They receive antenatal care in health facilities, yet do not deliver there: predictors of health facility delivery by women in rural Ghana

Boah, Michael; Mahama, Abraham B.; Ayamga, Emmanuel Awine

doi:10.1186/s12884-018-1749-6

Cited by 68 publications

(81 citation statements)

References 37 publications

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“…Parity was shown to have negatively in uenced the uptake of maternal health care services (11,12,19). Contrary to these reports, in our work, it is rather age of the mother that had a signi cant association with the type of the trajectory.…”

Section: Discussioncontrasting

confidence: 99%

“…Religion is considered to have an in uence over maternal healthcare utilization in some recent studies (10)(11)(12)19). However, the relationship is best understood with the present study as our nding shows the point where religion stimulates and fails to stimulate maternal healthcare utilization.…”

Section: Discussionmentioning

confidence: 49%

“…For these women, somehow ANC is not being translated to delivery and postnatal care utilization. Many factors might contribute to this gap including lack of awareness of the signs of labor, de ciency of exposure to information on delivery care, absence of problem during the current pregnancy, and absence of complications during previous births (18,19). Unassisted delivery carries a substantial risk in that unskilled attendants can hardly predict and manage serious complications which will lead to deaths of mothers during and after child birth (20).Thus, promotion and comprehensive education on the early signs of labor and birth preparedness and complication readiness need to be provided during the ANC sessions to translate the ANC uptake to delivery care and improve the overall maternal healthcare service utilization.…”

Section: Discussionmentioning

confidence: 99%

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Maternal Healthcare Services Utilization Trajectories in Four Regions of Ethiopia: A Latent Class Analysis

Higi

Tura

Sena

et al. 2020

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Background: Globally, in 2015 as result of complications related to pregnancy, childbirth, or the postnatal period, 303,000 women died. Among these mortality the lion share burden were in sub-Saharan and Southern Asian countries. To avert the preventable maternal mortality, providing the recommended pregnancy care, delivery and postnatal cares in a continuum manner is imperative. This study aims to assess the trajectories and determinants of maternal healthcare services utilization in four major regions of Ethiopia. Methods: Seven indicator variables were used to construct the maternal healthcare utilization variable. Latent class analysis was used to identify subgroups of maternal healthcare utilization along the continuum of care. Further, ordinal logistic regression was utilized to identify the determinants of the trajectories of maternal healthcare utilization. STATA 14 was used for data management and analysis and 5% level of significance was used to declare statistical significance. Result: There were 590 mothers who delivered a live-birth in the 12 months period before the interview date. The result of latent class analysis indicates that a little more than two in five of the mothers (43.9%) did not attempt to visit a health facility during pregnancy or for delivery or for postnatal checkup. While women with a good practice of maternal healthcare accounted 6.1%, half (50%) of the women had an inadequate maternal healthcare practice. The trajectory of maternal healthcare utilization has shown a marked difference by region and religious affiliation of women. Whereas older women and women of lowest socio-economic status tend to be in the lowest classes of maternal healthcare utilization, educated women, women of highest socio-economic status and women having a better birth preparedness and complication readiness are found to be in the highest classes of maternal health care service utilization. Conclusions: Women of lower socio-economic status and women of below secondary level of education should be targeted to intensify awareness of the benefit of maternal healthcare services utilization and plan births and deal with complications that arise with pregnancy and childbirth.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 49%

Section: Discussionmentioning

confidence: 99%

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Maternal Healthcare Services Utilization Trajectories in Four Regions of Ethiopia: A Latent Class Analysis

Higi

Tura

Sena

et al. 2020

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“…Also, four variables (number of antenatal visits, timing of antenatal visits, healthcare decision, and perception of whether or not distance to facility is a big problem to accessing healthcare) were selected for statistical control in the study. A number of studies have found antenatal care visits and timing to have significant association with institutional delivery [54][55][56][57][58], while healthcare decision which proxy women's status, and perception of distance were included in line with the causes of the second delay in the theoretical underpinning of the study [34]).…”

Section: Explanatory and Control Variablesmentioning

confidence: 99%

Household means of transportation and place of child delivery in Nigeria

Solanke¹,

Oluwatope²,

Adebayo³

et al. 2020

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Background The means of transportation available to pregnant women in households may serve either as a driver or deterrent of institutional delivery. However, how household means of transportation associates with place of delivery has been less explored in Nigeria. Methods This study was based on pooled data of 2008-2013 Nigeria Demographic and Health Survey. The study analysed a weighted sample size of 6,540 women. The multilevel logistic regression model was applied using STATA 14. Results The study revealed 37% institutional delivery among women in Nigeria. Women whose household mode of transport were cars were twice more likely to have institutional delivery compared to women who had no viable household means of transportation (AOR=2.044, p<0.01; CI=1.781-2.345). Women who live in communities with high proportions of households with no means of transportation were 12.8% less likely to have institutional delivery (AOR=0.872, p=0.01; CI: 0.788-0.967). Women who live in communities with high proportions of household who owned motorcycle compared to those in communities with low proportion were 31.9% more likely to have institutional delivery (AOR=1.319, p<0.05; CI: 1.071-1.625). Women who live in communities with high proportions of households who owned cars compared to those in communities with low proportion were more than three times more likely to have institutional delivery (AOR=3.146, p<0.01; CI: 2.621-3.777).Conclusion Means of transportation significantly explains choice of place of child delivery in urban Nigeria. A public-private transport support programme to reduce transportation burden among pregnant women is imperative in the country.

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“…30 Further, reproductive health characteristics such as parity and prior facility delivery may positively or negatively impact a woman's likelihood of returning to facilities, based on experiences with the health system. 31,32 Lastly, we collected first ANC visit facility location to address potential area-level variance on the likelihood of facility delivery.…”

Section: Data Collection and Study Variablesmentioning

confidence: 99%

Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

Maldonado

Songok

Snelgrove

et al. 2020

Preprint

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Background: Chamas for Change (Chamas) is a group-based health education and microfinance program for pregnant and postpartum women that aims to address inequities contributing to high rates of maternal and infant mortality in rural western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and facility-based delivery. We additionally explored the effect of participation on promoting other positive maternal, newborn and child health (MNCH) behaviors. Methods: We prospectively compared outcomes between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October-December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at rural health facilities in Busia County to participate in Chamas. Women enrolled in Chamas agreed to attend group-based health education and microfinance sessions for one year; controls received the standard of care. We used descriptive analyses, multivariable logistic regression models, and random effect models to compare outcomes across cohorts 12 months following enrollment, with α set to 0.05. Results: Compared to controls (n=115), a significantly higher proportion of Chamas participants (n=211) delivered in a health facility (84.4% vs. 50.4%, p<0.001), attended at least four ANC visits (64.0% vs. 37.4%, p<0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p<0·001), and received a CHV home visit within 48 hours postpartum (75.8% vs. 38.3%, p<0·001). In multivariable models, Chamas participants were over five times as likely as controls to deliver in a health facility (OR 5.49, 95% CI 3.12-9.64, p<0.001). Though not significant, Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Conclusions: Chamas participation was associated with increased odds of facility-based delivery compared to the standard of care in rural western Kenya. Larger proportions of program participants also practiced other positive MNCH behaviors. Our findings demonstrate Chamas’ potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect. Trial Registration: ClinicalTrials.gov, NCT03188250 (retrospectively registered 31 May 2017)

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They receive antenatal care in health facilities, yet do not deliver there: predictors of health facility delivery by women in rural Ghana

Cited by 68 publications

References 37 publications

Maternal Healthcare Services Utilization Trajectories in Four Regions of Ethiopia: A Latent Class Analysis

Maternal Healthcare Services Utilization Trajectories in Four Regions of Ethiopia: A Latent Class Analysis

Household means of transportation and place of child delivery in Nigeria

Promoting positive maternal, newborn, and child health behaviors through a group-based health education and microfinance program: a prospective matched cohort study in western Kenya

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