Coverage and timing of antenatal care among poor women in 6 Mesoamerican countries

McNellan, Claire R.; Gagnier, Marielle C.; Desai, Sima S.; Haakenstad, Annie; Johanns, Casey K.; Palmisano, Erin B.; Ríos-Zertuche, Diego; Schaefer, Alexandra; Zúñiga-Brenes, Paola; Hernández, Bernardo; Iriarte, Emma; Mokdad, Ali H.

doi:10.1186/s12884-016-1018-5

Cited by 20 publications

(15 citation statements)

References 22 publications

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“…Strategies to increase ANC contacts must target these women. Our findings were consistent with other studies [1,[24][25][26][27][28]: one of them examined coverage and timing of ANC among the poor in Mesoamerican countries and showed that education, parity and marital status were factors predicting timely ANC initiation [24]. Similarly, Gupta et al looked at utilization of antenatal care in Tanzania between 1990 and 2010 and found that urban residence, lower birth order and ANC initiation before four months of gestation were associated with utilization of at least four antenatal care visits [1].…”

Section: Discussionsupporting

confidence: 91%

“…Other studies have also documented the high ANC performance in Latin America and Caribbean [23]: although this region has the largest income inequalities globally, with varying ANC performance across countries, programs targeting the most vulnerable such as performance-based contracts and conditional-cash transfer schemes have been successful at promoting ANC utilization in recent years [23,24].…”

Section: Discussionmentioning

confidence: 99%

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Timing and number of antenatal care contacts in low and middle-income countries: Analysis in the Countdown to 2030 priority countries

Jiwani¹,

Amouzou-Aguirre²,

Carvajal³

et al. 2020

Journal of Global Health

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ResultsOverall, 49.9% of women with ANC1+ and 44.3% of all women had timely ANC initiation; 11.3% achieved ANC8+ and 11.2% received no ANC. Women with timely ANC initiation had 5.2 (95% confidence interval (CI) = 5.0-5.5) and 4.7 (95% CI = 4.4-5.0) times higher odds of receiving four and eight ANC contacts, respectively (P < 0.001), and were more likely to receive a higher content of ANC than women with delayed ANC initiation. Regionally, women in Central and Southern Asia had the best performance of timely ANC initiation; Latin America and Caribbean had the highest proportion of women achieving ANC8+. Women who did not initiate ANC in the first trimester or did not achieve 8 contacts were generally poor, single women, with low education, living in rural areas, larger households, having short birth intervals, higher parity, and not giving birth in a health facility nor with a skilled attendant.Conclusions Timely ANC initiation is likely to be a major driving force towards meeting the 2016 WHO guidelines for a positive pregnancy experience. Electronic supplementary material:The online version of this article contains supplementary material.Antenatal care (ANC) is a platform for the delivery of essential services to prevent pregnancy complications, provide counselling for birth and emergency preparedness [1], and improve health outcomes for children [2]. Timely initiation of antenatal care, defined as the first antenatal care contact occurring within the first trimester of pregnancy, provides an opportunity for early screening of modifiable risk-factors and pre-existing conditions [3].The 2016 WHO recommendations on antenatal care for a positive pregnancy experience suggest a shift from the focused ANC model with a recommended minimum of four ANC visits (ANC4+) to a more expanded model empha-

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Timing and number of antenatal care contacts in low and middle-income countries: Analysis in the Countdown to 2030 priority countries

Jiwani¹,

Amouzou-Aguirre²,

Carvajal³

et al. 2020

Journal of Global Health

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“…Accordingly, substantial progress has been made in the uptake of ANC, particularly in the MDG period (increased from only 1 in 4 women in 1990 to nearly 1 in 2 women in 2015) [ 5 ]. However, this is insufficient, as more than half of women living in LMICs do not receive any ANC during pregnancy, with significant within-country variations [ 6 – 10 ]. Consequently, around 303,000 maternal deaths, 2.6 million stillbirths, and 2.7 million newborn deaths occur in LMICs because of preventable causes related to pregnancy and childbirth [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…Subgroup analysis of these women across regions of countries found similar negative effects for sub-Saharan Africa and Latin America, while no effect was reported for Asia [ 21 ]. Conversely, country-level research in sub-Saharan Africa found highly inconsistent results with no [ 6 , 7 , 28 ] or negative effects of unintended pregnancy on ANC uptake [ 29 – 31 ]. Studies in Asian countries, including India and Bangladesh, found negative effects of unintended pregnancy on adequate (at least four visits) ANC [ 24 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of unintended pregnancy on skilled antenatal care uptake in Bangladesh: analysis of national survey data

et al. 2020

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Background Around 48% of all pregnancies in low- and middle-income countries are unintended. Unintended pregnancy may contribute to lower use of antenatal care (ANC); however, current research in the area is largely inconclusive due to the methodological approaches applied. Methods Responses from 4493 women extracted from the 2014 Bangladesh Demographic and Health Survey (BDHS) were used to assess the association between unintended pregnancy and subsequent uptake of at least one and at least four skilled ANC visits. For this, Bayesian multilevel logistic regression models with informative priors (representing a range of values within which the researcher is certain the true effect of the parameters included lies) were used, adjusting for other factors that affect ANC uptake. Informative priors were selected from the BDHS data collected in 2004, 2007, and 2011. Results Around 64% of women in Bangladesh who had at least one pregnancy within 3 years prior to the survey (that ended in a live birth) received ANC at least once, and of these around 32% used ANC at least four times. Mistimed (aOR, 0.73, 95% Cred I, 0.66–0.81) and unwanted (aOR, 0.69, 95% Cred I, 0.64–0.75) pregnancy were associated with reduced odds of attending the recommended minimum of four skilled ANC visits compared with wanted pregnancy. These likelihoods were even lower for at least one skilled ANC visit among women with a mistimed (aOR, 0.59, 95% Cred I, 0.53–0.65) or an unwanted pregnancy (aOR, 0.67, 95% Cred I, 0.61–0.74) than women with a wanted pregnancy. Conclusions In Bangladesh, more than one-quarter of women who report an unintended pregnancy at conception and do not terminate the pregnancy are at high risk of not using ANC. It is important for policies to include women with unintended pregnancy in mainstream healthcare services. This will increase the use of ANC and reduce associated adverse consequences.

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“…Poor mothers and children start to fall behind their better-off peers in health-related consequences [7,8]. High rates of maternal and infant mortality and complications related to pregnancy can be minimized by referring to both preconception (before pregnancy) and interconception (between pregnancies) care [9,10]. Moreover, the risk of death or disability among infants can be prevented by healthy birth outcomes and prior identification and treatment of health-related problems.…”

Section: Introductionmentioning

confidence: 99%

The Role of Health Information System in Maternal and Child Healthcare Services

Chowdhury¹,

Kumari

Panda³

2017

Asian J Pharm Clin Res

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Health information system deals with any system that helps in capturing, storing, transmitting, and managing health-related information of an individual or to demonstrate the activities or organizations working within health-care sector. In the developing countries, maternal and child health is gaining concern due to increasing cases of morbidity and mortality. The disparities among the maternal, infant, and child health are a growing concern in India and are governed by various determinants such as socioeconomic status, literacy, quality of health care, discrimination, and biological and genetic factors. Accurate and reliable health information and data are the basis for decision-making across the health-care sector and are crucial for the development and implementation of health system policy by the policy-makers. Strict monitoring and evaluation of the present program design and its implementation is required at the microlevel to effectively utilize the resources for the improvement of maternal and child health. Our present article focuses on evaluating the coverage gap at the different levels for the provision of health-care facilities to maternal, neonatal, and child health, immunization, and treatment of poor children. Big data plays a major role in providing sound and reliable health-related information and also help in managing and recording structured and unstructured data. More concrete plans are required further to reduce the inequalities in health-care interventions for providing better maternal and child health-care services in our nation.

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Coverage and timing of antenatal care among poor women in 6 Mesoamerican countries

Cited by 20 publications

References 22 publications

Timing and number of antenatal care contacts in low and middle-income countries: Analysis in the Countdown to 2030 priority countries

Timing and number of antenatal care contacts in low and middle-income countries: Analysis in the Countdown to 2030 priority countries

Effect of unintended pregnancy on skilled antenatal care uptake in Bangladesh: analysis of national survey data

The Role of Health Information System in Maternal and Child Healthcare Services

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