Effect of complete adherence to antenatal care guideline during first visit on maternal and neonatal complications during the intrapartum and postpartum periods: a prospective cohort study in Northwest Ethiopia

Seyoum, Tewodros; Alemayehu, Mekuriaw; Christensson, Kyllike; Lindgren, Helena

doi:10.1136/bmjopen-2021-049271

Cited by 3 publications

(2 citation statements)

References 34 publications

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“…A study that assessed the impact of implementing the 2016 WHO recommendations on antenatal care in South Africa revealed a 5.8% absolute decrease in stillbirths with the implementation of the recommendations [15]. A study conducted in Ethiopia showed that complete providers' adherence to the recommendations during antenatal care was significantly associated with a decrease in neonatal complications [16]. Finally, a study in Uganda showed that having four or more antenatal visits reduced the odds of stillbirth, early neonatal death, low birth weight, and a 5-minute Apgar score of less than seven [17].…”

Section: Introductionmentioning

confidence: 99%

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Muwema,

Nankabirwa,

Edwards

et al. 2024

BMC Pregnancy Childbirth

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Background Provision of effective care to all women and newborns during the perinatal period is a viable strategy for achieving the Sustainable Development Goal 3 targets on reducing maternal and neonatal mortality. This study examined perinatal care (antenatal, intrapartum, postpartum) and its association with perinatal deaths at three district hospitals in Bunyoro region, Uganda. Methods A cross-sectional study was conducted in which a questionnaire was administered consecutively to 872 postpartum women before discharge who had attended antenatal care and given birth in the study hospitals. Data on care received during antenatal, labour, delivery, and postpartum period, and perinatal outcome were extracted from medical records of the enrolled postnatal women using a pre-tested structured tool. The care received from antenatal to 24 h postpartum period was assessed against the standard protocol of care established by World Health Organization (WHO). Poisson regression was used to assess the association between care received and perinatal death. Results The mean age of the women was 25 years (standard deviation [SD] 5.95). Few women had their blood tested for hemoglobin levels, HIV, and Syphilis (n = 53, 6.1%); had their urine tested for glucose and proteins (n = 27, 3.1%); undertook an ultrasound scan (n = 262, 30%); and had their maternal status assessed (n = 122, 14%) during antenatal care as well as had their uterus assessed for contraction and bleeding during postpartum care (n = 63, 7.2%). There were 19 perinatal deaths, giving a perinatal mortality rate of 22/1,000 births (95% Confidence interval [CI] 8.1–35.5). Of these 9 (47.4%) were stillbirths while the remaining 10 (52.6%) were early neonatal deaths. In the antenatal phase, only fetal examination was significantly associated with perinatal death (adjusted prevalence ratio [aPR] = 0.22, 95% CI 0.1–0.6). No significant association was found between perinatal deaths and care during labour, delivery, and the early postpartum period. Conclusion Women did not receive all the required perinatal care during the perinatal period. Perinatal mortality rate in Bunyoro region remains high, although it’s lower than the national average. The study shows a reduction in the proportion of perinatal deaths for pregnancies where the mother received fetal monitoring. Strategies focused on strengthened fetal status monitoring such as fetal movement counting methods and fetal heart rate monitoring devices during pregnancy need to be devised to reduce the incidence of perinatal deaths. Findings from the study provide valuable information that would support the strengthening of perinatal care services for improved perinatal outcomes.

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Section: Introductionmentioning

confidence: 99%

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Muwema,

Nankabirwa,

Edwards

et al. 2024

BMC Pregnancy Childbirth

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“…Proper use of antenatal care (ANC) service remains a cost-effective intervention in the reduction of maternal and child mortality and morbidities due to pregnancy and childbirth complications [ 4 , 5 ]. Complete adherence to the World Health Organization's (WHO) ANC recommendations was also linked with decreased risk of neonatal complications [ 6 ]. Although ANC alone contributes to a 20% reduction in maternal mortality [ 7 ], adherence to timing and number of visits in developing countries is low [ 8 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Nonadherence to WHO’s Recommended Antenatal Care Visits among Women in Pastoral Community, Northeastern Ethiopia: A Community-Based Cross-Sectional Study

Mare

Wuneh

Awol

et al. 2022

Nursing Research and Practice

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Introduction. More than half of the pregnant women in Ethiopia do not receive the recommended number of antenatal care visits. In the Afar region, where women have limited access to healthcare services due to pastoral livelihood, evidence on noncompliance to the adequate number of antenatal care visits is scarce. Therefore, this study was intended to examine the level of nonadherence to the recommended antenatal care visits and its associated factors in the pastoral community of Northeast Ethiopia. Methods. A community-based cross-sectional study was conducted from 04 February to 22 March 2020 among randomly selected 703 women who gave birth within 24 months preceding the survey in the Transform HDR districts of the Afar region. Data were collected using a pretested structured interviewer-administered questionnaire. Data were entered into Epi-data version 4.2 and finally exported to Stata version 16 for further analysis. Bivariable and multivariable binary logistic regression analyses were done to identify factors affecting the nonadherence to the recommended antenatal care visits. Odds ratio with the corresponding 95% confidence interval were computed and the statistical significance of the explanatory variables was declared at a p -value <0.05. Results. Nonadherence to the recommended antenatal care visits was 57.0% (95% CI: 53.3%–60.7%). Attending primary (AOR (95% CI): 0.39 (0.22–0.72)) and secondary education and above (AOR (95% CI): 0.25 (0.08–0.77)), being married at the age of 18 years or older (AOR (95% CI): 0.48 (0.36–0.71)), and attending antenatal care at a health center (AOR (95% CI): 0.46 (0.26–0.81)) were associated decreased odds of nonadherence to the recommend visits. Moreover, a higher likelihood of nonadherence was found among women from households not possessing communication media (AOR (95% CI): 1.85 (1.18–2.88)) and those who initiated antenatal care attendance during the second (AOR (95% CI): 5.23 (3.54–7.72)) and third trimesters (AOR (95% CI): 8.81 (1.88–41.20)). Conclusions. Nearly six in ten women do not receive the recommended antenatal care visits, consistent with the national prevalence. Women’s education, age at marriage, type of health facility, possession of mass media, and timing of antenatal care attendance were associated with nonadherence to the recommended antenatal care visits. Thus, improving women’s literacy, dissemination of information regarding antenatal care through mass media, and strengthening interventions targeted to end child marriage are important in scaling up the level of adherence. Moreover, supporting community-based health education through health extension programs is crucial in reaching women with limited access to mass media.

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Intention to Use Eight Antenatal Care Model and Associated Factors Among Pregnant Women Who Come for Antenatal Care in Northwest of Amhara Region Referral Hospitals, Ethiopia, 2021

Semaw

Kebede

Admassu

et al. 2023

Preprint

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Background:Maternal and perinatal mortality is highly associated with four or fewer antenatal care (ANC) visit. Due to this, WHO develop a new model called minimum of eight antenatal care (ANC8+) contact. This model is used to re- think and re- design the service through context specific expectations. Besides, the model is beyond survival, aim to maximize health and wellbeing of women even at post pregnancy motherhood, and social health of the family and community at large. Since shortage of related studies in Ethiopia so far, this study aim to address those gaps. Objective:To assess intention to use ANC8+ model and associated factors among pregnant women who come for antenatal care contact in Northwest of Amhara region referral hospitals, Ethiopia, 2021. Method:An institution-based cross-sectional study was conducted from September 1st to October 30th, 2021 in Northwest of Amhara regional state referral hospitals. A multistage sampling technique was used to select 847 eligible women. A structured, pretested, and interviewer-administered questionnaire was employed. EPI data version 4.6 and SPSS version 23 were used for data entry and analysis, respectively. Binary logistic regression model was fitted to identify factors associated with pregnant women intention to use ANC8+ model. A p-value of ≤ 0.05 was used to declare statistical association in the last model. Result:Overall, 739 (88.8%, 95% CI: 86.68, 90.97) women had the intention to use ANC8+. Pregnant women in the age group between 20 to 30 years (AOR = 19.84, 95% CI: 3.01, 130.64), and ≥ 31 years (AOR = 3.92, 95% CI: 1.79, 8.58), being farmer in occupation (AOR = 0.13, 95% CI: 0.04, 0.43), government employee (AOR = 5.58, 95% CI: 1.64, 18.97), good attitude (AOR = 38.76, CI 5.99, 250.73), positive subjective norm (AOR = 10.83, 95% CI: 4.36, 26.92) and perceived behavioral control (AOR = 8.98, 95% CI: 3.26, 24.71) were factors associated with women’s intention to use ANC8+. Conclusion:More than four-fifths of the pregnant women had intention to use ANC8+. Increase in age, being the government employee , having good attitude, positive subjective norm and perceived behavioral control were positively, while being a farmer negatively associated to intention to use ANC8+ contact. Therefore, empowering women, developing socio cultural integrity with the health system through health education and trainings to local health cadres and community leaders would possibly increase the intention of using ANC8+.

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Effect of complete adherence to antenatal care guideline during first visit on maternal and neonatal complications during the intrapartum and postpartum periods: a prospective cohort study in Northwest Ethiopia

Cited by 3 publications

References 34 publications

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Factors Affecting Nonadherence to WHO’s Recommended Antenatal Care Visits among Women in Pastoral Community, Northeastern Ethiopia: A Community-Based Cross-Sectional Study

Intention to Use Eight Antenatal Care Model and Associated Factors Among Pregnant Women Who Come for Antenatal Care in Northwest of Amhara Region Referral Hospitals, Ethiopia, 2021

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