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Shannon K, Burridge J, Franklin B, Bhushan S, Hilsenbeck S, Petrova EV, N’Dow J, Iwuh I, Anandasabapathy S, Wilkinson JP. Gambian Mothers Lack Obstetric Danger Sign Knowledge, But Educational Intervention Shows Promise. Ann Glob Health 2024; 90:31. [PMID: 38800705 PMCID: PMC11122691 DOI: 10.5334/aogh.3930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/02/2024] [Indexed: 05/29/2024] Open
Abstract
Background The Gambia has the 12th highest maternal mortality rate in the world, with 80% of deaths resulting from avoidable causes. Unawareness of pregnancy danger signs (DS) has been shown to be a barrier to seeking obstetric care, while app-based education intervention has shown promise. Objective We aim to assess patient awareness of DS, identify barriers to awareness, and evaluate potential for implementing smartphone-based technologies for education. Methods A cross-sectional semi-structured survey was administered to Gambian women (n = 100) across five hospitals/health centers. Data and informed consent were collected via an online survey portal. Analysis included bivariate analysis and descriptive statistics with p < 0.05 significance level. Recall of 0-2 DS per category was classified as "low" knowledge, 3-5 as "moderate" knowledge, and 6+ as "sufficient" knowledge. Cross-category recall was quantified for overall awareness level (0-6 = "low", 7-12 = "moderate", 13+ = "sufficient". N = 28 total DS). Findings Although 75% of participants (n = 100) self-perceived "sufficient" knowledge of DS, the average recall was only two (SD = 2, n = 11) pregnancy DS, one labor and delivery DS (SD = 1, n = 8), and one postpartum DS (SD = 1, n = 9). Twenty-one women were unable to recall any danger signs. "Low" awareness was identified in 77% of women, while 23%, and 0% of women showed "moderate" and "sufficient" overall awareness, respectively. Education level was significantly correlated with overall danger sign recall (ρ(98) = .243, p = .015) and awareness level (ρ(98) = .265, p = .008). Monthly income was significantly correlated with awareness level (ρ(97) = .311, p = .002). Smartphone ownership was reported by 76% of women, and 97% expressed interest in using app-based video (94%) or provider (93%) teaching. Conclusions Women had low knowledge of obstetric danger signs, and true awareness of danger signs was remarkably lower than self-perceived knowledge. However, patients exhibited proper healthcare-seeking behavior when danger signs arose. Findings suggest that video- or messaging-based education from local healthcare providers may be effective DS educational interventions.
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Affiliation(s)
- Kara Shannon
- School of Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | | | | | - Susan Hilsenbeck
- Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA
| | | | - James N’Dow
- Baylor Global Health, Houston, TX, USA
- Horizons Trust Gambia, The Gambia
| | - Ibezimako Iwuh
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
| | | | - Jeffrey P. Wilkinson
- Academic Urology Unit, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, TX, USA
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Nigatu SG. Trend and determinants of home delivery in Gambia, evidence from 2013 and 2020 Gambia Demographic and Health Survey: A multivariate decomposition analysis. PLoS One 2023; 18:e0295219. [PMID: 38055662 DOI: 10.1371/journal.pone.0295219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 11/19/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Home delivery is defined as is an even of pregnant women getting giving birth in a woman her home or other homes without an unskilled health professional assistance. It is continuing as public health problem since its responsible for death of women and newborn. In Gambia there is a high maternal mortality rate, which may be related to home delivery. Therefore, this study aimed to assess the trend of home delivery and identify predictors using Gambia Demographic and Health Survey (GDHS) 2013 and 2019-2020 data sets. METHODS A Cross-Section survey was conducted based on GDHS 2013 and 2019-2020 among reproductive age group women. A total of 8607 women participated in this study. A bivariate decomposition model was fitted, and variables that had a p-value > 0.25 were dropped. Finally, variables that got a p-value of < 0.05 with 95% confidence interval (CI) in the multivariate decomposition analysis were considered as statistical significance variables in the overall decomposition. RESULTS There has been a dramatic decrement in maternal home delivery in Gambia. It was 36.18% (95% CI:34.78, 37.58) in 2013 GDHS and 14.39% (95% CI:13.31,15.47) in 2019-2020 GDHS. This reduction is real because there was a change in the characteristics effect of the population and the coefficient effect some variables in the home delivery. Changes in characteristics effect of husband education, women education, rural residents, more than three antenatal cares follow up, and no problem reaching health facilities played a significant role in the reduction of home delivery. Being urban resident and women who had occupation were variables that had a positive effect on coefficient effect change. CONCLUSION In this study, the home delivery rate had steeply declined in the Gambia during the study period of the two surveys. Just above nine-tenths decrement in home delivery rate resulted because there was a change in the characteristics effect of the study participants. Enhancing more citizens to attend high school and above, narrowing the gap between rural and urban in terms of accessing health facilities, and improving the availability of infrastructure should be done.
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Affiliation(s)
- Solomon Gedlu Nigatu
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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James PB, Yendewa GA, Bah AJ, Osborne A, Kpagoi SS, Margao EK, Kangbai J, Wardle J. Do disempowered childbearing women give birth at home in Sierra Leone? A secondary analysis of the 2019 Sierra Leone demographic health survey. BMC Pregnancy Childbirth 2023; 23:810. [PMID: 37993807 PMCID: PMC10664373 DOI: 10.1186/s12884-023-06126-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 11/14/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND A nationwide assessment of the link between women's empowerment and homebirth has not been fully examined in Sierra Leone. Our study examined the association between women's empowerment and homebirth among childbearing women in Sierra Leone using the 2019 Sierra Leone Demographic Health Survey (2019 SLDHS) data. METHOD We used the individual file (IR) of the 2019 SLDHS dataset for our analysis. A total of 7377 women aged 15-49 years who gave birth in the five years preceding the survey were included. Outcome variable was "home birth of their last child among women in the five years preceding the 2019 SLDHS. Women's empowerment parameters include women's knowledge level, economic participation, decision-making ability and power to refuse the idea of intimate partner violence. We used the complex sample command on SPSS version 28 to conduct descriptive and multivariate logistic regression analyses. RESULTS Three in every 20 women had home childbirth (n = 1177; 15.3%). Women with low [aOR 2.04; 95% CI 1.43-2.92] and medium [aOR 1.44; 95%CI 1.05-1.97] levels of knowledge had higher odds of giving birth at home compared to those with high levels of knowledge. Women who did not have power to refuse the idea of intimate partner violence against women were more likely to had given birth at home [aOR 1.38; 95% CI1.09-1.74]. In addition, women with no [aOR 2.71; 95% CI1.34-5.46) and less than four antenatal care visits [aOR 2.08; 95% CI:1.51-2.88] and for whom distance to a health facility was a major problem [aOR 1.95; 95% CI1.49-2.56] were more likely to have had a homebirth. However, no statistically significant association was observed between a women's decision-making power and home birth [aOR 1.11; 95% CI 0.86-1.41]. CONCLUSION Despite improvements in maternal health indicators, homebirth by unskilled birth attendants is still a public health concern in Sierra Leone. Women with low knowledge levels, who did not have power to refuse the idea of intimate partner violence against women, had less than four ANC visits and considered distance to a health facility as a major problem had higher odds of giving birth at home. Our findings reflect the need to empower women by improving their knowledge level through girl child and adult education, increasing media exposure, changing societal norms and unequal power relations that promote gender-based violence against women, and improving roads and transport infrastructure.
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Affiliation(s)
- Peter Bai James
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia.
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone.
| | - George A Yendewa
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, 44106, USA
- Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, 44106, USA
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Abdulai Jawo Bah
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
- Institute for Global Health and Development, Queen Margaret University Edinburg, Musselburgh, Scotland, UK
| | - Augustus Osborne
- Department of Biological Sciences, School of Environmental Sciences, Njala University, Njala Campus, Njala, Sierra Leone
| | - Satta Sylvia Kpagoi
- Bo Government Hospital, Ministry of Health and Sanitation, Bo, Sierra Leone
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
| | - Emmanuel Kamanda Margao
- Faculty of Pharmaceutical Sciences, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Jia Kangbai
- School of Community Health Sciences, Njala University, Bo Campus, Bo, Sierra Leone
- Faculty of Health Sciences and Disaster Management, Eastern Technical University of Sierra Leone, Kenema, Sierra Leone
| | - Jon Wardle
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia
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Quispe-Vicuña C, Fernandez-Guzman D, Caira-Chuquineyra B, Failoc-Rojas VE, Bendezu-Quispe G, Urrunaga-Pastor D. Association between receiving information on obstetric complications and institutional delivery: An analysis of the demographic and health survey of Peru, 2019. Heliyon 2023; 9:e21146. [PMID: 38027831 PMCID: PMC10665671 DOI: 10.1016/j.heliyon.2023.e21146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To evaluate the association between receiving information on obstetric complications and institutional delivery in Peruvian women in 2019. Methods We conducted a secondary analysis of the 2019 Peruvian Demographic and Family Health Survey (ENDES) database. The dependent variable was the type of delivery (institutional or non-institutional). The exposure variable was self-reporting of having received information on obstetric complications during prenatal care. The association of interest was evaluated using binary logistic regression models, obtaining crude odds ratios (cOR) and adjusted odds ratios (aOR) with their respective 95 % confidence intervals (95%CI). Values of p < 0.05 were considered statistically significant. Results We included a total of 14,835 women in the analysis. Of the total, 14,088 (94.1 %) reported having received information on pregnancy complications. Also, 13,883 (92.5 %) had an institutional delivery in their last pregnancy. The adjusted model showed that women who reported knowing the complications that can occur in pregnancy had a higher probability of presenting an institutional delivery (aOR = 1.47; 95%CI: 1.04-2.08). Conclusions Receiving information about pregnancy complications was found to be associated with a higher probability of institutional delivery. Ensuring the provision of information to the pregnant woman about pregnancy complications can be a useful strategy to increase institutional delivery.
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Affiliation(s)
- Carlos Quispe-Vicuña
- Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
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Parrish S, Vasan SK, Karpe F, Hardy-Johnson P, Jarjou O, Bittaye M, Prentice AM, Ulijaszek S, Jobe M. Concealed pregnancy as an act of care? A qualitative analysis of motivations for concealing and non-disclosure of early pregnancy in The Gambia. BMC Pregnancy Childbirth 2023; 23:374. [PMID: 37226126 PMCID: PMC10207755 DOI: 10.1186/s12884-023-05710-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 05/16/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND A barrier to achieving first trimester antenatal care (ANC) attendance in many countries has been the widespread cultural practice of not discussing pregnancies in the early stages. Motivations for concealing pregnancy bear further study, as the interventions necessary to encourage early ANC attendance may be more complicated than targeting infrastructural barriers to ANC attendance such as transportation, time, and cost. METHODS Five focus groups with a total of 30 married, pregnant women were conducted to assess the feasibility of conducting a randomised controlled trial to evaluate the effectiveness of early initiation of physical activity and/or yoghurt consumption in reducing Gestational Diabetes Mellitus in pregnant women in The Gambia. Focus group transcripts were coded through a thematic analysis approach, assessing themes as they arose in relation to failure to attend early ANC. RESULTS Two reasons for the concealment of pregnancies in the first trimester or ahead of a pregnancy's obvious visibility to others were given by focus group participants. These were 'pregnancy outside of marriage' and 'evil spirits and miscarriage.' Concealment on both grounds was motivated through specific worries and fears. In the case of a pregnancy outside of marriage, this was worry over social stigma and shame. Evil spirits were widely considered to be a cause of early miscarriage, and as such, women may choose to conceal their pregnancies in the early stages as a form of protection. CONCLUSION Women's lived experiences of evil spirits have been under-explored in qualitative health research as they relate specifically to women's access to early antenatal care. Better understanding of how such sprits are experienced and why some women perceive themselves as vulnerable to related spiritual attacks may help healthcare workers or community health workers to identify in a timely manner the women most likely to fear such situations and spirits and subsequently conceal their pregnancies.
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Affiliation(s)
- Sabine Parrish
- School of Anthropology and Museum Ethnography, University of Oxford, 51/53 Banbury Road, Oxford, OX2 6PE, UK.
| | - Senthil K Vasan
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, OUH Trust, Oxford, UK
| | | | | | - Mustapha Bittaye
- Department of Obstetrics and Gynaecology, Edward Francis Small Teaching Hospital, Banjul, The Gambia
- University of The Gambia, Banjul, The Gambia
| | | | - Stanley Ulijaszek
- School of Anthropology and Museum Ethnography, University of Oxford, 51/53 Banbury Road, Oxford, OX2 6PE, UK
| | - Modou Jobe
- MRC Unit The Gambia at LSHTM, Banjul, The Gambia
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Kamal SMM. Intra-regional variations and contextual effects on facility-based delivery in Bangladesh: A multi-level analysis. Health Care Women Int 2023; 44:175-197. [PMID: 34582312 DOI: 10.1080/07399332.2021.1963965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We examined intra-regional variations and contextual influences on institutional delivery of women using the nationally representative 2014 Bangladesh Demographic and Health Survey data. Due to the hierarchical structure of the data, we employed multi-level logistic regression analysis. Of the women who had had a live birth in the last three years preceding the survey, only 38% availed the opportunity of institutional delivery. From the findings of this study, we observed that women of the Eastern region were less likely and those of the Western region were more likely to use FBD compared to the women of the Central region. Both individual- and community-level factors influence women to use facility-based delivery. Community-level programs aimed at improving availability and easy accessibility to economically deprived and geographically disadvantaged areas may increase safe motherhood practices among women.
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Bain LE, Aboagye RG, Malunga G, Amu H, Dowou RK, Saah FI, Kongnyuy EJ. Individual and contextual factors associated with maternal healthcare utilisation in Mali: a cross-sectional study using Demographic and Health Survey data. BMJ Open 2022; 12:e057681. [PMID: 35193922 PMCID: PMC8867328 DOI: 10.1136/bmjopen-2021-057681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE We examined the national prevalence as well as the individual and contextual factors associated with maternal healthcare utilisation in Mali. SETTING The study was conducted in Mali. PARTICIPANTS We analysed data on 6335 women aged 15-49 years from Mali's 2018 Demographic and Health Survey. OUTCOME VARIABLE Maternal healthcare utilisation comprising antenatal care (ANC) attendant, skilled birth attendant (SBA), and postnatal care (PNC) attendant, was our outcome variable. RESULTS Prevalence of maternal healthcare utilisation was 45.6% for ANC4+, 74.7% for SBA and 25.5% for PNC. At the individual level, ANC4 + and SBA utilisation increased with increasing maternal age, level of formal education and wealth status. Higher odds of ANC4 + was found among women who are cohabiting (adjusted OR (aOR)=2.25, 95% CI 1.16 to 4.37) and delivered by caesarean section (aOR=2.53, 95% CI 1.72 to 3.73), while women who considered getting money for treatment (aOR=0.72, 95% CI 0.60 to 0.88) and distance to health facility (aOR=0.73, 95% CI 0.59 to 0.90) as a big problem had lower odds. Odds to use PNC was higher for those who were working (aOR=1.22, 95% CI 1.01 to 1.48) and those covered by health insurance (aOR=1.87, 95% CI 1.36 to 2.57). Lower odds of SBA use were associated with having two (aOR=0.48, 95% CI 0.33 to 0.71), three (aOR=0.37, 95% CI 0.24 to 0.58), and four or more (aOR=0.38, 95% CI 0.24 to 0.59) children, and residing in a rural area (aOR=0.35, 95% CI 0.17 to 1.69). Listening to the radio and watching TV were associated with increased maternal healthcare utilisation. CONCLUSION The government should increase availability, affordability and accessibility to healthcare facilities by investing in health infrastructure and workforce to achieve Sustainable Development Goal 3.4 of reducing maternal morality to less than 70 deaths per 100 000 live births by 2030. It is important to ascertain empirically why PNC levels are astonishingly lower relative to ANC and SBA.
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Affiliation(s)
- Luchuo Engelbert Bain
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, Lincolnshire, UK
- Global South Health Research and Services, Amsterdam, The Netherlands
| | - Richard Gyan Aboagye
- Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | | | - Hubert Amu
- Population and Behavioural Sciences, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Robert Kokou Dowou
- Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Farrukh Ishaque Saah
- Global South Health Research and Services, Amsterdam, The Netherlands
- Epidemiology and Biostatistics, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
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Stanikzai M, Khan A, Wyar W, Wasiq A, Sayam H. Factors associated with health facility delivery in the 12 th District of Kandahar City, Kandahar, Afghanistan: A community-based cross-sectional study. Indian J Community Med 2022; 47:172-176. [PMID: 36034262 PMCID: PMC9400356 DOI: 10.4103/ijcm.ijcm_985_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Maternal mortality and morbidity are increasing public health concerns in Afghanistan. Even more worrying is maternal death due to causes that can be prevented through maternal healthcare services utilization during pregnancy and delivery. Objectives: We sought to investigate the magnitude of women giving birth in a health facility and its associated factors in the 12th district of Kandahar city, Kandahar province, Afghanistan. Materials and Methods: A community-based cross-sectional study of women who gave birth in the last 2 years in the 12th district of Kandahar city was conducted in early 2021. We used a systematic random sampling method to enroll 850 women. We collected data on sociodemographics, reproductive characteristics, and delivery practices of respondents. Factors associated with health facility delivery were identified using a multivariable logistic regression model. Results: The proportion of women who gave birth at health facilities was 71.8% (confidence interval [CI]; 68.61%–74.77%). In this study, health facility delivery was associated with husbands’ education (adjusted odds ratio [AOR] = 3.07, 95% CI: 1.50–6.31), antenatal care (ANC) services utilization (AOR = 17.84, 95% CI: 11.86–26.8), and history of complications in previous births (AOR = 3.65, 95% CI: 2.32–5.74). Conclusion: In this study, the utilization of a health facility for delivery was slightly lower than reported on the national level. Our study found potential factors such as ANC visits, husbands’ education, and history of complications in previous births, for which interventions aimed at enhancing the proportion of health facility deliveries.
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Zegeye B, Ahinkorah BO, Idriss-Wheelr D, Oladimeji O, Olorunsaiye CZ, Yaya S. Predictors of institutional delivery service utilization among women of reproductive age in Senegal: a population-based study. Arch Public Health 2021; 79:5. [PMID: 33431061 PMCID: PMC7798284 DOI: 10.1186/s13690-020-00520-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/15/2020] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND In Senegal, sub-Saharan Africa, many women continue to die from pregnancy and childbirth complications. Even though health facility delivery is a key intervention to reducing maternal death, utilization is low. There is a dearth of evidence on determinants of health facility delivery in Senegal. Therefore, this study investigated the predictors of health facility-based delivery utilization in Senegal. METHODS Data from the 2017 Senegal Continuous Survey were extracted for this study, and approximately 11,487 ever-married women aged 15-49 years participated. Chi-square test was used to select significant variables and multivariable logistic regression analysis was performed to identify statistically significant predictors at a 95% confidence interval with a 0.05 p-value using Stata version 14 software. RESULTS Facility-based delivery utilization was 77.7% and the main predictors were maternal educational status (primary school Adjusted Odds Ratio [aOR] = 1.44, 95% CI; 1.14-1.83; secondary school aOR = 1.62, 95% CI; 1.17-2.25), husband's educational status (primary school aOR = 1.65, 95% CI; 1.24-2.20, secondary school aOR = 2.17, 95% CI; 1.52-3.10), maternal occupation (agricultural-self-employed aOR = 0.77, 95% CI; 0.62-0.96), ethnicity (Poular aOR = 0.74, 95% CI; 0.56-0.97), place of residence (rural aOR = 0.57, 95% CI; 0.43, 0.74), media exposure (yes aOR = 1.26, 95% CI; 1.02-1.57), economic status (richest aOR = 5.27, 95% CI; 2.85-9.73), parity (seven and above aOR =0.46, 95% CI; 0.34-0.62), wife beating attitude (refuse aOR =1.23, 95% CI; 1.05-1.44) and skilled antenatal care (ANC) (yes aOR = 4.34, 95% CI; 3.10-6.08). CONCLUSION Uptake of health facility delivery services was seen among women who were educated, exposed to media, wealthy, against wife-beating, attended ANC by skilled attendants and had educated husbands. On the other hand, women from ethnic groups like Poular, those working in agricultural activities, living in rural setting, and those who had more delivery history were less likely to deliver at a health facility. Therefore, there is the need to empower women by encouraging them to use skilled ANC services in order for them to gain the requisite knowledge they need to enhance their utilization of health facility delivery, whiles at the same time, removing socio-economic barriers to access to health facility delivery that occur from low education, poverty and rural dwelling.
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Affiliation(s)
- Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
| | - Bright Opoku Ahinkorah
- The Australian Centre for Public and Population Health Research (ACPPHR), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Dina Idriss-Wheelr
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario Canada
| | - Olanrewaju Oladimeji
- Department of Public Health, Walter Sisulu University, Mthatha, Eastern Cape South Africa
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
- Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | - Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Yaya S, Kota K, Buh A, Bishwajit G. Prevalence and predictors of taking tetanus toxoid vaccine in pregnancy: a cross-sectional study of 8,722 women in Sierra Leone. BMC Public Health 2020; 20:855. [PMID: 32503478 PMCID: PMC7273659 DOI: 10.1186/s12889-020-08985-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/24/2020] [Indexed: 12/30/2022] Open
Abstract
Background Immunization of women during pregnancy to protect them and their infants against tetanus, pertussis and influenza is recommended by the World health Organization (WHO). However, there is limited information about the coverage rate and associated factors in low-income countries. The aim of this study was to measure the prevalence and predictors of taking tetanus toxoid among pregnant women in Sierra Leone. Methods This study was based on the fifth round of Multiple Indicator Cluster Survey (MICS 5) conducted in Sierra Leone in 2017. In total 8722 women aged between 15 and 49 years were included in this study. Outcome variable was taking of Tetanus Toxoid vaccination during the last pregnancy. Data were analyzed using cross-tabulation and logistic regression methods. Results The overall prevalence of receiving TT immunization during women’s last pregnancy was 96.3% and that of taking at least two doses was 82.12%. In the regression analysis, women from Mende ethnicity had a 0.48 fold lower chance of being immunized (OR = 0.480, 95% CI = 0.385,0.59768) than those from the other ethnicity. In addition, women who attended at least four ANC visits had higher odds of receiving TT vaccine (OR = 1.919, 95% CI = 1.639,2.245) compared to those who attended less ANC visits. Stratified by areas, this association was observed in both urban (OR = 2.661, 95% CI = 1.924,3.679) and rural areas (OR = 1.716, 95% CI = 1.430,2.059). Attending at least four ANC visits showed a positive association with receiving at least two doses TT (OR = 2.434, 95% CI = 1.711,3.464) in both urban (OR = 2.815, 95% CI = 1.413,5.610) and rural areas (OR = 2.216, 95% CI = 1.463,3.356) as well. Conclusion Higher number of ANC visits, mass media exposure and higher wealth quintile increased the odds of receiving TT immunization. In addition, minimum two doses which were identified to reduce neonatal mortality. Therefore, immunization campaigns targeting improved utilization of healthcare and immunization services by women of childbearing age in Sierra Leone are strongly recommended.
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Affiliation(s)
- Sanni Yaya
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON, K1N 6N5, Canada. .,The George Institute for Global Health, The University of Oxford, Oxford, UK.
| | - Komlan Kota
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Amos Buh
- Faculty of Health Sciences, Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Ghose Bishwajit
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON, K1N 6N5, Canada
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