On the way to universal coverage of maternal services in Iringa rural District in Tanzania. Who is yet to be reached?

Straneo, Manuela; Fogliati, Piera; Pellis, Ingrid; Goodman, Catherine; Riva, Donata Dalla; Kisika, Firma; Mpuya, Ezekiel; Putoto, Giovanni

doi:10.4314/ahs.v16i2.10

Cited by 16 publications

(20 citation statements)

References 19 publications

(24 reference statements)

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“…In 14 studies, women of high socioeconomic status (SES) attended at least four ANC visits more than those in the lower socioeconomic/wealth strata15 25 27 29 30 32 41 54 64 69 77 89–91 (table 2).…”

Section: Resultsmentioning

confidence: 99%

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Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review

et al. 2019

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ObjectivesTo identify the determinants of antenatal care (ANC) utilisation in sub-Saharan Africa.DesignSystematic review.Data sourcesDatabases searched were PubMed, OVID, EMBASE, CINAHL and Web of Science.Eligibility criteriaPrimary studies reporting on determinants of ANC utilisation following multivariate analysis, conducted in sub-Saharan Africa and published in English language between 2008 and 2018.Data extraction and synthesisA data extraction form was used to extract the following information: name of first author, year of publication, study location, study design, study subjects, sample size and determinants. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist for reporting a systematic review or meta-analysis protocol was used to guide the screening and eligibility of the studies. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the quality of the studies while the Andersen framework was used to report findings.Results74 studies that met the inclusion criteria were fully assessed. Most studies identified socioeconomic status, urban residence, older/increasing age, low parity, being educated and having an educated partner, being employed, being married and Christian religion as predictors of ANC attendance and timeliness. Awareness of danger signs, timing and adequate number of antenatal visits, exposure to mass media and good attitude towards ANC utilisation made attendance and initiation of ANC in first trimester more likely. Having an unplanned pregnancy, previous pregnancy complications, poor autonomy, lack of husband’s support, increased distance to health facility, not having health insurance and high cost of services negatively impacted the overall uptake, timing and frequency of antenatal visits.ConclusionA variety of predisposing, enabling and need factors affect ANC utilisation in sub-Saharan Africa. Intersectoral collaboration to promote female education and empowerment, improve geographical access and strengthened implementation of ANC policies with active community participation are recommended.

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Section: Resultsmentioning

confidence: 99%

“…Women whose pregnancy was confirmed by missed period rather than urine test were more likely to delay booking ANC visit 87. Women who attended ANC in the first trimester were more likely to attend up to four ANC visits89 (table 2).…”

Section: Resultsmentioning

confidence: 99%

Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review

et al. 2019

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“…Studies conducted by Straneo et al in the Tosamaganga catchment area showed high rates of institutional birth coverage, probably facilitated by the high health facility density 36. However, coverage and quality do not always go together and the poorest women were reported accessing lower-level health services for birth where quality of care is suboptimal due to limited caseloads and poor staffing 37…”

Section: Discussionmentioning

confidence: 99%

Analysis of caesareansection and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study

et al. 2019

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ObjectiveCaesarean section (CS) rates have increased worldwide in recent decades. In 2015, the WHO proposed the use of the 10-group Robson classification as a global standard for assessing, monitoring and comparing CS rates both within healthcare facilities over time and between them. The aim of this study was to assess the pattern of CS rates according to the Robson classification and describe maternal and perinatal outcomes by group at the Tosamaganga Hospital in rural Tanzania.DesignObservational retrospective study.SettingSt. John of the Cross Tosamaganga Hospital, a referral centre in rural Tanzania.Participants3012 women who gave birth in Tosamaganga Hospital from 1 January to 30 June 2014 and from 1 March to 30 November 2015.ResultsThe overall CS rate was 35.2%, and about 90% of women admitted for labour were in Robson groups 1 through 5. More than 40% of the CS carried out in the hospital were performed on nulliparous women at term with a single fetus in cephalic presentation (groups 1 and 3), and the most frequent indication for the procedure was previous uterine scar (39.2%). The majority of severe neonatal outcomes were observed in groups 1 (27.7%), 10 (24.5%) and 3 (19.1%).ConclusionWe recorded a high CS rate in Tosamaganga Hospital, particularly in low-risk patients groups (Robson groups 1 and 3). Our analysis of Robson classification and neonatal outcomes suggests the need to improve labour management at the hospital and to provide timely referrals in order to prevent women from arriving there in critical conditions.

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“…Mwanza Region had 96.6% ANC coverage, 53.3% health facilities deliveries, 54.2% skilled birth attendances, and 20.7% postpartum check-ups [3]. Other studies in Tanzania showed a 58.3% ANC4+ visits and 87.7% health facility delivery in Iringa rural district [9] and 56% health facilities deliveries in Biharamulo [10].…”

Section: Introductionmentioning

confidence: 99%

Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

Orwa

Mantel²,

Mugerwa³

et al. 2019

Preprint

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Background Improving maternal health by reducing maternal morbidity and mortality relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.Methods A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four or more ANC visits (ANC4+), health facility delivery, and postpartum visits. Factors associated with the three outcomes were determined using generalized estimating equations to account for clustering at the district level while adjusting for all variables.Results Of the 409 eligible women, 58.2% attended ANC4+, 76.8% delivered in a health facility, and 43.5% attended a postpartum clinic. Women from peri-urban, island, and rural regions were less likely to have completed ANC4+ or health facility delivery compared with urban women. Education and early first antenatal visit were associated with ANC4+ and health facility delivery. Mothers from peri-urban areas and those who with health facility delivery were more likely to attend postpartum check-ups.Conclusion Use of ANC services in early pregnancy influences the number of ANC visits, leading to higher uptake of ANC4+ and health facility delivery. Postpartum check-ups for mothers and newborns are associated with health facility delivery. Encouraging early initiation of ANC visits may increase the uptake of maternal healthcare services.

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On the way to universal coverage of maternal services in Iringa rural District in Tanzania. Who is yet to be reached?

Cited by 16 publications

References 19 publications

Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review

Determinants of antenatal care utilisation in sub-Saharan Africa: a systematic review

Analysis of caesareansection and neonatal outcome using the Robson classification in a rural district hospital in Tanzania: an observational retrospective study

Maternal healthcare services use in Mwanza Region, Tanzania: A cross-sectional baseline survey

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