Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers

Heaman, Maureen; Sword, Wendy; Elliott, Lawrence; Moffatt, Michael; Helewa, Michael; Morris, Heather; Gregory, Patricia; Tjaden, Lynda; Cook, Catherine

doi:10.1186/s12884-015-0431-5

Cited by 93 publications

(81 citation statements)

References 42 publications

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“…This means that the age at first marriage of deceased spouses was relatively low compared to that of their husbands. The low age at first marriage has also been noted in earlier studies 22–26…”

Section: Discussionsupporting

confidence: 77%

Factors influencing maternal mortality among rural communities in southwestern Nigeria

Azuh¹,

Azuh²,

Iweala³

et al. 2017

IJWH

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BackgroundMaternal mortality and morbidity reflect the status of population health and quality of life across nations. Poor understanding of the interplay of many antecedent factors, including sociocultural, economic and logistic factors, combined with an overwhelming poor health services delivery, is a basic challenge in several countries, particularly in rural settings where functional health care services are relatively scarce. There are still uncertainties as to the extent of this burden, owing to current challenges with information and data collation. This study aimed at identifying nonmedical factors associated with maternal mortality in rural and semiurban communities of southwestern Nigeria.MethodologyThe study was carried out in Ado-Odo/Ota Local Government Area of Ogun State. A multistage sampling technique and an informant survey approach were used in the study. A total sample of 360 eligible respondents were selected randomly from 11 out of 16 political wards in the study area and interviewed through the administration of questionnaires. The data were processed using descriptive statistics and regression analyses.ResultsPlace of consultation (P=0.000), who pays the treatment costs (P=0.000), awareness of pregnancy complications (P=0.002) and knowledge of the place of antenatal care treatment (P=0.000) significantly influenced maternal mortality (proxy by place of delivery of last birth). The F-statistic (15.100) confirmed the hypothesis that nonmedical factors influence maternal mortality. The correlation of predictor variables was significant at both the 0.01 level and the 0.05 level (2-tailed).ConclusionOur findings suggest that in a rural community setting with a depleted health care system, health education tailored toward community culture, subsidized maternal health care services by the government and operators of private clinics, as well as empowering and improving the status of women may reduce maternal mortality and prompt better utilization and survival chances of women in the study area as well as in all of Nigeria.

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Section: Discussionsupporting

confidence: 77%

Factors influencing maternal mortality among rural communities in southwestern Nigeria

Azuh¹,

Azuh²,

Iweala³

et al. 2017

IJWH

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“…Indeed, 41 % of women initially assessed for study eligibility were excluded from study participation because they were over 25 weeks gestation. Barriers to timely prenatal care use among low-income women include delay in obtaining government or private organization support coverage (e.g., Medi-Cal) (Egerter et al, 2002) and practical challenges such as child care, transportation, lack of time and support (Heaman et al, 2015). …”

Section: Discussionmentioning

confidence: 99%

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

et al. 2015

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This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.

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“…These improved outcomes have been attributed to improved access and utilization of antenatal care, as well as of delivery in health facilities that have skilled birth attendants [6–8]. …”

Section: Introductionmentioning

confidence: 99%

Seasonal variation in geographical access to maternal health services in regions of southern Mozambique

et al. 2017

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BackgroundGeographic proximity to health facilities is a known determinant of access to maternal care. Methods of quantifying geographical access to care have largely ignored the impact of precipitation and flooding. Further, travel has largely been imagined as unimodal where one transport mode is used for entire journeys to seek care. This study proposes a new approach for modeling potential spatio-temporal access by evaluating the impact of precipitation and floods on access to maternal health services using multiple transport modes, in southern Mozambique.MethodsA facility assessment was used to classify 56 health centres. GPS coordinates of the health facilities were acquired from the Ministry of Health while roads were digitized and classified from high-resolution satellite images. Data on the geographic distribution of populations of women of reproductive age, pregnancies and births within the preceding 12 months, and transport options available to pregnant women were collected from a household census. Daily precipitation and flood data were used to model the impact of severe weather on access for a 17-month timeline. Travel times to the nearest health facilities were calculated using the closest facility tool in ArcGIS software.ResultsForty-six and 87 percent of pregnant women lived within a 1-h of the nearest primary care centre using walking or public transport modes respectively. The populations within these catchments dropped by 9 and 5% respectively at the peak of the wet season. For journeys that would have commenced with walking to primary facilities, 64% of women lived within 2 h of life-saving care, while for those that began journeys with public transport, the same 2-hour catchment would have contained 95% of the women population. The population of women within two hours of life-saving care dropped by 9% for secondary facilities and 18% for tertiary facilities during the wet season.ConclusionsSeasonal variation in access to maternal care should not be imagined through a dichotomous and static lens of wet and dry seasons, as access continually fluctuates in both. This new approach for modelling spatio-temporal access allows for the GIS output to be utilized not only for health services planning, but also to aid near real time community-level delivery of maternal health services.

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Barriers and facilitators related to use of prenatal care by inner-city women: perceptions of health care providers

Cited by 93 publications

References 42 publications

Factors influencing maternal mortality among rural communities in southwestern Nigeria

Factors influencing maternal mortality among rural communities in southwestern Nigeria

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

Seasonal variation in geographical access to maternal health services in regions of southern Mozambique

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