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Kinney M, Kumar MB, Kaboré I, Kiendrébéogo J, Waiswa P, Lawn JE. Global Financing Facility investments for vulnerable populations: content analysis regarding maternal and newborn health and stillbirths in 11 African countries, 2015 to 2019. Glob Health Action 2024; 17:2329369. [PMID: 38967540 PMCID: PMC11229757 DOI: 10.1080/16549716.2024.2329369] [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: 10/30/2023] [Accepted: 03/07/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND The Global Financing Facility (GFF) was launched in 2015 to catalyse increased domestic and external financing for reproductive, maternal, newborn, child, adolescent health, and nutrition. Half of the deaths along this continuum are neonatal deaths, stillbirths or maternal deaths; yet these topics receive the least aid financing across the continuum. OBJECTIVES To conduct a policy content analysis of maternal and newborn health (MNH), including stillbirths, in GFF country planning documents, and assess the mortality burden related to the investment. METHODS Content analysis was conducted on 24 GFF policy documents, investment cases and project appraisal documents (PADs), from 11 African countries. We used a systematic data extraction approach and applied a framework for analysis considering mindset, measures, and money for MNH interventions and mentions of mortality outcomes. We compared PAD investments to MNH-related deaths by country. RESULTS For these 11 countries, USD$1,894 million of new funds were allocated through the PADs, including USD$303 million (16%) from GFF. All documents had strong content on MNH, with particular focus on pregnancy and childbirth interventions. The investment cases commonly included comprehensive results frameworks, and PADs generally had less technical content and fewer indicators. Mortality outcomes were mentioned, especially for maternal. Stillbirths were rarely included as targets. Countries had differing approaches to funding descriptions. PAD allocations are commensurate with the burden. CONCLUSIONS The GFF country plans present a promising start in addressing MNH. Emphasising links between investments and burden, explicitly including stillbirth, and highlighting high-impact packages, as appropriate, could potentially increase impact.
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Affiliation(s)
- Mary Kinney
- School of Public Health, University of the Western Cape, Cape Town, South Africa
| | - Meghan Bruce Kumar
- Department of Nursing, Midwifery and Health, Nothumbria University, Newcastle upon Tyne, UK
- Health Systems and Research Ethics, KEMRI-Wellcome Trust Programme, Nairobi, Kenya
| | - Issa Kaboré
- Operations Division, Research, Expertise and Training Department, Recherche Pour la Santé et le Développement (RESADE, Ouagadougou, Burkina Faso
| | - Joël Kiendrébéogo
- Department of Research, Expertise and Capacity Building, Research, Expertise and Training Department, Recherche Pour la Santé et le Développement (RESADE), Ouagadougou, Burkina Faso
- Department of Public Health, University Joseph Ki-Zerbo, Ouagadougou, Burkina Faso
- Heidelberg Institute of Global Health, Medical Faculty and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Peter Waiswa
- School of Public Health, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joy E. Lawn
- Department of Infectious Disease Epidemiology and International Health, London School of Hygiene & Tropical Medicine, London, UK
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Moxon SG, B SS, Penn-Kekana L, Sharma S, Talbott J, Campbell OMR, Freedman L. Evolving narratives on signal functions for monitoring maternal and newborn health services: A meta-narrative inspired review. Soc Sci Med 2024; 352:116980. [PMID: 38820693 DOI: 10.1016/j.socscimed.2024.116980] [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: 10/24/2023] [Revised: 04/16/2024] [Accepted: 05/14/2024] [Indexed: 06/02/2024]
Abstract
Emergency obstetric care (EmOC) signal functions are a shortlist of key clinical interventions capable of averting deaths from the five main direct causes of maternal mortality; they have been used since 1997 as a part of an EmOC monitoring framework to track the availability of EmOC services in low- and middle-income settings. Their widespread use and proposed adaptation to include other types of care, such as care for newborns, is testimony to their legacy as part of the measurement architecture within reproductive health. Yet, much has changed in the landscape of maternal and newborn health (MNH) since the initial introduction of EmOC signal functions. As part of a project to revise the EmOC monitoring framework, we carried out a meta-narrative inspired review to reflect on how signal functions have been developed and conceptualised over the past two decades, and how different narratives, which have emerged alongside the evolving MNH landscape, have played a role in the conceptualisation of the signal function measurement. We identified three overarching narrative traditions: 1) clinical 2) health systems and 3) human rights, that dominated the discourse and critique around the use of signal functions. Through an iterative synthesis process including 19 final articles selected for the review, we explored patterns of conciliation and areas of contradiction between the three narrative traditions. We summarised five meta-themes around the use of signal functions: i) framing the boundaries; ii) moving beyond clinical capability; iii) capturing the woods versus the trees; iv) grouping signal functions and v) measurement challenges. We intend for this review to contribute to a better understanding of the discourses around signal functions, and to provide insight for the future roles of this monitoring approach for emergency obstetric and newborn care.
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Affiliation(s)
- Sarah G Moxon
- London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 3HT, UK.
| | | | - Loveday Penn-Kekana
- London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 3HT, UK.
| | - Sudha Sharma
- CIWEC Hospital and Travel Medicine Center, GPO Box, 12895, Kapurdhara Marg, Kathmandu, Nepal.
| | - Jennifer Talbott
- Averting Maternal Death and Disability (AMDD), Columbia University Mailman School of Public Health, 60 Haven Avenue, Suite B3, New York, NY, 10032, USA; Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA.
| | - Oona M R Campbell
- London School of Hygiene and Tropical Medicine (LSHTM), Keppel Street, London, WC1E 3HT, UK.
| | - Lynn Freedman
- Averting Maternal Death and Disability (AMDD), Columbia University Mailman School of Public Health, 60 Haven Avenue, Suite B3, New York, NY, 10032, USA; Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY, 10032, USA.
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Haza'a AA, Odhah MA, Al-Ahdal SA, Abol-Gaith FM, Ismail NA, Al-Awar MS, Al-Jaradi AS, Eidah WS, Kaid MM. Utilisation of postnatal care services among maternal in Maeen District - Sana'a City, Yemen. BMC Pregnancy Childbirth 2024; 24:422. [PMID: 38872137 PMCID: PMC11170784 DOI: 10.1186/s12884-024-06617-6] [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: 06/09/2023] [Accepted: 05/31/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND One of the most effective ways to reduce maternal and neonatal mortality is to improve mother and newborn health via the provision of appropriate postnatal care services by qualified healthcare providers. However, there is limited information on the use of postnatal care services in Yemen. This study aimed to determine the utilisation of postnatal care services among mothers in Yemen. METHODOLOGY A descriptive cross-sectional study was conducted in the Maeen District of Sana'a City, Yemen from December 2022 to January 2023. Convenience sampling was employed to recruit 321 participants. Semi-structured questionnaires were applied as the study tool in the face-to-face survey. RESULT Less than half (45.2%) of the study participants utilised postnatal care services in this study. The mode of delivery, place of delivery, and receiving information about postnatal care during antenatal visits were significantly associated with postnatal care service utilisation. CONCLUSION Less than half of the study participants were informed about postnatal care services, contributing to their low utilisation. Thus, it is vital to strengthen the provision of information, education, and communication with regard to postnatal care services among pregnant mothers visiting antenatal clinics.
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Affiliation(s)
- Abdulnasser A Haza'a
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen.
| | - Marzoq A Odhah
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen
| | - Saddam A Al-Ahdal
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen
| | - Fawz M Abol-Gaith
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen
- Department of Nursing, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
| | - Nada A Ismail
- Department of Nursing, Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
- Nursing and Midwifery Department, Faculty of Medical Sciences, Azal University, Sana'a, Yemen
| | | | - Abdulfatah S Al-Jaradi
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen
| | - Wedian S Eidah
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen
| | - Manar M Kaid
- Nursing and Midwifery Department, Faculty of Medicine and Health Sciences, Al-Razi University, Sana'a, Yemen
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Noghanibehambari H, Fletcher J. Long-Term Health Benefits of Occupational Licensing: Evidence from Midwifery Laws. JOURNAL OF HEALTH ECONOMICS 2023; 92:102807. [PMID: 37722296 PMCID: PMC10841694 DOI: 10.1016/j.jhealeco.2023.102807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/19/2023] [Accepted: 09/03/2023] [Indexed: 09/20/2023]
Abstract
During the late 19th and early 20th century, several states mandated midwifery licensing requirements to improve midwives' knowledge, education, and quality. Previous studies point to the health benefits of midwifery quality improvements for maternal and infant health outcomes. This paper exploits the staggered adoption of midwifery laws across states using event-study and difference-in-difference frameworks. We use the universe of death records in the US over the years 1979-2020 and find that exposure to a midwifery licensing law at birth is associated with a 2.5 percent reduction in cumulative mortality rates and an increase of 0.6 months in longevity during adulthood and old age. The effects are concentrated on deaths due to infectious diseases, neoplasm diseases, and suicide mortality. We also show that the impacts are confined among blacks and are slightly larger among males. Additional analyses using alternative data sources suggest small but significant increases in educational attainments, income, measures of socioeconomic status, employment, and measures of height as potential mechanism channels. We provide a discussion on the economic magnitude and policy implication of the results.
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Affiliation(s)
- Hamid Noghanibehambari
- College of Business, Austin Peay State University, Marion St, Clarksville, TN 37040, USA.
| | - Jason Fletcher
- La Follette School of Public Affairs, University of Wisconsin-Madison, 1225 Observatory Drive, Madison, WI 53706-1211, USA.
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Naranjee N, Naidoo V, Krishna SBN, Jinabhai CC, Sibiya MN. Utilisation of Maternal Health Services and its Impact on Maternal Mortality Rate: A Case for KwaZulu-Natal, South Africa. AFRICA JOURNAL OF NURSING AND MIDWIFERY 2023. [DOI: 10.25159/2520-5293/14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Despite several strategies in place in South Africa and globally to prevent maternal mortality and morbidity, maternal deaths remain high, especially in sub-Saharan Africa and lower to middle-income countries. The aim of the study was to identify the challenges that lead to pregnant women’s delays in seeking antenatal care (ANC) early and to find strategies to prevent such delays, contributing to a reduction of maternal deaths in South Africa. The study was conducted in two phases. Phase one analysed data on maternal deaths collected by the District Health Information System (DHIS) of the KwaZulu-Natal Department of Health from all 11 districts over a 10-year period (2009–2019). The data on maternal deaths revealed that there was a very high maternal mortality rate; between 800 and 1 780 per 100 000 live births. This correlated with very low antenatal visits; between 695–895 per 100 000 live births. In phase two, a literature review was conducted using several computer-assisted databases, bibliographies and websites to identify and source current policies. The literature review presents causes of delay in seeking ANC and strategies to prevent maternal deaths. Recommendations were made to consider strengthening education and awareness related to family planning; women empowerment through community health programmes and change in healthcare providers’ behaviours and attitudes; ensuring availability of maternal health resources; and developing strategies to ensure that the ANC services delivered are in line with the South African Department of Health Guidelines.
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Adams YJ, Agbenyo JS. Improving the Quality of Postpartum Care in Ghana: Protocol for a Parallel Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e47519. [PMID: 37606965 PMCID: PMC10481215 DOI: 10.2196/47519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/05/2023] [Accepted: 06/06/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Although the postpartum period poses substantial risks and can result in significant maternal morbidity and mortality, postpartum care of the mother receives much less attention in transitional countries. OBJECTIVE We describe the protocol for a randomized controlled trial to implement and evaluate a postpartum care delivery model titled Focused-PPC (Focused Postpartum Care). METHODS Focused-PPC is an integrated group postpartum care model that meets the clinical care, education, and support needs of mothers up to 1 year after birth. The Focused-PPC intervention is a parallel randomized controlled trial with a total of 192 postpartum women at 4 health centers in Tamale, Ghana. Participants will be randomized into 1 of 2 trial arms at a 1:1 allocation ratio: (1) the control arm, which receives the standard postnatal care currently delivered in health facilities, or (2) the intervention arm, which receives the Focused-PPC model of care. Women enrolled in the intervention arm will receive postpartum clinical assessments and education for the first 6 weeks and will continue to receive education, measures of vital signs, and peer support for 12 months post partum during child welfare visits. Led by trained midwives, each postpartum group in the intervention arm will meet at 1-2 weeks, 6 weeks, and monthly thereafter for up to 1 year post partum, following the Ghana Health Service postnatal care schedule. RESULTS The Focused-PPC guide, data collection tools, and audiovisual education materials were successfully developed and translated into the local language. We have enrolled and conducted baseline surveys for 192 women (sample size met) in the Focused-PPC trial who have been randomized into intervention and control arms. We have established a total of 12 Focused-PPC groups in the intervention arm, 3 groups from each site, all of which have sessions underway. CONCLUSIONS Focused-PPC has the potential to change the postpartum care delivery model in Ghana and other countries in sub-Saharan Africa and beyond. TRIAL REGISTRATION ClinicalTrials.gov NCT05280951; https://clinicaltrials.gov/study/NCT05280951. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47519.
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Affiliation(s)
- Yenupini Joyce Adams
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, United States
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Zhao S, Zhang Y, Xiao AY, He Q, Tang K. Key factors associated with quality of postnatal care: a pooled analysis of 23 countries. EClinicalMedicine 2023; 62:102090. [PMID: 37533417 PMCID: PMC10393561 DOI: 10.1016/j.eclinm.2023.102090] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/18/2023] [Accepted: 06/25/2023] [Indexed: 08/04/2023] Open
Abstract
Background Progress in reducing maternal and neonatal mortality, particularly in low-income and middle-income countries (LMICs) and regions, is insufficient to achieve the Sustainable Developmental Goals by 2030. High-quality postnatal care (PNC) for mothers and neonates is crucial for mothers and babies, yet it remains the most neglected intervention on the continuum of maternal and child care. We aimed to estimate the associations between observable factors and high-quality maternal and neonatal PNC in pooled and country-specific analyses. Methods In this cross-sectional study, we used the most recent (2015-2022) Demographic and Health Surveys from 23 countries across Africa (n = 14), Southeast Asia (n = 3), Eastern Mediterranean (n = 2), Europe (n = 2), Americas (n = 1), and Western Pacific (n = 1). Women who, within the last 5 years, were aged 15-49 years at their last live birth that had delivered a singleton child were included. We identified eleven PNC behaviours recommended by the World Health Organization (WHO) to measure PNC quality, and applied thresholds to create binary outcomes for quality maternal and neonatal PNC. 15 factors were included in our analysis to assess their association with high-quality PNC for mothers and neonates in a series of single-adjusted and mutually adjusted logistic regression models, both in pooled and country-specific analysis. We also conducted two sets of subgroup analyses for place of residence and maternal age at last birth, and two sets of supplementary analyses to test the robustness of the results. Findings Among 172,526 women and their most recent child, 41.42% (40.93-41.91) received quality maternal PNC while 42.34% (41.86-42.83) received quality neonatal PNC. In the pooled analysis, we found that the factors showing the strongest associations with quality maternal PNC were delivery by skilled birth attendants (SBAs) (OR: 4.92; 95% CI: 4.32-5.59), four or more antenatal care (ANC) visits (OR: 1.69, 1.58-1.81), and institutional delivery (OR: 1.61; 1.46-1.78). Consistent results were found for all factors of quality newborn care (e.g., delivery by SBA: OR, 4.25; 3.75-4.81; four or more ANC visits: OR, 1.83; 1.70-1.96) except institutional delivery. The association between these leading factors and PNC quality were broadly consistent across countries. Subgroup analyses and sensitivity analyses showed generally consistent results. Interpretation Our study demonstrated that institutional delivery and frequent ANC visits had the strongest positive associations with quality PNC for both mothers and neonates. Our findings highlight that improvements to the quality of maternal and neonatal PNC in the LMICs we assessed are urgently needed to achieve ambitious maternal, newborn, and child health goals. Funding China National Natural Science Foundation.
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Affiliation(s)
- Shuangyu Zhao
- Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, PR China
| | - Yixuan Zhang
- Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, PR China
- School of Traffic and Transportation, Beijing Jiaotong University, No.3, Shangyuan Village, Haidian District, Beijing, 100044, PR China
| | - Angela Y. Xiao
- Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, PR China
| | - Qiwei He
- Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, PR China
- Institute of International Development Cooperation, Chinese Academy of International Trade and Economic Cooperation, Beijing, 100710, PR China
| | - Kun Tang
- Vanke School of Public Health, Tsinghua University, No. 30, Shuangqing Road, Haidian District, Beijing, 100084, PR China
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Sjetne IS, Iversen HH. Women report better experiences from maternity care after postnatal consultations: A cross sectional study. PATIENT EDUCATION AND COUNSELING 2023; 111:107690. [PMID: 36893560 DOI: 10.1016/j.pec.2023.107690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/28/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE To determine if the patient reported experiences (PREMs) of women in maternity care differ by whether or not they had a postnatal consultation before leaving the birth institution. METHODS Secondary analysis of cross-sectional data to compare PREMs of women who had received an individual consultation (86 %), a group consultation (3 %), and women who had received no consultation (11 %). PREMs were collected using a self-administered questionnaire. Eight summated scales were constructed from 29 single items, pertaining to different parts of the received care. Scores ranged between 0 and 100, with high scores representing positive experiences. RESULTS Among the 8156 sampled women, 3387 (42 %) responded. There were statistically significant (p ≤ 0.002) differences (from 3.7 to 16.3 points) on all eight scales. The scores from women who had an individual postnatal consultation were consistently higher than the scores from the other groups. The largest difference was in the scale with the worst score: information about women's health during the postnatal stay. CONCLUSION Women who participated in individual postnatal consultations reported more positive experiences compared to those who did not. PRACTICE IMPLICATION The consistent differences found in this study provide support for administering individual postnatal consultations.
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Høgmo BK, Alstveit M, Bondas T. Being a "Warrior" to Care for the New Family: A Meta-ethnography of Nurses' Perspectives on Municipal Postnatal Healthcare. Glob Qual Nurs Res 2023; 10:23333936231218843. [PMID: 38149124 PMCID: PMC10750548 DOI: 10.1177/23333936231218843] [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: 03/27/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 12/28/2023] Open
Abstract
Care in the postnatal period is a goal for all families with a newborn baby, and support from nurses might prevent long-term health problems and contribute to a positive postnatal experience. This meta-ethnography aims to integrate and synthesize qualitative studies that illuminate and describe nurses' perspectives on municipal postnatal health care in high-income countries. Systematic literature searches for qualitative studies were conducted and 13 articles were included. The analysis followed the seven phases of Noblit and Hare. Being a "warrior" to care for the new family was identified as an overarching metaphor accompanied by three main themes: Stretching human boundaries, Stretching system boundaries, and Stretching knowledge boundaries. The overarching metaphor offers a deeper understanding of the nurses as "warriors" who despite tight timeframes and heavy workloads are stretching toward a caring relationship with the families. Being a warrior continuously pushing system boundaries puts the nurses in risk of being overstretched, balancing between their ideals and the reality. As more knowledge and clearer policies and procedures regarding the inclusion of fathers and LGBTQ parents in municipal postnatal healthcare are needed, more focus placed on the father or non-birthing parent, different cultural traditions and family constellations in practice and education is suggested.
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Hassen SS, Lelisho ME. Determining factors associated with the prevalence of knowledge, attitude, and practice in seeking skilled maternal healthcare services among women in a remote area of Gesha district. BMC Health Serv Res 2022; 22:1318. [PMID: 36329430 PMCID: PMC9635200 DOI: 10.1186/s12913-022-08710-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Skilled health care is essential for the mother's and newborn's health and well-being during pregnancy, labor, and the postpartum period. This study aimed to analyze women's knowledge, attitudes, and practices while requesting competent assistance for maternity healthcare in Gesha District, Southwest Region of Ethiopia. Methods A community-based cross-sectional study design was conducted from September 20, 2021 to October 19, 2021. A total of 424 mothers participated in this study and a systematic sampling technique was used to select the respondents. The data were collected using a pretested and structured questionnaire. Statistical software SPSS-20 and R-4.1.2 were used to enter and analyze the data respectively. The factors associated with the prevalence of Knowledge, Attitude, and Practice in seeking Skilled Maternal Healthcare Services were identified using descriptive analysis and a binary logistic regression model. Results This study result revealed that the overall proportions of good knowledge, positive attitude, and good practice in seeking skilled maternal health care services were 39.15%, 37.5%, and 34.67% respectively. Estimated odds of having knowledge, attitude, and practice were as follows: for having age between 20–24 years at first pregnancy 1.859, 1.86, and 1.799; having a plan for pregnancy 2.74,2.315 and 2.579; mothers attended elementary education 2.337, 2.565 and 3.312; having maternal age 20–24 years 4.336,4.989 and 5.870; maternal age 25–29 years 2.917, 3.794 and 4.017; maternal age 35–49 years 2.837, 2.991 and 3.412; having husbands who had attended elementary education level 2.736, 2.542 and 2.134; secondary and above education 3.464, 3.360 and 2.508; rich mothers 2.261, 1.995 and 2.452; having antenatal care 4 times and above 2.606, 2.570, 2.682; having transportation access 1.921, 1.956 and 2.404; having media access 1.979, 2.171 and 2.715 respectively. The odds of having attitude and practice respectively were as follows: married 1.762, and 2.208; having medium wealth index 1.933 and 2.424. The odds of having previous pregnancy complications was 2.147 which significantly affect the practice of seeking skilled maternal care assistance. Conclusions This study discovered that the study participants' knowledge, attitude, and practice of skilled maternal health care are low. Associated factors included age at first pregnancy, planned pregnancy, maternal education level, husband’s education level, maternal age, antenatal care service visits, transport access, and access to media were found to significantly affect the knowledge, attitude, and practice of the respondents in seeking skilled maternal care assistance in common. The household wealth index was also associated with attitude. Pregnancy complications, current marital status, and household wealth index also significantly affect the practice of seeking skilled maternal care assistance. As a result of the findings, initiatives to increase women's knowledge, attitudes, and use of expert maternal health services in the research area are needed for women residing in rural areas.
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Affiliation(s)
- Sali Suleman Hassen
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia.
| | - Mesfin Esayas Lelisho
- Department of Statistics, College of Natural and Computational Science, Mizan-Tepi University, Tepi, Ethiopia
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