Integrating Water Treatment into Antenatal Care: Impact on Use of Maternal Health Services and Household Water Treatment by Mothers—Rural Uganda, 2013

Matanock, Almea; Anderson, Tara; Ayers, Tracy; Likicho, Lilian; Wamimbi, Richard; Lu, Xin; Emeetai, Thomas; Kakande, Celia; Mutabazi, Miriam; Quick, Robert

doi:10.4269/ajtmh.15-0356

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…8,43 A similar study in Uganda found only a modest increase in confirmed water treatment and no change in maternal health service use, perhaps in response to a water treatment product that was not a sufficiently desirable incentive to motivate pregnant women to attend clinic. 44 In contrast to water treatment, we found that most households had soap for handwashing at baseline, and observed a statistically significant increase from baseline to follow-up only in the percentage of mothers able to demonstrate correct handwashing technique. Similar results were observed in studies in Malawi and Kenya.…”

Section: Discussioncontrasting

confidence: 58%

Impact of the Integration of Water Treatment, Hygiene, Nutrition, and Clean Delivery Interventions on Maternal Health Service Use

Fagerli

O’Connor

Kim

et al. 2017

The American Society of Tropical Medicine and Hygiene

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Reducing barriers associated with maternal health service use, household water treatment, and improved hygiene is important for maternal and neonatal health outcomes. We surveyed a sample of 201 pregnant women who participated in a clinic-based intervention in Kenya to increase maternal health service use and improve household hygiene and nutrition through the distribution of water treatment products, soap, protein-fortified flour, and clean delivery kits. From multivariable logistic regression analyses, the adjusted odds of ≥ 4 antenatal care (ANC4+) visits (odds ratio [OR] = 3.0, 95% confidence interval [CI] = 1.9-4.5), health facility delivery (OR = 5.3, 95% CI = 3.4-8.3), and any postnatal care visit (OR = 2.8, 95% CI = 1.9-4.2) were higher at follow-up than at baseline, adjusting for demographic factors. Women who completed primary school had higher odds of ANC4+ visits (OR = 1.8, 95% CI = 1.1-2.9) and health facility delivery (OR = 4.2, 95% CI = 2.5-7.1) than women with less education. For women who lived ≤ 2.5 km from the health facility, the estimated odds of health facility delivery (OR = 2.4, 95% CI = 1.5-4.1) and postnatal care visit (OR = 1.6, 95% CI = 1.0-2.6) were higher than for those who lived > 2.5 km away. Compared with baseline, a higher percentage of survey participants at follow-up were able to demonstrate proper handwashing ( = 0.001); water treatment behavior did not change. This evaluation suggested that hygiene, nutritional, clean delivery incentives, higher education level, and geographical contiguity to health facility were associated with increased use of maternal health services by pregnant women.

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Section: Discussioncontrasting

confidence: 58%

Impact of the Integration of Water Treatment, Hygiene, Nutrition, and Clean Delivery Interventions on Maternal Health Service Use

Fagerli

O’Connor

Kim

et al. 2017

The American Society of Tropical Medicine and Hygiene

Self Cite

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“…While there are conceivable linkages between WASH and MCH services, there are few reports addressing potential benefits and challenges of integrated programming. A few, mostly small, intervention studies examined the usage of antenatal service as an entry to other public health interventions, including water treatment and hygiene education [ 13 ], or HIV testing and treatment [ 13 , 15 ]. Future operational research is needed to reveal potential benefits and challenges of integrated WASH and MCH programming.…”

Section: Discussionmentioning

confidence: 99%

“…While research has demonstrated the importance of water, sanitation, and hygiene (WASH) for maternal and child health (MCH) [ 11 , 12 ], access to improved water and sanitation facilities and use of basic MCH health services have rarely been considered together. Recently, a handful of programs that aimed to increase women’s use of antenatal care services also included water treatment [ 13 ] and hygiene education [ 14 , 15 ], pointing towards potential opportunities for MCH and WASH integrated intervention strategies in resource constraint setting.…”

Section: Introductionmentioning

confidence: 99%

Improved Water, Sanitation and Utilization of Maternal and Child Health Services in South Asia—An Analysis of Demographic Health Surveys

Omidakhsh

Ehrenstein

2021

IJERPH

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Globally, many millions of people still lack access to safe drinking water and sanitation facilities. Here, we examined whether household availability of improved drinking water and sanitation, respectively, is associated with utilization of maternal and child health (MCH) services in South Asia. Demographic and Health Survey population-based data from Bangladesh, Nepal, India, and Pakistan were used, restricted to women with a child aged 0–36 months (n = 145,262). Types of households’ water source and sanitation facilities were categorized based on the World Health Organization and UNICEF’s definitions of “improved” and “unimproved”. We applied logistic regressions to estimate odds ratios (OR) and 95% confidence intervals (CI) for improved water and sanitation, respectively, in relation to reported antenatal care visits, having a skilled attendant at birth, and infant vaccination coverage, stratified by maternal education. Among lower educated women, access to improved water was associated with greater ORs for presence of a skilled attendant at delivery and their children having up-to-date immunizations (OR: 1.29; 95% CI: 1.17, 1.42). Among lower and higher educated women, improved sanitation (vs. unimproved) was associated with greater ORs for having had adequate antenatal care visits (OR: 1.74; 95% CI: 1.62, 1.88; OR: 1.71; 95% CI: 1.62, 1.80), and similarly for having had a skilled attendant at birth, and children with up-to-date immunizations. MCH services and water/sanitation should be addressed across sectors aiming at improvement of MCH.

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“…According to the decision tree analysis, hand-washing was the most important factor in the first year of the intervention. According to the results of a previous study in Uganda, while sanitary education had a significant effect on 4 + ANC services among reproductive women, hand-washing did not [29]. We presented health education detailing the infection risks to newborns simultaneously with hand-washing education.…”

Section: Discussionmentioning

confidence: 99%

“…Enabling factor variables were selected, including promotion by radio broadcasting, source of MCH awareness (such as a community leader, signboard, radio, etc. ), distance to the health facility, RECO activities, type of delivery, and hand-washing practice [23272829]. This study selected the independent variable from among need factors such as frequency of childbirth, abortion, hand-washing, awareness of the importance of exclusive breastfeeding, ANC, delivery at health facilities, satisfaction with the services at the health facilities, and satisfaction with the health facility setting [7203031].…”

Section: Methodsmentioning

confidence: 99%

The Impact of the Interventions for 4+ Antenatal Care Service Utilization in the Democratic Republic of Congo: A Decision Tree Analysis

Lee

Park

Ndombi

et al. 2019

Annals of Global Health

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Background:In 2015, the United Nations set the sustainable development goals (SDGs) with a focus on the maternal mortality ratio (MMR), to decrease the mortality rate of newborns to 70 per 100,000 by 2030. Despite efforts to achieve the SDGs, the MMR in the Democratic Republic of Congo (DRC) was 693 per 100,000 in 2015—the sixth highest in the world and higher than the average (547 per 100,000) of sub-Saharan Africa.Objectives:The primary aim was to identify effect factors of 4+ antenatal care (ANC) of the maternal and child health care (MCH) project focused on reproductive women in the DRC.Methods:This study used a before and after study design and focused on ANC utilization of reproductive age women in Kenge, DRC. This study provided the MCH intervention based on three phases of the Three Delays Model from 2014 to 2017. We interviewed 2,663 participants from 2014 to 2017. This study used the decision tree node for prediction of 4+ ANC utilization.Findings:The decision tree showed that hand-washing (1.000) was the most important factor for receiving 4+ ANC services in the midline I survey, followed by writing skills (0.891), satisfaction with health facilities (0.869), age (0.782), and awareness of interventions (0.621). The results of the midline II decision tree demonstrated that MCH promotion by signboard (1.000) was the most important factor for 4+ ANC services, followed by income (0.970), and abortion (0.894). In the third year, distance (1.000) was the most important factor, followed by abortion (0.940) and knowledge of exclusive breastfeeding (0.806).Conclusions:The most important factors were related to awareness. We recommend conducting interventions focused on improving awareness increase 4+ ANC utilization. Sustainability intervention for improving the 4+ ANC utilization requires that focus on the infrastructure, such as accessibility and knowledge, of reproductive women.

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Integrating Water Treatment into Antenatal Care: Impact on Use of Maternal Health Services and Household Water Treatment by Mothers—Rural Uganda, 2013

Cited by 6 publications

References 17 publications

Impact of the Integration of Water Treatment, Hygiene, Nutrition, and Clean Delivery Interventions on Maternal Health Service Use

Impact of the Integration of Water Treatment, Hygiene, Nutrition, and Clean Delivery Interventions on Maternal Health Service Use

Improved Water, Sanitation and Utilization of Maternal and Child Health Services in South Asia—An Analysis of Demographic Health Surveys

The Impact of the Interventions for 4+ Antenatal Care Service Utilization in the Democratic Republic of Congo: A Decision Tree Analysis

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