Women’s education and coverage of skilled birth attendance: An assessment of Sustainable Development Goal 3.1 in the South and Southeast Asian Region

Bhowmik, Jahar; Biswas, Raaj Kishore; Ananna, Nurjahan

doi:10.1371/journal.pone.0231489

Cited by 18 publications

(15 citation statements)

References 61 publications

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“…It was further observed that having one's partner attained a higher level of education increases the likelihood of a woman utilising SBA. Women whose partners had higher education, being more likely to utilise the service of skilled birth attendants is consistent with Bhowmik et al [38]. Our finding is probable because most SSA countries are largely patriarchal societies [39,40], hence partners with high education who are aware of the importance of skilled birth attendance can easily induce their wives to utilise the service of SBAs.…”

Section: Plos Onesupporting

confidence: 89%

Women empowerment and skilled birth attendance in sub-Saharan Africa: A multi-country analysis

2021

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Introduction In 2017, the highest global maternal deaths occurred in sub-Saharan Africa (SSA). The WHO advocates that maternal deaths can be mitigated with the assistance of skilled birth attendants (SBAs) at childbirth. Women empowerment is also acknowledged as an enabling factor to women’s functionality and healthcare utilisation including use of SBAs’ services. Consequently, this study investigated the association between women empowerment and skilled birth attendance in SSA. Materials and methods This study involved the analysis of secondary data from the Demographic and Health Surveys of 29 countries conducted between January 1, 2010, and December 3, 2018. For this study, only women who had given birth in the five years prior to the surveys were included, which is 166,022. At 95% confidence interval, Binary Logistic Regression analyses were conducted and findings were presented as adjusted odds ratios (aORs). Results The overall prevalence of skilled birth attendance was 63.0%, with the lowest prevalence in Tanzania (13.8%) and highest in Rwanda (91.2%). Women who were empowered with high level of knowledge (aOR = 1.60, 95% CI = 1.51, 1.71), high decision-making power (aOR = 1.19, 95% CI = 1.15, 1.23), and low acceptance of wife beating had higher likelihood of skill birth attendance after adjusting for socio-demographic characteristics. Women from rural areas had lesser likelihood (OR = 0.53, 95% CI = 0.51–0.55) of skilled birth attendance compared to women from urban areas. Working women had a lesser likelihood of skilled birth attendance (OR = 0.91, 95% CI = 0.88–0.94) as compared to those not working. Women with secondary (OR = 2.13, 95% CI = 2.03–2.22), or higher education (OR = 4.40, 95% CI = 3.81–5.07), and women in the richest wealth status (OR = 3.50, 95% CI = 3.29–3.73) had higher likelihood of skilled birth attendance. Conclusion These findings accentuate that going forward, successful skilled birth attendant interventions are the ones that can prioritise the empowerment of women.

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Section: Plos Onesupporting

confidence: 89%

Women empowerment and skilled birth attendance in sub-Saharan Africa: A multi-country analysis

2021

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“…This evidence, together with our findings, suggests that the Colombian health care system urgently needs to shift towards universal coverage and a structural redesign to address these high levels of fragmentation. In line with previous studies, our findings also support the role of maternal education as a determinant of birth outcomes, particularly of low birth weight [14][15][16]. The overall improvement in maternal education between 2008 and 2018 could have contributed to the amplification of the inequalities between the two extremes of the spectrum because less educated mothers in 2018 were a smaller, more disadvantaged and more vulnerable social group than those in 2008.…”

Section: Discussionsupporting

confidence: 91%

“…For example, mothers with lower educational levels tend to have poorer economic conditions and experience greater exposure to stress, which in turn results in a higher likelihood of engaging in risk-taking behaviours such as smoking and alcohol/drug abuse [15]. Less-educated mothers also make, on average, fewer prenatal care visits and are less likely to access skilled birth attendance care during childbirth [16].…”

Section: Introductionmentioning

confidence: 99%

Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia

2021

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Objective To examine socioeconomic inequalities in birth outcomes among infants born between 2008 and 2018 and assessed trends in inequalities during that period in Colombia, a middle-income country with high levels of inequality emerging from a long internal armed conflict. Methods Using birth certificate data in Colombia, we analysed the outcomes of low birth weight, an Apgar score <7 at 5 minutes after birth and the number of prenatal visits among full-term pregnancies. Maternal education and health insurance schemes were used as socioeconomic position (SEP) indicators. Inequalities were estimated using the prevalence/mean of the outcomes across categories of the SEP indicators and calculating the relative and slope indices of inequality (RII and SII, respectively). Results Among the 5,433,265 full-term singleton births analysed, there was a slight improvement in the outcomes analysed over the study period (lower low-birth-weight and Apgar<7 prevalence rates and higher number of prenatal visits). We observed a general pattern of social gradients and significant relative (RII) and absolute (SII) inequalities for all outcomes across both SEP indicators. RII and SII estimates with their corresponding CIs revealed a general picture of no significant changes in inequalities over time, with some particular, time-dependent exceptions. When comparing the initial and final years of our study period, inequalities in low birth weight related to maternal education increased while those in Apgar score <7 decreased. Relative inequalities across health insurance schemes increased for the two birth outcomes but decreased for the number of prenatal visits. Conclusion The lack of a consistent improvement in the magnitude of inequalities in birth outcomes over an 11-year period is a worrying issue because it could aggravate the cycle of inequality, given the influence of birth outcomes on health, social and economic outcomes throughout the life course. The findings of our analysis emphasize the importance of policies aimed at providing access to quality education and providing a health care system with universal coverage and high levels of integration.

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“…Various studies have been conducted in SA to explore the associated factors of IYCF practices [ 18 , 19 , 20 , 21 , 22 ] and have identified a range of detrimental factors, including but not limited to the place of residence, household wealth status, household income, cultural beliefs, parental education, mother’s age, mother’s occupation, antenatal and postnatal care, child’s age, child’s sex, modes of delivery, place of delivery, and women’s and mother’s exposure to mass media [ 18 , 19 , 20 , 21 , 22 ]. Among all these factors, the role of mother’s education is beneficial to health and nutritional well-being [ 23 , 24 , 25 , 26 , 27 , 28 ]. Some single-country-specific studies also found a positive association between mother’s education and IYCF practices [ 5 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Mother’s Education and Infant and Young Child Feeding Practices in South Asia

et al. 2022

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The association between mother’s education and the World Health Organization’s (WHO’s) eight Infant and Young Child Feeding (IYCF) core indicators has yet to be explored in South Asia (SA). This study aimed to explore the association between mother’s education and the WHO’s eight IYCF core indicators in SA. We analyzed data from the most recent nationally representative Demographic and Health Surveys of six South Asian Countries (SACs)—Afghanistan, Bangladesh, India, Maldives, Nepal, and Pakistan. We found significantly higher odds (adjusted odds ratio, AOR, 1.13 to 1.47) among mothers who completed secondary or higher education than among mothers with education levels below secondary for the following seven IYCF indicators: early initiation of breastfeeding (EIBF), exclusive breastfeeding under 6 months (EBF), the introduction of solid, semisolid or soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), minimum acceptable diet (MAD), and consumption of iron-rich or iron-fortified foods (CIRF); the exception was for the indicator of continued breastfeeding at one year. Country-specific analyses revealed significantly higher odds in EIBF (AOR 1.14; 95% CI: 1.11, 1.18) and EBF (AOR 1.27; 95% CI: 1.19, 1.34) among mothers with secondary or higher education levels in India. In contrast, the odds were lower for EIBF in Bangladesh and for EBF in Pakistan among mothers with secondary or higher education levels. For country-specific analyses for complementary feeding indicators such as ISSSF, MDD, MMF, MAD, and CIRF, significantly higher odds (AOR, 1.15 to 2.34) were also observed among mothers with secondary or higher education levels. These findings demonstrate a strong positive association between mother’s education and IYCF indicators. Strengthening national policies to educate women at least to the secondary level in SACs might be a cost-effective intervention for improving IYCF practices.

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Women’s education and coverage of skilled birth attendance: An assessment of Sustainable Development Goal 3.1 in the South and Southeast Asian Region

Cited by 18 publications

References 61 publications

Women empowerment and skilled birth attendance in sub-Saharan Africa: A multi-country analysis

Women empowerment and skilled birth attendance in sub-Saharan Africa: A multi-country analysis

Socioeconomic inequalities in birth outcomes: An 11-year analysis in Colombia

Association between Mother’s Education and Infant and Young Child Feeding Practices in South Asia

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