Maternal health in rural Pakistan: An analysis of knowledge and practices of antenatal care using the socio-ecological model

Abstract

Background: Pakistan carries a heavy burden of maternal and child health vulnerabilities. Maternal health can be prevented with culturally specific interventions and women’s enhanced access to healthcare facilities, yet women in rural areas in Pakistan are deprived of such interventions. In this study, we assessed the prevalent knowledge and practices of antenatal care and the impact of low-income and gender inequalities on maternal health in rural areas of Pakistan. Methods: We conducted a cross-sectional study using the Socio-Ecological Model (SEM) in five villages in the Sindh province of Pakistan. We tested hypotheses using descriptive reliability and regression techniques. Results: Findings show that the socio-geographical and cultural factors influencing maternal health were embedded within the different levels of SEM. The prevalence of Maternal Health Vulnerabilities (MHV) was high in villages where women had limited literacy and awareness. Of the 352 participants, 173 (49%) women were not literate and could not read pregnancy-related information imparted through leaflets or brochures. Data showed that women consumed less milk, multivitamins, and proper food due to poverty. At the same time, they had restricted access to health facilities: 119 (34%) women had lost their babies after birth. In this study, poverty and gender inequality correlate with MHV (significant 65.60% and .000 and 10.50% and .000, respectively) and exacerbate the situation by complementing each other. Conclusion: Culturally appropriate and evidence-based interventions are needed to reduce gender inequality and prioritise women’s and girls’ maternal health needs. This study has considered cultural, social, geographical, and economic factors influencing maternal health. It provides a nuanced account of a complex web of barriers to attaining Sustainable Development Goals (SDGs), particularly goals 3, ‘Good health and well-being’ and 5 ‘, Gender equality’.