Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi

Stewart, Catherine Louise; Hall, Jennifer

doi:10.1371/journal.pone.0279613

Cited by 7 publications

(9 citation statements)

References 65 publications

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“…Therefore, the utilization of care continuity needs to be strengthened. A long distance to a health facility [ 50 ], the mother’s low education level [ 23 , 28 , 30 , 31 ], the partner’s low education level [ 48 ], less participation of women in decision-making [ 48 ], economic restrictions [ 24 , 26 – 29 ], and a lack of knowledge regarding ANC [ 51 ] prevent mothers from utilizing ANC. A delay in a first ANC visit also contributes to less frequency of ANC visits [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, this low percentage in our study suggested that health care providers did not sufficiently educate mothers on the importance of delivery with an SBA during ANC. There are also other reasons why women avoid delivery with an SBA or institutional delivery, such as economic restrictions [ 24 , 26 – 29 ] and a long distance to a health facility [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Utilization of health services is hampered by rural residence, a long distance from health facilities, low literacy and education background of mothers, and younger age of mothers in Angola [ 23 ]. Other factors are the experience of miscarriage [ 24 ], parity [ 25 ], women’s and/or household’s wealth [ 24 , 26 – 29 ], women’s or parents’ education [ 23 , 28 , 30 , 31 ], birth plan [ 24 , 28 ], ethnicity [ 28 , 30 ], and sex of the healthcare providers [ 27 ] as reported from African countries. However, mothers who use ANC services are more likely to re-visit to receive care [ 26 , 27 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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Continuum of care for maternal and child health and child undernutrition in Angola

Saito,

Kondo

2024

BMC Public Health

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Background Continuum of care (CoC) for maternal and child health provides opportunities for mothers and children to improve their nutritional status, but many children remain undernourished in Angola. This study aimed to assess the achievement level of CoC and examine the association between the CoC achievement level and child nutritional status. Methods We used nationally representative data from the Angola 2015–2016 Multiple Indicator and Health Survey. Completion of CoC was defined as achieving at least four antenatal care visits (4 + ANC), delivery with a skilled birth attendant (SBA), child vaccination at birth, child postnatal check within 2 months (PNC), and a series of child vaccinations at 2, 4, 6, 9 and 15 months of child age. We included under 5 years old children who were eligible for child vaccination questionnaires and their mothers. The difference in CoC achievement level among different nutritional status were presented using the Kaplan-Meier method and examined using the Log-Lank test. Additionally, the multivariable logistic regression analysis examined the associations between child nutritional status and CoC achievement levels. Results The prevalence of child stunting, underweight and wasting was 48.3%, 23.2% and 5.9% respectively. The overall CoC completion level was 1.2%. The level of achieving CoC of mother-child pairs was 62.8% for 4 + ANC, 42.2% for SBA, 23.0% for child vaccination at birth, and 6.7% for PNC, and it continued to decline over 15 months. The Log-Lank test showed that there were significant differences in the CoC achievement level between children with no stunting and those with stunting (p < 0.001), those with no underweight and those with underweight (p < 0.001), those with no wasting and those with wasting (p = 0.003), and those with malnutrition and those with a normal nutritional status (p < 0.001). Achieving 4 + ANC (CoC1), 4 + ANC and SBA (CoC 2), and 4 + ANC, SBA, and child vaccination at birth (CoC 3) were associated with reduction in child stunting and underweight. Conclusions The completion of CoC is low in Angola and many children miss their opportunity of nutritional intervention. According to our result, improving care utilization and its continuity could improve child nutritional status.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Continuum of care for maternal and child health and child undernutrition in Angola

Saito,

Kondo

2024

BMC Public Health

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“…A unique finding in our study was the lack of guidance and proper follow-up and management of orphaned babies and a mother without a living baby; there is a need to provide guidance and training on how to manage these subgroups so that their care is not compromised. There is limited literature on this aspect however a previous study conducted in Malawi on the overall utilization of maternity services showed that women who had a miscarriage were less likely to use health services [ 29 ]. This area requires more research so that the experiences of such women and babies are unearthed for optimal and inclusive strategies.…”

Section: Discussionmentioning

confidence: 99%

Uptake of, barriers and enablers to the utilization of postnatal care services in Thyolo, Malawi

Nyondo-Mipando

Chirwa

Kumitawa

et al. 2023

BMC Pregnancy Childbirth

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Background Postnatal care (PNC) ensures early assessments for danger signs during the postpartum period and is to be provided within 24 h of birth, 48–72 h, 7–14 days, and six weeks after birth. This study assessed the uptake of and the barriers and facilitators to receiving PNC care among mothers and babies. Methods A concurrent mixed-method study employing a retrospective register review and a qualitative descriptive study was conducted in Thyolo from July to December 2020. Postnatal registers of 2019 were reviewed to estimate the proportion of mothers and newborns that received PNC respectively. Focus Group Discussions (FGDs) among postnatal mothers, men, health care workers, and elderly women and in-depth interviews with midwives, and key health care workers were conducted to explore the barriers and enablers to PNC. Observations of the services that mothers and babies received within 24 h of birth, at 48–72 h, 7–14 days, and six weeks after birth were conducted. Descriptive statistics were tabulated for the quantitative data using Stata while the qualitative data were managed using NVivo and analysed following a thematic approach. Results The uptake of PNC services was at 90.5%, 30.2%, and 6.1% among women and 96.5%, 78.8%, and 13.7% among babies within 48 h of birth, 3 to 7 and 8 to 42 days respectively. The barriers to PNC services included the absence of a baby or mother, limited understanding of PNC services, lack of male involvement, and economic challenges. Cultural and religious beliefs, advice from community members, community activities, distance, lack of resources, and poor attitude of health care workers also impeded the utilisation of PNC services. The enablers included the mother’s level of education, awareness of the services, economic resources, community-based health support, adequacy and attitude of health workers, seeking treatment for other conditions, and other clinic activities. Conclusion Optimisation of uptake and utilization of PNC services for mothers and neonates will require the involvement of all stakeholders. The success of PNC services lies in the communities, health services, and mothers understanding the relevance, time points, and services that need to be delivered to create demand for the services. There is a need to assess the contextual factors for a better response in improving the uptake of PNC services and in turn inform the development of strategies for optimizing the uptake of PNC services.

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“…The ensuing factors have been pointed out as contributors to an increase in the utilization of ANC and SBD services: encouraging females/girls' education [71,113], peer influence, spousal involvement/support in MHC partner education [58,71], partner educator [113,172], education monitoring strategies, unpleasant pregnancy history, employment, media, religion, and pregnancy preparedness. In Uganda, Guinea, Malawi and Ethiopia, studies in these aforementioned countries by Atuhaire et al, Atuoye et al, Stewart et al, and Tareke et al discovered that having decision-making power to visit a health facility, financial independence and easy access to the health facilities were directly linked with ANC and SBD utilization services [56,119,164,180]. • Staffing of medical personnel: nurses, midwives and doctors in a health facility.…”

Section: Determinant Of Anc and Sbd Servicesmentioning

confidence: 99%

Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review

Lateef,

Kuupiel,

Mchunu

et al. 2024

IJERPH

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Daily, the number of women who die around the world reaches an average of 800; these deaths are a result of obstetric complications in pregnancy and childbirth, and 99% of these deaths occur in low- and middle-income countries. This review probes the use of antenatal care (ANC) and skilled birth delivery (SBD) services in sub-Saharan Africa (SSA) and highlights research gaps using Arksey and O’Malley’s methodological approach. The screening of abstracts and full text was carried out by two independent authors who ensured the eligibility of data extraction from the included articles. An exploration of the data was undertaken with descriptive analyses. In total, 350 potentially eligible articles were screened, and 137 studies were included for data extraction and analysis. From the 137 included studies, the majority were from Ethiopia (n = 40, 29.2%), followed by Nigeria (n = 30, 21.9%). Most of the studies were published between 2019 and 2023 (n = 84, 61%). Significant trends and challenges with ANC and SBD services emerged from the studies. It is revealed that there are wide gaps in the utilization of ANC and SBD services. Policy attention, intervention strategies to improve access, resources, rural–urban disparity, and women’s literacy are recommended to improve the utilization of ANC and SBD services in SSA countries.

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Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi

Cited by 7 publications

References 65 publications

Continuum of care for maternal and child health and child undernutrition in Angola

Continuum of care for maternal and child health and child undernutrition in Angola

Uptake of, barriers and enablers to the utilization of postnatal care services in Thyolo, Malawi

Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review

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