Factors influencing institutional delivery and the role of accredited social health activist (ASHA): a secondary analysis of India human development survey 2012

Paul, Pooja L.; Pandey, Shanta

doi:10.1186/s12884-020-03127-z

Cited by 22 publications

(30 citation statements)

References 42 publications

(46 reference statements)

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“…Women who make decisions on their healthcare utilization alone or jointly with the spouse had signi cantly higher chances of getting more components than those whose spouses are the only decision-maker of the women's health care. Our nding is in agreement with existing literature [39,42,44].…”

Section: Discussionsupporting

confidence: 94%

“…Similarly, there is a higher likelihood of receiving all components among pregnant women aged 40 to 49 years relative to those aged 15 to 19 years just as those from households in the wealthiest quintile had higher chances of receiving complete ANC components. Although education mediates in choice of place of ANC services [39,42], and more educated women are more likely to belong to households in wealthier quintiles [27] and initiate ANC earlier [31,43], it is not certain if different categories of women attending the same facility received different components based on their educational status. This will require further studies.…”

Section: Discussionmentioning

confidence: 99%

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A Multilevel Bayesian Markov Chain Monte Carlo Poisson Modelling of Factors Associated With Number of Components of Antenatal Care Offered Pregnant Women In Nigeria

Fagbamigbe

Olaseinde

et al. 2021

Preprint

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Background: The most recent WHO guideline on antenatal care (ANC) utilization reaffirmed the necessary and compulsory care and services a pregnant woman should receive to maximize the importance and gains of ANC. While most studies focused on the time of initiation and number of ANC contacts, emphasis was rarely placed on the components of ANC offered women. This study assessed the number of components of ANC received by pregnant women as a proxy for the quality of ANC services offered in Nigeria. We also assessed the clustering of the components and within-country differentials and inequalities in the components of ANC received in Nigeria.Methods: We used nationally representative cross-sectional data from the 2018 Nigeria Demographic Health Survey. We analysed data of 11867 women who had at least one ANC contacts during the most recent pregnancy within five years preceding the survey. The assessed components were tetanus injection, blood pressure, urine test, blood test, iron supplement, malaria intermittent preventive treatment in pregnancy (IPTp), and told about danger signs. Others are intestinal parasite drugs (IPD)intermittent and HIV/PMTCT counsel. Descriptive statistics, bivariable and multivariable multilevel Bayesian Monte Carlo Poisson model were used. Results: In all, 94% had blood pressure measured, 91% received tetanus injection, had iron supplement-89%, blood test-87%, urine test-86%, IPTp-24%, danger signs-80%, HIV/PMTC-82% and IPD-22%. The overall prevalence of receiving all 9 components was 5% and highest in Ogun (24%) and lowest in Kebbi (0.1%). The earlier the initiation of ANC, the higher the number of contacts, and the higher the quality of ANC received. Respondents with higher education have 4% (adjusted incidence risk ratio (aIRR): 1.04, 95% credible interval (CrI): 1.01-1.09) higher risk of receiving more components of ANC relative to those with no education. The risk of receiving more ANC components were 5% (aIRRR: 1.05, 95% CI: 1.01-1.10) higher among pregnant women aged 40 to 49 years than those aged 15 to 19 years. Women who decide their healthcare utilization alone had 2% higher risk of getting more components than those whose spouses are the only decision taker of health care use. Other significant factors were household wealth status, spouse education, ethnicity, place of ANC, and skill of ANC provider. Pregnant women who had their blood pressure measured were very likely to have blood and urine tests, tetanus injection, iron supplement, and HIV talks.Conclusions: Only one in every 20 pregnant women received all the 9 ANC components with wide disparities and inequalities across the background characteristics and the States of residence in Nigeria. There is a need to ensure that all pregnant women receive adequate components. Stakeholders should increase supplies, train, and create awareness among ANC providers and pregnant women in particular.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

A Multilevel Bayesian Markov Chain Monte Carlo Poisson Modelling of Factors Associated With Number of Components of Antenatal Care Offered Pregnant Women In Nigeria

Fagbamigbe

Olaseinde

et al. 2021

Preprint

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“…Mothers who had a lot of media exposure had a higher chance of giving birth in a hospital. Prior research in Nigeria ( 43) Bangladesh ( 44) India (45). The possible reason is that health information may improve health-seeking habits via various electronic and print media, as information about what services are available, where and when to get them, as well as the bene ts and risks of accessing speci c services, can be communicated via such media(46)…”

Section: Discussionmentioning

confidence: 99%

Spatial Pattern And Determinants of Institutional Delivery in Ethiopia: Spatial and Multilevel Analysis Using 2019 Ethiopian Mini Demographic and Health Survey.

Dirirsa¹,

Jemal²

2021

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Background: In Ethiopia, despite the progress that has been made to improve maternal and child health, the proportion of births occurring at health institutions is still very low (26%), Which significantly contribute to a large number of maternal death 412 deaths/100,000 live births. Therefore, this study intended to determine spatial pattern and factors affecting institutional delivery among women who had live birth in Ethiopia within five years preceding survey.Method: Data from 2019 mini Ethiopian demographic and health survey were used. Taking into account the nested structure of the data, multilevel logistic regression analysis has been employed to a nationally representative sample of 5753 women nested with in 305 communities/clusters.Result: A significant heterogeneity was observed between clusters for institutional delivery which explains about 57% of the total variation. Individual-level variables: primary education (OR= 1.8: 95% CI: 1.44-2.26), secondary education (OR= 3.65: 95% CI: 2.19- 6.1), diploma and higher (OR= 2.74: 95% CI: 1.02 – 7.34), women who had both Radio and Television were 4.6 times (OR= 4.6; 95% CI: 2.52, 8.45), four and above Antenatal visit (AOR=2.72 ,95% CI:2.2, 3.34), rich wealth index (OR= 2.22; 95% CI: 1.62- 2.99), birth interval for 18 to 33 months (OR= 1.8; 95% CI: 1.19, 2.92), and women who space birth for 33 and above months (OR= 2.02; 95% CI: 1.3, 3.12) were associated with institutional delivery. Community level variables, community high proportion of antenatal visit (OR= 4.68; 95% CI: 4.13- 5.30), and Region were associated with institutional deliveryConclusion: A clustered pattern of areas with low institutional delivery was observed in Ethiopia. Both individual and community level factors found significantly associated with institutional delivery theses showed the need for community women education through health extension programs and community health workers. And the effort to promote institutional delivery should pay special attention to antenatal care, less educated women and interventions considering awareness, access, and availability of the services are vital for regions.

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“…"They only come to me to get tested when they have missed their periods for two to three months. Most of the women do not remember their LMP 3 date" (unqualified practitioner-JJ 4 ) The preference for ANC registration at formal health facility varied with education, income, age, and parity. The registration rate was higher in the notified slum and two thirds of the pregnant women registered at a public health facility or private facility for ANC.…”

Section: Variation In Health Seeking Behaviourmentioning

confidence: 99%

“…2 Literature shows that complications during delivery and poor perinatal outcome is mostly associated with nonutilization of antenatal, 1,2 and intrapartum services. 3,4 Also, utilization of ANC services is associated with increase in the probability of institutional delivery. A lot of research has been undertaken to understand the factors affecting the utilization of maternal health services in the rural areas but few exploring the urban poor.…”

Section: Introductionmentioning

confidence: 99%

Factors shaping decisions to utilize maternal health services among the urban poor of south Delhi: A longitudinal case study

Singh¹

2020

JCHM

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Background: Ending preventable maternal mortality remains one of the most critical challenges despite significant progress over past decades. Maternal mortality remains high and the burden of death is disproportionately higher among the marginalized population. Contrary to the view that those residing in urban areas have better access to quality health services, the health outcomes of the urban poor are not better than rural communities. Data on urban poor are concealed within urban averages, and few studies provide disaggregated data on spatial dimensions of population in urban areas. Aims: The study was conducted to understand variations and factors responsible for decisions to seek healthcare services for maternal healthcare. Materials and Methods: The study was conducted using qualitative case study design and qualitative data were collected from fifty pregnant women enrolled from two slums of south Delhi after informed consent. The slums were revisited twice after a gap of two/three years to understand changes in maternal health seeking behaviour of the communities. Data were analyzed using grounded theory methodology. Results: The maternal health seeking behaviour among urban poor is determined by structural inequalities, predisposing factors of individuals including age, income, education, and parity. Other factors that had a bearing on their decision to seek care included legal status of the slums, and its inhabitants. Incremental changes in health seeking behaviour overtime was observed due to government policies/programs implemented to benefit the poor. Conclusions: It is essential to build a sensitive and responsive health system that is acceptable to the most marginalized to enhance access to health services. Key Messages: Understanding factors contributing to urban poor seek maternal health care services is necessary to build a sensitive and responsible heath system that is acceptable to the most marginalized and will ensure its use.

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Factors influencing institutional delivery and the role of accredited social health activist (ASHA): a secondary analysis of India human development survey 2012

Cited by 22 publications

References 42 publications

A Multilevel Bayesian Markov Chain Monte Carlo Poisson Modelling of Factors Associated With Number of Components of Antenatal Care Offered Pregnant Women In Nigeria

A Multilevel Bayesian Markov Chain Monte Carlo Poisson Modelling of Factors Associated With Number of Components of Antenatal Care Offered Pregnant Women In Nigeria

Spatial Pattern And Determinants of Institutional Delivery in Ethiopia: Spatial and Multilevel Analysis Using 2019 Ethiopian Mini Demographic and Health Survey.

Factors shaping decisions to utilize maternal health services among the urban poor of south Delhi: A longitudinal case study

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