Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities

Magadi, Monica; Madise, Nyovani; Rodrigues, Roberto do Nascimento

doi:10.1016/s0277-9536(99)00495-5

Cited by 297 publications

(312 citation statements)

References 22 publications

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“…Although this result needs to be confirmed with more elaborate multivariate analysis, it does lend support to the vast amount of research that have shown strong linkages between education and wealth and various health outcomes. 8,27,28,32 In particular, the finding that the least educated or poorest women exhibited substantially poorer maternal health outcomes in these overall poor and resource-deprived settings is an illustration of the power of education and wealth as predictors of health in developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…This is probably due to the fact that most income-earning opportunities, the major hospitals, and a disproportionate high share of health budgets are concentrated in cities and towns. 8 Despite the vast amount of research on maternal health in Africa, [26][27][28][29] very few have focused on the urban poor. Data available from nationally representative Demographic and Health Surveys (DHS) and other population-based surveys remain largely inadequate to answer questions relevant to the growing urban poor populations.…”

Section: Poor Maternal Health Progress In Developing Countriesmentioning

confidence: 99%

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Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

2008

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In sub-Saharan Africa, the unprecedented population growth that started in the second half of the twentieth century has evolved into unparalleled urbanization and an increasing proportion of urban dwellers living in slums and shanty towns, making it imperative to pay greater attention to the health problems of the urban poor. In particular, urgent efforts need to focus on maternal health. Despite the lack of reliable trend data on maternal mortality, some investigators now believe that progress in maternal health has been very slow in sub-Saharan Africa. This study uses a unique combination of health facility-and individual-level data collected in the slums of Nairobi, Kenya to: (1) describe the provision of obstetric care in the Nairobi informal settlements; (2) describe the patterns of antenatal and delivery care, notably in terms of timing, frequency, and quality of care; and (3) draw policy implications aimed at improving maternal health among the rapidly growing urban poor populations. It shows that the study area is deprived of public health services, a finding which supports the view that low-income urban residents in developing countries face significant obstacles in accessing health care. This study also shows that despite the high prevalence of antenatal care (ANC), the proportion of women who made the recommended number of visits or who initiated the visit in the first trimester of pregnancy remains low compared to Nairobi as a whole and, more importantly, compared to rural populations. Bivariate analyses show that household wealth, education, parity, and place of residence were closely associated with frequency and timing of ANC and with place of delivery. Finally, there is a strong linkage between use of antenatal care and place of delivery. The findings of this study call for urgent attention by Kenya's Ministry of Health and local authorities to the void of quality health services in poor urban communities and the need to provide focused and sustained health education geared towards promoting use of obstetric services.

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Section: Discussionmentioning

confidence: 99%

Section: Poor Maternal Health Progress In Developing Countriesmentioning

confidence: 99%

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

2008

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“…Appropriate use of ANC could significantly improve early identification and mitigation of risk factors in pregnancy [4]. In contrast, failure to attend ANC or inadequate ANC attendance could lead to complications, exacerbate pre-existing conditions, or worsen the consequences of an unhealthy lifestyle during pregnancy [5,6]. …”

Section: Introductionmentioning

confidence: 99%

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Sakeah

Okawa

Oduro

et al. 2017

Global Health Action

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Background: Improving maternal health is a global challenge. In Ghana, maternal morbidity and mortality rates remain high, particularly in rural areas. Antenatal care (ANC) attendance is known to improve maternal health. However, few studies have updated current knowledge regarding determinants of ANC attendance. Objective: This study examined factors associated with ANC attendance in predominantly rural Ghana. Methods: We conducted a cross-sectional study at three sites (i.e. Navrongo, Kintampo, and Dodowa) in Ghana between August and September 2013. We selected 1500 women who had delivered within the two years preceding the survey (500 from each site) using two-stage random sampling. Data concerning 1497 women’s sociodemographic characteristics and antenatal care attendance were collected and analyzed, and factors associated with attending ANC at least four times were identified using logistic regression analysis. Results: Of the 1497 participants, 86% reported attending ANC at least four times, which was positively associated with possession of national health insurance (AOR 1.64, 95% CI: 1.14–2.38) and having a partner with a high educational level (AOR 1.64, 95% CI: 1.02–2.64) and negatively associated with being single (AOR 0.39, 95% CI: 0.22–0.69) and cohabiting (AOR 0.57, 95% CI: 0.34–0.97). In site-specific analyses, factors associated with ANC attendance included marital status in Navrongo; marital status, possession of national health insurance, partners’ educational level, and wealth in Kintampo; and preferred pregnancy timing in Dodowa. In the youngest, least educated, and poorest women and women whose partners were uneducated, those with health insurance were more likely to report at least four ANC attendances relative to those who did not have insurance. Conclusions: Ghanaian women with low socioeconomic status were less likely to report at least four ANC attendances during pregnancy if they did not possess health insurance. The national health insurance scheme should include a higher number of deprived women in predominantly rural communities.

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“…The important role of these elements in improving reproductive health of women is undisputed (WHO, 1989;Magadi, Madise and Rodrigues, 2000). Furthermore, several studies have shown the importance of providing health care services to mothers during and after pregnancy (Ben Yousssef and Wessen, 1974;Abbas and Walker, 1986;Kwast et al, 1986;Obermeyer and Potter, 1991;Bhatia, 1993).…”

Section: Introductionmentioning

confidence: 99%

Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach

Sunil

Rajaram²,

Zottarelli

2006

Social Science & Medicine

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Current studies on the utilization of maternal care services in India focus on individual factors. In the present study, we use the theoretical model developed by Andersen and Newman (1973) to understand the utilization of maternal care services in rural areas of India. This theoretical model accommodates individual, and program (or system factors) to study health care utilization. Data collected through the National Family Health Survey-2 are used in the present study. The study results suggest that in addition to individual characteristics, program and system factors influence the utilization of maternal care in rural areas. Program factors, particularly educational activities promoting the benefits of maternal care services carried out through Mahila Mandal and Anganwadi Centers, are important in increasing the use of maternal care services in rural areas. Additionally, the results indicate that the mere presence of a private health care facility need not necessarily improve utilization. Increase in utilization is observed among households if the health worker visited these households during pregnancy. More statespecific studies incorporating both program and individual characteristics are recommended to further strengthen our understanding of the utilization of health care services in general and maternal care services specifically.

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Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities

Cited by 297 publications

References 22 publications

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

Provision and Use of Maternal Health Services among Urban Poor Women in Kenya: What Do We Know and What Can We Do?

Determinants of attending antenatal care at least four times in rural Ghana: analysis of a cross-sectional survey

Do individual and program factors matter in the utilization of maternal care services in rural India? A theoretical approach

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