1
|
Majumder K, Sarkar M, Mallick R, Mondal S, Chouhan P. Does women's decision-making autonomy matter in utilization of antenatal care services in India? An analysis from nationally representative survey. PLoS One 2024; 19:e0308576. [PMID: 39172924 PMCID: PMC11340970 DOI: 10.1371/journal.pone.0308576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 07/26/2024] [Indexed: 08/24/2024] Open
Abstract
The primary goal is to examine the association between women's decision-making autonomy and utilization of antenatal care services among ever-married women in India. The entire study has been accomplished with the help of secondary data composed from the latest round of the National Family Health Survey (NFHS-5) conducted during 2019-21. A total of 34,618 ever-married women aged 15-49 with at least one live birth preceding five years of the survey have been taken into consideration in this study. Bivariate and multivariate analyses were conducted for proper illustration of the outcome. A sizable proportion of women did not fulfill the WHO-recommended criterion of obtaining ANC services. Utilization of full ANC services is found in some regions of southern, eastern, northern, and northeastern states, and in some districts of Gujarat. After adjusting the other explanatory variables, the result of multivariate analysis indicates that women's autonomy is significantly and positively associated with the utilization of full antenatal care services. Women who participate actively in decision-making are more likely to use full ANC services (AOR: 1.316, 95% CI: 1.197-1.446, p<0.05). Additionally, likelihood of utilization of full ANC services is high among women aged 25-34 years, are educated, have access to the media, come from richest wealth quintile, and are from southern, western, and eastern regions. Therefore, appropriate measures should be adopted to eliminate gender bias and promote women's empowerment for the overall improvement of maternal health as well as societal health.
Collapse
Affiliation(s)
- Koyel Majumder
- Department of Geography, University of Gour Banga (UGB), Malda, West Bengal, India
| | - Mithun Sarkar
- Department of Geography, University of Gour Banga (UGB), Malda, West Bengal, India
| | - Rahul Mallick
- Department of Geography, Rammohan College, Kolkata, West Bengal, India
| | - Sabbir Mondal
- Department of Geography, University of Gour Banga (UGB), Malda, West Bengal, India
| | - Pradip Chouhan
- Department of Geography, University of Gour Banga (UGB), Malda, West Bengal, India
| |
Collapse
|
2
|
Singh M, Alam MS, Majumdar P, Tiwary B, Narzari H, Mahendradhata Y. Understanding the Spatial Predictors of Malnutrition Among 0-2 Years Children in India Using Path Analysis. Front Public Health 2021; 9:667502. [PMID: 34395360 PMCID: PMC8362662 DOI: 10.3389/fpubh.2021.667502] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 05/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Despite several programs and policies to turn down the burden of malnutrition in the country, the rank of India in the Global Hunger Index (GHI) is 102 among 117 countries, which indicates a serious hunger situation. It is essential to design more specific interventions by focusing on the key determinants that may directly or indirectly influence malnutrition in India. Methods: Utilizing data from the National Family and Health Survey-4 (NFHS) (2015-16), we developed a structural equation model to find the direct, indirect, and total effect of various determinants on stunting, wasting, and underweight. We used spatial analysis to identify local occurrences of factors that are critical in controlling malnutrition. A p-value of 0.05 was considered to be significant throughout the study. Analysis was performed using STATA (version 15.1MP) and GeoDa software (version 1.14). Results: A final sample of 90, 842 children of 0-24 months of age was selected for the analysis. The CFI and TLI values of 0.98 and 0.93, respectively, are indicative of a good fit model. Moran's I value of global spatial autocorrelation for the widespread presence of diarrhea, poor drinking water source, exclusive breastfeeding, low birth weight, no prenatal visits, poor toilet facility was observed to be 0.446, 0.638, 0.345, 0.439, 0.620, and 0.727, respectively. Conclusion: A robust direct relation was observed for diarrhea, exclusive breastfeeding, and children born with stunting, underweight, and wasting. The variables associated indirectly with the outcome variables were the education of the mother, residence, and desired pregnancy. The identification of hotspots through spatial analysis would help revive control strategies in the affected area according to geographical needs. It is extensively addressed that interventions related to health and nutrition during the first 1, 000 days of life is crucial to seize the upshoot of growth floundering among children.
Collapse
Affiliation(s)
- Monika Singh
- District Resource Unit, Bihar Technical Support Program, Care India, West Champaran, India.,Institute of Health Management Research, IIHMR University, Jaipur, India
| | - Md Sayeef Alam
- Department of Fertility Studies, International Institute for Population Sciences, Mumbai, India
| | - Piyusha Majumdar
- Institute of Health Management Research, IIHMR University, Jaipur, India
| | - Bhaskar Tiwary
- Institute of Health Management Research, IIHMR University, Jaipur, India.,Concurrent Measurement and Learning Unit, Bihar Technical Support Program, Care India, Saharsa, India
| | - Hina Narzari
- Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India
| | - Yodi Mahendradhata
- Department of Health Policy and Management, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
3
|
Sangho O, Tounkara M, Whiting-Collins LJ, Beebe M, Winch PJ, Doumbia S. Determinants of intermittent preventive treatment with sulfadoxine-pyrimethamine in pregnant women (IPTp-SP) in Mali, a household survey. Malar J 2021; 20:231. [PMID: 34022901 PMCID: PMC8141251 DOI: 10.1186/s12936-021-03764-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 05/11/2021] [Indexed: 11/12/2022] Open
Abstract
Background In malaria endemic regions, intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is recommended for all pregnant women during prenatal consultation, from the fourth month of pregnancy up to the time of delivery. The Government of Mali is aiming for universal coverage of IPTp-SP. However, coverage is still low, estimated to be 18% for completion of three doses (IPTp-SP3). The objective of this study was to identify the factors that influence IPTp-SP adherence in the Health District of Sélingué, Mali. Methods This was a cross-sectional survey with 30 clusters, proportional to village size, with two stages of sampling. Data were collected electronically with Magpi software during face-to-face interviews/surveys. The data were analysed with SPSS version 20. A descriptive analysis and bivariate and multivariate logistic regression were performed. An equity analysis examined the effect of distance from health care facility on completion of three or more antenatal visits (ANC3 +) and three or more doses of intermittent preventive treatment (IPTp-SP3 +). Results Of the 1,021 women surveyed, 87.8% (n = 896) attended at least one ANC visit. Of these, 86.3% (n = 773) received at least one dose of IPTp-SP. Compliance with three or more doses of IPTp-SP was 63.7%. The determinants statistically related to ANC3 + were the early initiation of ANC (OR = 3.22 [1.22, 10.78]), and the presence of a community health centre (CHC) in the village (OR = 9.69 [1.09, 86.21]). The ability to read (OR = 1.60 [1.01, 2.55]), the early initiation of ANC (OR = 1.46 [1.06, 2.00], knowledge of the utility of the drug (OR = 2.38 [1.24, 4.57]), and knowledge of the recommended dose of the drug (OR = 6.11 [3.98, 9.39]) were related to completion of three or more treatments (IPTp-SP3 +). Conclusion The early initiation of ANC was a positive determinant of the completeness of both ANC3 + and IPTp-SP3 + . This study shows that a successful implementation of the IPTp strategy can be achieved by improving access to prenatal care at community health facilities, and strengthening patient-provider communication to ensure adequate knowledge on dosing of IPTp-SP and the benefits to mother and child.
Collapse
Affiliation(s)
- Oumar Sangho
- Department of Education and Research of Biological and Medical Sciences, Faculty of Pharmacy, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali. .,Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali.
| | - Moctar Tounkara
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Madeleine Beebe
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peter J Winch
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Seydou Doumbia
- Department of Education and Research in Public Health and Specialties, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| |
Collapse
|
4
|
Kiross GT, Chojenta C, Barker D, Loxton D. Optimum maternal healthcare service utilization and infant mortality in Ethiopia. BMC Pregnancy Childbirth 2021; 21:390. [PMID: 34011300 PMCID: PMC8136182 DOI: 10.1186/s12884-021-03860-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 05/06/2021] [Indexed: 01/05/2023] Open
Abstract
Background Ethiopia has one of the highest rates of infant mortality in the world. Utilization of maternal healthcare during pregnancy, at delivery, and after delivery is critical to reducing the risk of infant mortality. Studies in Ethiopia have shown how infant survival is affected by utilization of maternal healthcare services, however, no studies to date have investigated the relationship between optimum utilization of maternal healthcare services utilization and infant mortality. Therefore, this study examined the effect of optimum utilization of maternal healthcare service on infant mortality in Ethiopia based on the World Health Organization (WHO, 2010) guidelines. Methods We used nationally representative cross-sectional data from the Ethiopian Demographic and Health Survey (EDHS). Sampling weights were applied to adjust for the non-proportional allocation of the sample to the nine regions and two city administrations as well as the sample difference across urban and rural areas. A total of 7193 most recent births from mothers who had provided complete information on infant mortality, ANC visits, tetanus injections, place of delivery and skilled birth attendance during pregnancy were included. The EDHS was conducted from January to June 2016. We applied a multivariate logistic regression analysis to estimate the relationship between optimum maternal healthcare service utilization and infant mortality in Ethiopia. Results The findings from this study showed that optimum maternal healthcare service utilization had a significant association with infant mortality after adjusting for other socioeconomic characteristics. This implies that increased maternal healthcare service utilization decreases the rate of infant mortality in Ethiopia. The main finding from this study indicated that infant mortality was reduced by approximately 66% among mothers who had high utilization of maternal healthcare services compared to mothers who had not utilized maternal healthcare services (AOR = 0.34; 95%CI: 0.16–0.75; p-value = 0.007). Furthermore, infant mortality was reduced by approximately 46% among mothers who had low utilization of maternal healthcare services compared to mothers who had not utilized any maternal healthcare services (AOR = 0.54; 95%CI: 0.31–0.97; p-value = 0.040). Conclusions From this study, we concluded that optimum utilization of maternal healthcare services during pregnancy, at delivery and after delivery might reduce the rate of infant mortality in Ethiopia.
Collapse
Affiliation(s)
- Girmay Tsegay Kiross
- Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia. .,Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
| | - Catherine Chojenta
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Daniel Barker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Deborah Loxton
- Research Centre for Generational Health and Ageing, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
5
|
Olorunsaiye CZ, Brunner Huber LR, Laditka SB, Kulkarni SJ, Boyd S. Individual and community socioeconomic factors related to the quality of antenatal care: a multilevel analysis of West and Central Africa. Women Health 2020; 61:15-26. [PMID: 33256565 DOI: 10.1080/03630242.2020.1847748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Antenatal care (ANC) can improve maternal health. We examined associations of individual and community socioeconomic status (SES) with the quality of ANC in West and Central Africa. Data were from the 2009-2011 UNICEF Multiple Indicator Cluster Surveys for women in seven countries (n = 24,718). Individual SES variables included women's education and wealth; community SES was defined as low or high poverty index. ANC quality was defined as receiving six services: blood pressure monitoring, blood tests, urine tests, malaria prophylaxis, tetanus vaccine, and HIV screening, and coded low or high. We used multilevel logistic regression to estimate fixed and random effects of individual and community SES on ANC quality. Less than one-fourth of women received high-quality ANC. Only small percentages of women had malaria prophylaxis and were counseled and tested for HIV. In adjusted country-stratified results, living in a poor community was associated with reduced odds of receiving high-quality ANC in six countries (Central African Republic: odds ratio, OR = 0.76; 95% confidence interval, CI:0.58-0.98; Chad: OR = 0.48; CI:0.32-0.74; Ghana: OR = 0.86; CI:0.61-0.97; Nigeria: OR = 0.74; CI:0.61-0.92; Sierra Leone: OR = 0.71; CI:0.57-0.91; and Togo: OR = 0.80; CI:0.47-0.91). The health system may be missing important opportunities to provide high-quality ANC and, thereby, improve pregnancy outcomes in these settings.
Collapse
Affiliation(s)
- Comfort Z Olorunsaiye
- Department of Public Health, College of Health Sciences, Arcadia University , Glenside, PA, USA
| | - L R Brunner Huber
- Department of Public Health Sciences, University of North Carolina at Charlotte , Charlotte, NC, USA
| | - S B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte , Charlotte, NC, USA
| | - Shanti J Kulkarni
- School of Social Work, University of North Carolina at Charlotte , Charlotte, NC, USA
| | - Suzanne Boyd
- School of Social Work, University of North Carolina at Charlotte , Charlotte, NC, USA
| |
Collapse
|
6
|
Olorunsaiye CZ, Huber LB, Laditka SB, Kulkarni S, Boyd AS. Factors associated with health facility delivery in West and Central Africa: A multilevel analysis of seven countries. Health Care Women Int 2019; 41:3-21. [PMID: 31621528 DOI: 10.1080/07399332.2019.1678161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
We examined associations between individual and community socioeconomic status (SES) and childbirth in a health facility in West and Central Africa using data from the 2009-2011 United Nations Children's Fund (UNICEF) Multiple Indicator Cluster Survey for women in seven countries (n = 34,487). Individual SES measures were education and wealth; community SES was low or high poverty index. In adjusted results, women residing in communities with high poverty had significantly lower odds of facility delivery than those who lived in more affluent communities in five countries (all p < 0.001). Reducing out-of-pocket healthcare costs may improve women's access to delivery in health facilities.
Collapse
Affiliation(s)
| | - Larissa Brunner Huber
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Shanti Kulkarni
- School of Social Work, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - A Suzanne Boyd
- School of Social Work, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| |
Collapse
|
7
|
Taylor YJ, Laditka JN, Laditka SB, Brunner Huber LR, Racine EF. Is having any prenatal care associated with lower infant mortality in West Africa? Evidence from the Demographic and Health Surveys. Health Care Women Int 2019; 40:196-212. [PMID: 30849281 DOI: 10.1080/07399332.2018.1522317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Although developing countries may find it difficult to provide adequate prenatal care, it is likely that they can provide at least some. We examined associations of prenatal care with infant mortality in West Africa. We used data from the Demographic and Health Surveys (n = 57,322) and proportional hazards regression models to estimate the risk of infant mortality. Having any prenatal care was associated with lower infant mortality risk in all but the poorest wealth quintile, with 56% lower risk in the wealthiest quintile (95% confidence interval [CI] 0.28-0.69). Even limited prenatal care may significantly reduce infant mortality in developing countries.
Collapse
Affiliation(s)
- Yhenneko J Taylor
- a Center for Outcomes Research and Evaluation , Atrium Health , Charlotte , North Carolina , USA
| | - James N Laditka
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - Sarah B Laditka
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - Larissa R Brunner Huber
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| | - Elizabeth F Racine
- b Department of Public Health Sciences , University of North Carolina at Charlotte , Charlotte , North Carolina , USA
| |
Collapse
|
8
|
Adebowale A, Obembe T, Bamgboye E. Relationship between household wealth and childhood immunization in core-North Nigeria. Afr Health Sci 2019; 19:1582-1593. [PMID: 31148987 PMCID: PMC6531962 DOI: 10.4314/ahs.v19i1.33] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Childhood immunization rate is lowest in the core-North Nigeria. We examined the relationship between inequality in household wealth and complete childhood immunization in that part of the country. METHODS A cross-sectional survey was conducted among 4079 mothers with children 12-23 months of age. Children were considered 'fully-immunized' if they received all the vaccines included in the immunization schedule. Data were analyzed using descriptive statistics and logistic regression models (α=5.0%). RESULTS About 39% and 5.0% children of the rich and poor received complete immunization respectively. Also, 64.2% and 49.6% children of the rich women received BCG and DPT 3 compared to 15.9% and 8.7% observed among the children of the poor. Higher proportion of children from poor households (40.6%) received no immunization than 20.8% found from the rich households. The likelihood of receiving complete immunization was 1.95(C.I=1.35-2.80, p<0.001) times higher among the children of the rich than the poor. Other important predictors of childhood immunization were age, religion, media access, working status, husband's education, prenatal attendants and delivery place. CONCLUSION Disparities existed in childhood immunization between the poor and rich in the core-North part of Nigeria. Policy makers should institute effective interventions that will assist children from poor households to improve their immunization access.
Collapse
Affiliation(s)
- Ayo Adebowale
- University of Cape Town, Centre for Actuarial research
- University of Ibadan, Epidemiology and Medical statistics
| | - Taiwo Obembe
- University of Ibadan, Health Policy and Management
| | | |
Collapse
|
9
|
Islam MM, Masud MS. Health care seeking behaviour during pregnancy, delivery and the postnatal period in Bangladesh: Assessing the compliance with WHO recommendations. Midwifery 2018; 63:8-16. [PMID: 29758443 DOI: 10.1016/j.midw.2018.04.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 03/01/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommends four antenatal care (ANC) visits, delivery in a health facility and three postnatal care (PNC) visits for women to optimize the maternal health outcomes. OBJECTIVES To examine the level and determinants of maternal health care seeking behaviour during pregnancy, delivery and the postnatal period, and assess the compliance with the WHO recommended levels of care in Bangladesh. DESIGN/SETTING The study is based on secondary analysis of the data obtained from the 2014 Bangladesh Demographic and Health Survey (BDHS). The 2014 BDHS was a cross-sectional survey of a nationally representative sample of 17,863 ever-married women aged 15-49 years. The sample was selected following a two-stage stratified cluster sampling design. PARTICIPANTS The dataset from a subsample of 4.627 ever-married women who had delivered their last birth within three years before the survey were included in the analysis to meet the objectives of the study. ANALYSIS Descriptive statistics and multinomial logistic regression model were used for data analysis. FINDINGS It has been observed that only 31% mothers had recommended four or more ANC visits, 37% births were delivered at health facilities, and 65% mothers received at least one PNC visit. Only 18.0% mothers received the WHO recommended optimal level of four or more ANC visits, births in a health facility and at least one PNC visit. Mothers aged less than 20 years, living in rural area, having no education and media exposure, multiparous, poor wealth status, husband with no education and husband's employment status appeared as significant predictors of optimal level maternal health care after adjusting for other factors. Mothers living in Sylhet, Chittagong and Barisal regions were less likely to receive the optimum level health care. KEY CONCLUSION Utilization of maternal health care during pregnancy, delivery and the postnatal period among Bangladeshi women does not reflect the complete compliance with the WHO recommendations. Further studies are needed to identify the reasons for underutilization of optimum level maternal care practice in Bangladesh. IMPLICATION FOR PRACTICE The findings underscore the need for targeted intervention for those groups of mothers who were identified as having lowest level of maternal care across the continuum of care.
Collapse
Affiliation(s)
- M Mazharul Islam
- Department of Mathematics and Statistics, College of Science, Sultan Qaboos University, Al-Khoudh, P.O. Box 36, 123 Muscat, Oman .
| | - Mohammad Shahed Masud
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, 1000, Bangladesh .
| |
Collapse
|
10
|
Sustainable Development and the Literacy of Women and Girls. MCN Am J Matern Child Nurs 2017; 42:182. [PMID: 28448337 DOI: 10.1097/nmc.0000000000000332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|