Antenatal Care as a Means of Increasing Birth in the Health Facility and Reducing Maternal Mortality: A Systematic Review

Abstract

BACKGROUND: Although there is a general agreement on the importance of antenatal care to improve the maternal and perinatal health, little is known about its importance to improve health facility delivery in developing countries. The objective of this study was to assess the association of antenatal care with birth in health facility. METHODS: A systematic review with meta-analysis of Mantel-Haenszel odds ratios was conducted by including seventeen small scale studies that compared antenatal care and health facility delivery between 2003 and 2013. Additionally, national survey data of African countries which included antenatal care, health facility delivery and maternal mortality in their report were included. Data were accessed via a computer based search from MEDLINE, African Journals Online, HINARI and Google Scholar databases. RESULTS: The regression analysis of antenatal care with health facility delivery revealed a positive correlation. The pooled analysis also demonstrated that woman attending antenatal care had more than 7 times increased chance of delivering in a health facility. The comparative descriptive analysis, however, demonstrated a big gap between the proportion of antenatal care and health facility delivery by the same individuals (27%-95% vs 4%-45%). Antenatal care and health facility delivery had negative correlation with maternal mortality. CONCLUSION: The present regression and meta-analysis has identified the relative advantage of having antenatal care to give birth in health facilities. However, the majority of women who had antenatal care did not show up to a health facility for delivery. Therefore, future research needs to give emphasis to identifying barriers to health facility delivery despite having antenatal care follow up.

Determinants of place of delivery: A comparison between an urban and a rural community in Nigeria

“…This finding lead previously to a recommendation that although antenatal care may not be efficient in identifying women who are most in need of obstetric care, if promoted it may become an effective instrument to facilitate better use of emergency obstetric care services. However, some other studies have failed to find this association between ANC attendance and subsequent delivery in a health facility (Berhan and Berhan, 2014;Choe et al, 2016) The proportion of women who delivered in the health facility was 65.0 and 4.7% in the urban and rural groups respectively; whereas the proportion that had skilled assistance was 70 and 4.3% in the urban and rural groups, respectively. These estimates compare well with the national level rates (67 vs. 60% for urban groups and 27 vs. 24% for rural populations) for the respondents in Sokoto South LGA than Gwadabawa (NDHS, 2013).…”

Home delivery among antenatal care booked women in their last pregnancy and associated factors: community-based cross sectional study in Debremarkos town, North West Ethiopia, January 2016

“…Comparative descriptive analysis demonstrated high gap between the proportion of antenatal care utilization and institutional delivery by the same individuals, which ranges 27–95% verses 4–45% [3]. …”

Determinants of Home Delivery among Women attending Antenatal Care in Bagwai Town, Kano Nigeria

“…Antenatal care is a form of health service provided to a woman throughout pregnancy to ensure a safe gestation and childbirth, and prevent complications to the mother and the baby 1 . This type of care offers a range of healthcare services including prevention, detection, and treatment of anaemia, malaria, malnutrition, pre-eclampsia, sexually transmitted infections (STIs), and prevention of mother to child transmission of human immunodeficiency virus (HIV).…”