Continuum of maternity care in Zambia: a national representative survey

Sserwanja, Quraish; Musaba, Milton W.; Mutisya, Linet M.; Olal, Emmanuel; Mukunya, David

doi:10.1186/s12884-021-04080-1

Cited by 31 publications

(63 citation statements)

References 36 publications

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“…This is similar to that of other countries in the region, and has not changed much since the previous survey done in 2011 ( S1 Table ). Similar studies based on secondary data from nationally representative samples have reported a 9.1% level of coverage in Ethiopia [ 35 ], and 38% level of coverage in Zambia [ 41 ]. This may be explained by differences in the levels of gross domestic product (GDP), while Uganda is in the low income category, both Kenya and Zambia have attained middle income status according to the World Bank rankings [ 42 ].…”

Section: Discussionmentioning

confidence: 59%

Continuum of care for maternal health in Uganda: A national cross-sectional study

Sserwanja¹,

Mukunya

Nabachenje

et al. 2022

PLoS ONE

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Introduction A continuum of maternal care approach can reduce gaps and missed opportunities experienced by women and newborns. We determined the level of coverage and factors associated with the continuum of maternal care in Uganda. Methods We used weighted data from the Uganda Demographic and Health Survey (UDHS) 2016. We included 10,152 women aged 15 to 49 years, who had had a live birth within five years preceding the survey. Stratified two-stage cluster sampling design was used to select participants. Continuum of maternal care was considered when a woman had at least four antenatal care (ANC) visits, had delivered in a health facility and they had at least one postnatal check-up within six weeks. We conducted multivariable logistic regression analysis to determine factors associated with completion of the continuum of maternal care using SPSS version 25. Results The level of coverage of complete continuum of maternal care was 10.7% (1,091) (95% CI: 10.0–11.2). About 59.9% (6,080) (95% CI: 59.0–60.8) had four or more antenatal visits while 76.6% (7,780) (95% CI: 75.8–77.5) delivered in a health facility and 22.5% (2,280) (95% CI: 21.5–23.2) attended at least one postnatal care visit within six weeks. The following factors were associated with continuum of maternal care; initiating ANC in the first trimester (AOR 1.49, 95% CI: 1.23–1.79), having secondary level of education (AOR 1.60, 95% CI: 1.15–2.22) and tertiary level of education (AOR 2.08 95% CI: 1.38–3.13) compared to no formal education, being resident in Central Uganda (AOR 1.44, 95% CI:1.11–1.89), Northern Uganda (AOR 1.35, 95% CI: 1.06–1.71) and Western Uganda (AOR 0.61, 95% CI: 0.45–0.82) compared to Eastern Uganda, and exposure to newspapers and magazines. Conclusion The level of coverage of the complete continuum of maternal care was low and varied across regions. It was associated with easily modifiable factors such as early initiation of ANC, exposure to mass media and level of education. Interventions to improve utilisation of the continuum of maternal care should leverage mass media to promote services, especially among the least educated and the residents of Western Uganda.

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Section: Discussionmentioning

confidence: 59%

Continuum of care for maternal health in Uganda: A national cross-sectional study

Sserwanja¹,

Mukunya

Nabachenje

et al. 2022

PLoS ONE

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“…Early initiation of antenatal care (ANC) is highly recommended by the new 2016 World Health Organization (WHO) guidelines [ 1 ]. Accessing ANC services within the first trimester has been associated with better outcomes during the antenatal period, because it allows for timely identification and management of high risk patients [ 2 , 3 ]. Unfortunately, there are large global disparities in ANC utilization, with sub-Saharan Africa and South Asia having the lowest utilization rates [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…ANC is an entry point to the utilization of maternal health services [ 7 ]. Studies have documented that women who initiate ANC early develop confidence in the maternity services and they are more likely to deliver under the care of a skilled birth attendant and also utilize early postnatal care (PNC); practices which have been associated with positive maternal and neonatal outcomes of pregnancy [ 3 , 7 , 8 ]. WHO previously recommended focused ANC Model that emphasized at least four ANC visits for every normal pregnancy [ 9 ], this was modified in 2016 from four to at least eight contacts, with the first contact to be made within the first 12 weeks of gestation [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Exposure to different types of mass media and timing of antenatal care initiation: insights from the 2016 Uganda Demographic and Health Survey

Sserwanja¹,

Mutisya

Musaba

2022

BMC Women's Health

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Background Early initiation of antenatal care (ANC) within the first trimester is highly recommended in the current 2016 World Health Organization (WHO) guidelines. Mass media has the potential to promote early initiation of ANC because it has been used successfully in several programs. However, there is paucity of literature on the effect of exposure to different types of media on the timing of ANC initiation in Uganda. Our study aimed at exploring associations between exposure to different types of mass media and timing of ANC initiation among women in Uganda. Methods We used a cross sectional study design, to conduct a secondary analysis of data collected in the 2016 Uganda Demographic and Health Survey (UDHS). We included weighted data of all the 10,152 women of reproductive age (15–49 years). Multistage stratified sampling was used to select study participants. Multivariable logistic regression was used to determine the association between exposure to different types of mass media and early initiation of ANC. Results Almost a third of the women (2953/10,152, 29.1%, 95% CI 27.9–29.6) initiated their first ANC contact in the first trimester. Women who listened to radio at least once a week (adjusted OR (aOR 1.14, 95% CI 1.01–1.30) and those who watched television less than once a week (aOR 1.28, 95% CI 1.07–1.53) had higher odds of initiating ANC earlier compared to their counterparts not exposed to radio and television respectively. Conclusion Exposure to radio and television is associated with timing of ANC initiation in Uganda. Importantly, the two types of mass media have the potential to reach women with low levels of education and encourage them to utilize maternal health services. The Ugandan government needs to prioritize and intensify the use of radio and television to promote the benefits associated with timing of ANC initiation.

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“…The 2019 Sierra Leone Demographic and Health Survey (SLDHS) showed that the maternal mortality ratio (MMR) was 717 deaths per 100,000 live births, meaning for every 1000 live births, about seven women (7.17) died during pregnancy, childbirth or within 6 weeks of childbirth [ 4 ]. This MMR is over 10 times higher than the SDG 3 target of 70 deaths per 100,000 live births by 2030 [ 5 ]. SLDHS further shows that neonatal mortality ratio (NMR) stands at 31 per 1000 live births, down from 39 per 1000 live births in 2013 [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the progress has been mainly with skilled antenatal care attendance and facility-based deliveries with little progress regarding PNC utilisation [ 7 , 8 ]. Yet,the immediate postpartum period is critical for the survival of both mothers and newborns because that is when most physiological adaptations occur [ 1 , 5 ]. In this regard, receipt of timely postnatal care (PNC) is widely used to track progress towards national and international maternal child health goals [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

Sserwanja¹,

Nuwabaine²,

Kamara

et al. 2022

BMC Public Health

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Background Within Sub-Saharan Africa, some countries still report unacceptably high rates of maternal and perinatal morbidity and mortality, despite improvements in the utilisation of maternity care services. Postnatal care (PNC) is one of the recommended packages in the continuum of maternity care aimed at reducing maternal and neonatal mortality. This study aimed to determine the prevalence and factors associated with PNC utilisation in Sierra Leone. Methods We used Sierra Leone Demographic and Health Survey (UDHS) 2019 data of 7326 women aged 15 to 49 years. We conducted multivariable logistic regression to determine the factors associated with PNC utilisation, using SPSS version 25. Results Out of 7326 women, 6625 (90.4, 95% CI: 89.9–91.2) had at least one PNC contact for their newborn, 6646 (90.7, 95% CI: 90.2–91.5) had a postnatal check after childbirth and 6274 (85.6, 95% CI: 85.0–86.6) had PNC for both their babies and themselves. Delivery by caesarean section (aOR 8.01, 95% CI: 3.37–19.07), having a visit by a health field worker (aOR 1.80, 95% CI: 1.46–2.20), having had eight or more ANC contacts (aOR 1.37, 95% CI: 1.08–1.73), having tertiary education (aOR 2.71, 95% CI: 1.32–5.56) and having no big problems seeking permission to access healthcare (aOR 1.51, 95% CI: 1.19–1.90) were associated with higher odds of PNC utilisation. On the other hand, being resident in the Northern (aOR 0.48, 95% CI: 0.29–0.78) and Northwestern regions (aOR 0.54, 95% CI: 0.36–0.80), belonging to a female headed household (aOR 0.69, 95% CI: 0.56–0.85) and being a working woman (aOR 0.66, 95% CI: 0.52–0.84) were associated with lower odds of utilizing PNC. Conclusion Factors associated with utilisation of PNC services operate at individual, household, community and health system/policy levels. Some of them can be ameliorated by targeted government interventions to improve utilisation of PNC services.

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Continuum of maternity care in Zambia: a national representative survey

Cited by 31 publications

References 36 publications

Continuum of care for maternal health in Uganda: A national cross-sectional study

Continuum of care for maternal health in Uganda: A national cross-sectional study

Exposure to different types of mass media and timing of antenatal care initiation: insights from the 2016 Uganda Demographic and Health Survey

Prevalence and factors associated with utilisation of postnatal care in Sierra Leone: a 2019 national survey

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