Health-related quality of life determinants among Rwandan women after delivery: does antenatal care utilization matter? A cross-sectional study

Abstract

BackgroundDespite the widespread use of antenatal care (ANC), its effectiveness in low-resource settings remains unclear. In this study, self-reported health-related quality of life (HRQoL) was used as an alternative to other maternal health measures previously used to measure the effectiveness of antenatal care.The main objective of this study was to determine whether adequate antenatal care utilization is positively associated with women’s HRQoL. Furthermore, the associations between the HRQoL during the first year (1–13 months) after delivery and socio-economic and demographic factors were explored in Rwanda.MethodsIn 2014, we performed a cross-sectional population-based survey involving 922 women who gave birth 1–13 months prior to the data collection. The study population was randomly selected from two provinces in Rwanda, and a structured questionnaire was used.HRQoL was measured using the EQ-5D-3L and a visual analogue scale (VAS). The average HRQoL scores were computed by demographic and socio-economic characteristics. The effect of adequate antenatal care utilization on HRQoL was tested by performing two multivariable linear regression models with the EQ-5D and EQ-VAS scores as the outcomes and ANC utilization and socio-economic and demographic variables as the predictors.ResultsAdequate ANC utilization affected women’s HRQoL when the outcome was measured using the EQ-VAS. Social support and living in a wealthy household were associated with a better HRQoL using both the EQ-VAS and EQ-5D. Cohabitating, and single/unmarried women exhibited significantly lower HRQoL scores than did married women in the EQ-VAS model, and women living in urban areas exhibited lower HRQoL scores than women living in rural areas in the ED-5D model. The effect of education on HRQoL was statistically significant using the EQ-VAS but was inconsistent across the educational categories. The women’s age and the age of their last child were not associated with their HRQoL.ConclusionsANC attendance of at least four visits should be further promoted and used in low-income settings. Strategies to improve families’ socio-economic conditions and promote social networks among women, particularly women at the reproductive age, are needed.

Postpartum Health-Related Quality of Life Among Mothers: An Analytical Cross-Sectional Study in a Tertiary Care Hospital of Rawalpindi

“…A statistical significant difference was found in domains of EWB and GH among women who had done four to six antenatal visits. This result showed congruency with a study conducted by Hitimana et al, concluding that women who had at least 4 ante natal visits had better HRQOL after delivery 15 . Women whose husbands were educated had better HRQOL in domains of RLPH, RLEH and GH in postpartum period.…”

Health‐related quality of life among Ethiopian pregnant women during COVID‐19 pandemic

“…The mean score of WHOQOL‐BREF for those women on second trimester was highest and significantly different from the score of those women who were on first and third trimester. This finding was in agreement with previous study (Hitimana et al., 2018) and inconsistent with others (Lagadec et al., 2018; Mazúchová et al., 2018) in which women at early pregnancy had scored best on quality of life scale. This may be due to the fact that factors like increased weight gain and concern about labor during third trimester and temporary symptoms like nausea and vomiting at the time of first trimester could affect the quality of life among pregnant mothers (Zarajczyk, 2019).…”

Incremental cost and health gains of the 2016 WHO antenatal care recommendations for Rwanda: results from expert elicitation

“…Another limitation is that this study limited the consideration of health gains to maternal and perinatal mortality. In a previous study, we found evidence that health-related quality of life 1 year postpartum was positively associated with adequate ANC utilisation [52]. Other studies have similarly shown that the benefits of ANC extend beyond mortality to a reduction in maternal morbidity, women’s life satisfaction [4], children’s health status [6], and control of other diseases such as malaria and HIV.…”