utilization of antenatal care services in a selected rural area in Bangladesh

Begum¹,

Rahman²,

Rahman³

et al. 2015

Northern Int. Med. Coll. J.

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Background : Antenatal care, the care that a woman receives during pregnancy, helps to ensure healthy outcomes for mother and newborns. Utilization of antenatal care services is the basic component of maternal care on which the life of mothers and babies depend.Objectives : To find out the utilization of antenatal care services in a selected rural area in Bangladesh.Methodology : Descriptive cross-sectional study was conducted between January to June 2014 A total 199 married women of reproductive age who had a live baby below 5years of age, were selected purposively from village Islampur in Dhamrai Upzilla under Dhaka district. Data were collected by face to face interview using a pre-tested structured questionnaire.Result : The study revealed that 94.97% utilized ANC services among them 44.72% visited for ANC more than 4 times, 20.10% for 4 times and 30.15% less than 4 times during pregnancy. Health care centre was within walking distance. Most of them were young women aged between 23-27 years (45.72%) and 18-22 years (36.18%). Majority (33.16%) was educated up to secondary level but 83.42% were house wife. Economic status was lower economic group. Half of the respondents (52%) took ANC on their own and permission of husband and 95.97% received special care from their family during pregnancy. For birth planning 86.83% planned health provider to conduct delivery and 71.36% wanted hospital delivery. Majority (97.98%) took birth preparedness during pregnancy and 55% received antenatal care from qualified doctor. About 87% found them available on duty and good behavior was found by 70.90% respondents. Information about danger signs during pregnancy were received by 77.89% of the respondents.Conclusion : Utilization of Antenatal care service was higher in the study area. Most of the mothers had idea about benefit of ANC. Mother's education, family support, behaviour, availability of health care service provider and distance of health centre influence higher utilization. Therefore, to strengthen and intensify the ANC service at all level of health care delivery throughout the country is necessary for sustainability and targeting suboptimum ANC utilization group.Northern International Medical College Journal Vol.6(1) 2014: 25-28

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“…[57] Evidence shows that illiteracy is a barrier to accessing ANC. [58] Some women have lack of awareness on delivery care, and cost. [59,60] and also lack of knowledge about available services.…”

Section: Theme Two: Personal Barriersmentioning

confidence: 99%

The barriers preventing pregnant women from accessing midwife-led antenatal care in Nigeria

Nwankwo

Ezenwaka²

2020

JNEP

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Background: Nigeria records high maternal deaths despite available antenatal care services in the country. This review aims to synthesise literature on barriers affecting access to midwife-led antenatal care (ANC) among pregnant women in Nigeria.Methods: This is a systematic literature review and involved searching of studies done in Nigeria and published between 2007 and 2018. MEDLINE 1946 to present, CINAHL, JBI, and Pubmed Central were electronically searched to identify studies on barriers affecting access to midwife-led ANC among pregnant women in Nigeria. Reference lists were hand-searched, Grey literature; Google scholar, and NuSearch e-dissertation were also searched. Citation chaining was also used. Twenty articles met the inclusion and exclusion criteria while only seven out of the twenty were included in the review after quality appraisal.Results: The data synthesis of the literature review showed disproportionate absence of the use of midwife-led ANC in this population. Several barriers were identified in the various works reviewed. The identified core barriers are economic relating to issues like high costs of services, poverty, unemployment, financial barriers; personal barrier relates to lack of autonomy, greater convenience of using other services and personal preference, low maternal educational levels, lack of information on healthcare services/ignorance about required health services, maternal age, marital status, parity/number of children; environmental relates to distance to health facility, location of residence/rural dwellers, geographical location, lack of transportation, and farness of ANC service provider; and cultural barriers relates to husband’s permission, culture of patriarchy, traditional beliefs, cultural sensitivity, cultural perception of the role of TBAs, ethnicity.Conclusions: This review highlights the need to thoroughly explore and address context-based barriers affecting access to midwife-led ANC in order to make safe motherhood a reality in Nigeria. The principal solution to these identified barriers is antenatal education by midwives which will help to empower women thereby increasing their access to midwife-led ANC. \textit{Recommendations:} Government/Policy makers should allocate sufficient fund to maternal healthcare and health promotion. They should improve ANC use by making it available, accessible and affordable to all women in Nigeria irrespective of their area of residence. Also incorporate in the educational curriculum of the approved schools of midwifery in Nigeria the suggested midwifery strategies such as named midwife, team midwife, caseload midwifery.Midwives should avail themselves of update courses in midwifery; play the necessary roles of a midwife especially being women-centered; develop interest in conducting midwifery research and using the best available evidence in their practice.

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Antenatal Care among Women in Rural Nepal: A Community-based Study

Cited by 10 publications

References 15 publications

Social determinants of health affecting utilisation of routine maternity services in Nepal: a narrative review of the evidence

Social determinants of health affecting utilisation of routine maternity services in Nepal: a narrative review of the evidence

Utilization of antenatal care services in a selected rural area in Bangladesh

The barriers preventing pregnant women from accessing midwife-led antenatal care in Nigeria

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