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Sheikh NS, Hussein AM, Mohamed SS, Gele A. Does living in major towns favor institutional delivery in Somalia? Front Glob Womens Health 2024; 5:1216290. [PMID: 39119357 PMCID: PMC11306125 DOI: 10.3389/fgwh.2024.1216290] [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: 07/13/2023] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Background In developing countries, institutional delivery is a key proven intervention that reduces maternal mortality and can reduce maternal deaths by approximately 16%-33%. In Somalia, only 32% of births are delivered in a health facility with the assistance of a skilled healthcare provider. We aimed to investigate the factors hindering women from giving birth at healthcare facilities in major towns in Somalia, where most of the health facilities in the country are concentrated. Methods A community-based health survey was carried out in 11 major towns in Somalia between October and December 2021. A structured and pretested questionnaire was used to collect data from 430 women who gave birth in the last five years. Women were recruited through convenient sampling. Descriptive statistics were used to summarize the data, and binary and multivariable logistic regression analysis was performed. Adjusted odds ratios (AOR) with 95% CI were estimated to assess the associations. Results The overall prevalence of institutional delivery was 57%. Approximately 38% of women living in Mogadishu and 53% living in another ten towns give birth at home. Women who had poor knowledge of the importance of health facility delivery had nearly four times higher odds of delivering at home (AOR 3.64 CI: 1.49-8.93). Similarly, those who did not receive antenatal care (AOR 2.5, CI: 1.02-6.39) and those who did not receive a consultation on the place of delivery (AOR 2.15, CI: 1.17-3.94) were more likely to give birth at home. The reasons for home delivery included financial reasons, the long distance to the health facility, and the fact that it was easier to give birth at home. Conclusion The study found that home delivery is high in major towns in Somalia and is associated with a lack of understanding of the importance of health facility delivery, not using ANC, and not receiving consultancy about where to give birth. Primary health care should strengthen information, education, and communication activities. Since the health care system in Somalia is overwhelmingly private, the government may consider access to free and within-reach ANC and health facility delivery for women and girls from families who cannot pay the ANC and childbirth delivery cost.
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Affiliation(s)
- Naima Said Sheikh
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
| | - Ahmed M. Hussein
- Department of Maternal and Reproductive Health, Somali Institute for Health Research, Mogadishu, Somalia
| | - Shukri Said Mohamed
- Department of Maternal and Reproductive Health, Somali Institute for Health Research, Mogadishu, Somalia
| | - Abdi Gele
- Department of Maternal and Reproductive Health, Somali Institute for Health Research, Mogadishu, Somalia
- Department of Health Services, Norwegian Institute of Public Health, Oslo, Norway
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Amo-Adjei J, Yenyi A, Ahanotu B, Okyere J. Reaching young people living with HIV & AIDS and young people in detention with comprehensive sexuality education (CSE): a preparatory formative study in Ghana. Sex Reprod Health Matters 2023; 31:2235801. [PMID: 37493474 PMCID: PMC10373617 DOI: 10.1080/26410397.2023.2235801] [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] [Indexed: 07/27/2023] Open
Abstract
As an interface between health and education, comprehensive sexuality education (CSE) offers a potent tool among other interventions to accelerate healthy transition of adolescents into adulthood. With increasing interest in in-school CSE provision/delivery, young people in out-of-school contexts may be left behind. This study forms part of implementation research to understand if the activities used to train and support the facilitators are feasible, appropriate, acceptable, and effective in enabling them to engage a defined group of young people, deliver CSE to them in the out-of-school context, and assist them in obtaining relevant services. This paper presents findings of mapping of out-of-school CSE interventions in Ghana, ongoing or completed between 2015 and 2020, and then discusses a needs assessment of two purposively selected groups of vulnerable out-of-school youth: young people living with HIV and AIDS (YPLHIV) and those living in detention (YPiD). We conducted 10 interviews with YPLHIV and three focus group discussions with YPiD in November 2020. Qualitative data were analysed thematically using both deductive and inductive approaches. The mapping yielded 29 interventions (18/62% were ongoing) focused extensively on the delivery of CSE-related knowledge and information; none were aimed at building facilitators' capacity and most targeted the northern regions. Among YPLHIV, living positively after diagnosis, disclosure skills and use of HIV/AIDS health services were critical. YpID sought clarification on personal hygiene, consent in sexual relationships, medium/channel to deliver CSE, and issues around same-sex sexual intercourse. Both groups sought skills in dealing with stigmatisation and discrimination. Implications of the findings for our own and other interventions are highlighted.
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Affiliation(s)
- Joshua Amo-Adjei
- Senior Lecturer, Department of Population and Health, University of Cape Coast, CA, Cape Coast, Ghana
| | - Adwoa Yenyi
- Programme Specialist – Adolescents and Youth, UNFPA, Accra, Ghana
| | - Brian Ahanotu
- Monitoring and Evaluation Associate, UNFPA, Accra, Ghana
| | - Joshua Okyere
- PhD Candidate, Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Rahman MH, Akter E, Ameen S, Jabeen S, Ahmed A, Rahman AE, Hossain AT. Disparities in the maternal healthcare continuum among Bangladeshi women: evidence from nationally representative surveys. Midwifery 2023; 127:103814. [PMID: 37806164 DOI: 10.1016/j.midw.2023.103814] [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: 05/31/2022] [Revised: 08/17/2023] [Accepted: 09/03/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Utilisation of maternal healthcare is low, and it consistently decreases across antenatal to postnatal period in Bangladesh. However, there is paucity of knowledge in Bangladesh to understand gaps and associated factors in seeking continuum of maternal healthcare along the pathway. Therefore, we aimed to assess the trend in socioeconomic and demographic factors and wealth inequity in maternal CoC using the Bangladesh Multiple Indicator Cluster Survey (MICS). METHODS We performed a secondary analysis on nationally representative data from the last two MICS survey, carried out in 2012-13 and 2019. The study included women of reproductive age (15-49 years) with a live birth within two years preceding the survey. Total of 7,950 and 9,183 respondents were identified from these two surveys, respectively. We used multivariable logistic regression and concentration index to examine the covariates and inequity, respectively, in the utilisation of CoC. RESULTS Utilisation of ≥4 antenatal care, skilled delivery, and postnatal care for both mother and newborn increased from 13 percent in 2012-13 to 25 percent in 2019 survey. Moreover, wealth inequity persists favouring the rich in utilisation of CoC in Bangladesh. Women belonging to wealthier quintile, urban areas, and non-Muslim families, with higher education, a household head with higher education, media use, and fewer children were most likely to avail complete CoC in both the surveys. CONCLUSION Overall utilisation of maternal CoC increased between 2012 and 13 and 2019, however, women in Bangladesh still lack the CoC with persistent wealth inequality. Integrated provision of ANC, delivery by SBA, and PNC should be introduced, comprising both private and public health facilities, and targeting women in poor and rural communities. Efforts should also focus on women's education, autonomy, fertility rate, and exposure to media.
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Affiliation(s)
- Md Hafizur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b).
| | - Ema Akter
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Shafiqul Ameen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Sabrina Jabeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Anisuddin Ahmed
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
| | - Aniqa Tasnim Hossain
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b)
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Armah-Ansah EK, Bawa B, Dindas J, Budu E, Ahinkorah BO, Ameyaw EK. A multilevel analysis of social determinants of skilled birth attendant utilisation among married and cohabiting women of Madagascar. Int Health 2023:ihad108. [PMID: 38011796 DOI: 10.1093/inthealth/ihad108] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/30/2023] [Accepted: 10/31/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Maternal mortality ratio (MMR) in Madagascar is 392 deaths per 100 000 live births, and this is a major public health concern. One of the strategies for reducing MMR and achieving target 3.1 of the Sustainable Development Goals (i.e. reducing the global MMR below 70 per 100 000 live births) is the utilisation of skilled birth attendants (SBAs). This analysis examined the prevalence and social determinants of SBA utilisation among married and cohabiting women of Madagascar. METHODS Data from the 2021 Madagascar Demographic and Health Surveys was analysed on a weighted sample of 6997 married and cohabiting women. A multilevel regression was carried out to determine the social determinants of utilising SBAs. The results are presented as odds ratios (ORs) associated with 95% confidence intervals (CIs) and a p-value <0.05 to determine the significant associations. RESULTS The prevalence of SBAs among married and cohabiting women of Madagascar was 64.4% (95% CI 0.62 to 0.68). In model 3 of the multilevel regression, women 35-39 y of age (adjusted OR [aOR] 1.86 [95% CI 1.30 to 2.60]), women with secondary/higher education (aOR 1.67 [95% CI 1.32 to 2.10]), women whose partners had secondary/higher education (aOR 1.58 [95% CI 1.25 to 1.99]), cohabiting women (aOR 1.33 [95% CI 1.07 to 1.65]), women who had four or more antenatal care visits (aOR 2.05 [95% CI 1.79 to 2.35]), female household head (aOR 1.44 [95% CI 1.06 to 1.95]), Muslims (aOR 1.58 [95% CI 0.71 to 3.53]), those of the richest wealth index (aOR 4.32 [95% CI 2.93 to 6.36]) and women who lived in communities with high literacy levels (aOR 2.17 [95% CI 1.57 to 3.00]) had higher odds of utilisation of SBA. CONCLUSION This current analysis revealed low SBA utilisation among married and cohabiting women in Madagascar. The analysis points to the fact that understaffing and inaccessibility of health facilities remain major contributors to the low utilisation of SBAs. The findings call on the government and stakeholders in Madagascar to consider implementing programs that will empower women and focus on disadvantaged groups. These programs could include providing free maternal healthcare services to all pregnant women and intensifying health education programs that target women and their partners with no formal education.
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Affiliation(s)
- Ebenezer Kwesi Armah-Ansah
- Population Dynamics Sexual and Reproductive Health Unit, African Population and Health Research Center, Nairobi, Kenya
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Department of Population and Development, National Research University, Higher School of Economics, Moscow, Russia
| | | | - John Dindas
- Department of Public Health and Healthcare, I.M. Scehenov First Moscow State Medical University, Moscow, Russia
| | - Eugene Budu
- Korle Bu Teaching Hospital, P.O. Box, 77, Accra, Ghana
| | - Bright Opoku Ahinkorah
- School of Clinical Medicine, University of New South Wales, Sydney, Australia
- REMS Consult Limited, Sekondi-Takoradi, Western Region, Ghana
| | - Edward Kwabena Ameyaw
- Institute of Policy Studies and School of Graduate Studies, Lingnan University, Tuen Mun, Hong Kong
- L & E Research Consult Limited, Wa, Upper West Region, Ghana
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Tampah-Naah AM, Yendaw E, Sumankuuro J. Residential status and household wealth disparities in modern contraceptives use among women in Ghana: a cross-sectional analysis. BMC Womens Health 2023; 23:550. [PMID: 37875940 PMCID: PMC10594689 DOI: 10.1186/s12905-023-02684-7] [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: 11/25/2022] [Accepted: 10/03/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Modern contraceptive refers to "a product or medical procedure that interferes with reproduction from acts of sexual intercourse". The aim of this study was to assess the relationship between residential status and wealth quintile, and modern contraceptive use among women in Ghana. METHODS We examined residential status and wealth quintile on contraceptive use analysing the 2006, 2011 and 2018 Multiple Indicator Cluster Surveys datasets. A sample of 30,665 women in their reproductive ages (15-49 years) were enrolled in the surveys across Ghana. STATA version 13 was used to process and analyse the data. It examined socioeconomic and demographic characteristics, assessed modern contraceptive use prevalence among women, and used logistic regression models to determine predictors. The results were presented in odds ratio and adjusted odds ratio with 95% confidence intervals. All statistical tests were measured with p < 0.05. RESULTS In the three survey years, the highest prevalence of modern contraceptive usage was observed in 2011 (27.16%). The odds of using modern contraceptive increased by 19% in rural places (AOR = 1.19; 95% CI = 1.097-1.284) compared to urban places. The likelihood of women in second (AOR = 1.17; 95% CI = 1.065-1.289), middle (AOR = 1.24; 95% CI = 1.118-1.385), and fourth (AOR = 1.25; 95% CI = 1.113-1.403) wealth quintile using contraceptives increased compared to those of low wealth quintile. With the interactive terms, rural-second (AOR = 1.38; 95% CI = 1.042-1.830), rural-middle (AOR = 1.45; 95% CI = 1.084-1.933), rural-fourth (AOR = 1.52; 95% CI = 1.128-2.059), and rural-high (AOR = 1.42; 95% CI = 1.019-1.973) were more likely to use contraceptives compared to urban-low women. Despite lower odds, women of the age groups 20-24 (AOR = 2.33; 95% CI = 2.054-2.637), cohabitaing (AOR = 1.07; 95% CI = 0.981-1.173), secondary or higher education (AOR = 1.55; 95% CI = 1.385-1.736), Central (AOR = 1.48; 95% CI = 1.296-1.682) and Eastern (AOR = 1.48; 95% CI = 1.289-1.695) regions significantly predicted modern contraceptive use. CONCLUSION Modern contraceptive use in Ghana is low. Women in rural-rich categories are more likely to use modern contraceptives. Background factors such as age, marital status, educational attainment, and previous child experiences predict modern contraceptive use. It is recommended for the intensification of contraceptive awareness and utilization for all reproductive age women, regardless of education, marriage, or wealth.
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Affiliation(s)
- Anthony Mwinilanaa Tampah-Naah
- Department of Geography, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Post Office Box WA64, Ghana.
| | - Elijah Yendaw
- Department of Governance and Development Management, Faculty of Public Policy and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
- Centre for Environment, Migration and International Relations, Simon Diedong Dombo, University of Business and Integrated Development Studies, Wa, Ghana
| | - Joshua Sumankuuro
- Department of Public Policy and Management, Faculty of Public Policy and Governance, Simon Diedong Dombo University of Business and Integrated Development Studies, Wa, Ghana
- Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- School of Allied Health, Exercise and Sports Sciences, Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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Negash Dechasa A, Mulaw Endale Z, Sertsu Gerbi A, Bekele Sime H, Ayanaw Kassie B. Preference of birth attendant gender and associated factors among antenatal care attendants at Debre Markos town public health facilities, Northwest Ethiopia: A cross-sectional study design 2021. SAGE Open Med 2022; 10:20503121221135024. [PMID: 36385788 PMCID: PMC9643756 DOI: 10.1177/20503121221135024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 10/06/2022] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE To assess the preference of birth attendant gender and associated factors among antenatal care attendants in Debre Markos town public health facilities, northwest Ethiopia, 2021. METHOD A facility-based cross-sectional study was conducted from 8 January 2021 to 28 February 2021 at Debre Markos town public health facilities. A total of 662 study participants were selected by systematic random sampling technique. Pretested interviewer-administered structured questionnaires were used for data collection. Data were entered using Epi Data version 3.1 and analyzed using SPSS version 25. Bivariable and multivariable logistic regression were applied to identify factors associated with birth attendant gender preference. Association was described by the "odd ratio" along with a 95% confidence interval. Finally, a P value < 0.05 in the adjusted analysis was used to declare a significant association. RESULT In this study, 644 women participated making a response rate of 97.3%. Of the total study participants, 108 (16.8%; 95% confidence interval: 13.8-19.4) preferred male birth attendants, while 232 (36%; 95% confidence interval: 32.5-39.8) preferred female birth attendants. Age (15-24) (adjusted odds ratio = 4.81, 95% confidence interval: 1.79, 12.94), no formal education (adjusted odds ratio = 2.94, 95% confidence interval: 1.32, 6.52), and primary education (adjusted odds ratio = 2.42, 95% confidence interval: 1.07, 5.47) were significantly associated with female birth attendant preference. A lack of formal education (adjusted odds ratio = 0.08; 95% confidence interval: 0.01, 0.68), secondary education (adjusted odds ratio = 0.34; 95% confidence interval: 0.16, 0.71), and history of assisted vaginal delivery (adjusted odds ratio = 3.72; 95% confidence interval: 1.40, 9.87) were significantly associated with a male birth attendant preference. CONCLUSION A female birth attendant is preferred by almost one-third of pregnant mothers, while one-sixth preferred a male. The clients who were younger in age and lower in educational status were more likely to prefer female birth attendants, whereas those who had a history of assisted vaginal delivery were more likely to prefer male birth attendants. To have a mother in the continuum of care, it is crucial to take her preferences into account when providing services.
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Affiliation(s)
- Abraham Negash Dechasa
- Department of Midwifery, School of
Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University,
Harar, Ethiopia
| | - Zerfu Mulaw Endale
- Department of Clinical Midwifery,
School of Midwifery, College of Medicine and Health Sciences, University of Gondar,
Ethiopia
| | - Addisu Sertsu Gerbi
- Department of Nursing, School of
Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University,
Harar, Ethiopia
| | - Habtamu Bekele Sime
- Department of Midwifery, School of
Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University,
Harar, Ethiopia
| | - Belayneh Ayanaw Kassie
- Department of Clinical Midwifery,
School of Midwifery, College of Medicine and Health Sciences, University of Gondar,
Ethiopia
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Determinants and Trends of Health Facility Delivery in Bangladesh: A Hierarchical Modeling Approach. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1359572. [PMID: 35937411 PMCID: PMC9355761 DOI: 10.1155/2022/1359572] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 05/30/2022] [Accepted: 06/20/2022] [Indexed: 11/18/2022]
Abstract
Background Most maternal deaths occur during childbirth and after childbirth. This study was aimed at determining the trends of health facilities during delivery in Bangladesh, as well as their influencing factors. Methods This study used secondary data from three Bangladesh Multiple Indicator Cluster Surveys (MICSs) in 2006, 2012–13, and 2019. The study's target sample was those women who gave birth in the last two years of the survey. A two-level logistic regression was applied to determine the effects on health facility delivery separately in these two survey points (MICSs 2012–13 and 2019). Results The results show that the delivery of health facilities has increased by almost 37.4% in Bangladesh, from 16% in 2006 to 53.4% in 2019. The results of two-level logistic regression show that the total variation in health facility delivery across the community has decreased over recent years. After adding community variables, various individual-level factors such as women with secondary education (OR = 0.55 in 2012-13 vs. OR =0.60 in 2019), women from middle wealth status (OR = 0.49 in 2012-13 vs. OR = 0.65 in 2019), religion, and child ever born showed a strong relationship with health facility delivery in both survey years. At the community level, residents showed significant association only in the 2012-13 survey and indicated a 43% (OR = 1.43 for 2012-13) greater availability of health facilities in urban residences than in rural residences. Using media showed a highly significant connection with health facility delivery in both years as well as an increasing trend over the years in Bangladesh (OR = 1.19 in 2012-13 vs. OR = 1.38 in 2019). However, division, prenatal care, and skilled services all contribute greatly to increasing the delivery of health facilities in Bangladesh. Conclusions The results of this study suggest that policymakers need to pay attention to individual and community-level factors, especially women's education, poverty reduction, and adequate prenatal care provided by well-trained caregivers.
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Ojeleke O, Groot W, Bonuedi I, Pavlova M. The impact of armed conflicts on health‐care utilization in Northern Nigeria: A difference‐in‐differences analysis. WORLD MEDICAL & HEALTH POLICY 2022. [DOI: 10.1002/wmh3.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Olabayo Ojeleke
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences Maastricht University Medical Centre, Maastricht University Maastricht The Netherlands
| | - Wim Groot
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences Maastricht University Medical Centre, Maastricht University Maastricht The Netherlands
| | - Isaac Bonuedi
- Bureau of Integrated Rural Development (BIRD) Kwame Nkrumah University of Science and Technology (KNUST) Kumasi Ghana
| | - Milena Pavlova
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences Maastricht University Medical Centre, Maastricht University Maastricht The Netherlands
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Budu E, Chattu VK, Ahinkorah BO, Seidu AA, Mohammed A, Tetteh JK, Arthur-Holmes F, Adu C, Yaya S. Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa. BMC Pregnancy Childbirth 2021; 21:834. [PMID: 34906105 PMCID: PMC8670119 DOI: 10.1186/s12884-021-04280-9] [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: 12/02/2020] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
Background Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. Methods Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. Results Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. Conclusion Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.
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Affiliation(s)
- Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Vijay Kumar Chattu
- Department of Public Health, Saveetha Medical College and Hospitals, SIMATS, Saveetha University, Chennai, TN, 600077, India.,Department of Community Medicine, Faculty of Medicine, Datta Meghe Institute of Medical Sciences (Deemed University), Wardha, MS, 442107, India
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Abdul-Aziz Seidu
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia. .,Centre For Gender and Advocacy, Takoradi Technical University, P.O.Box 256, Takoradi, Ghana.
| | - Aliu Mohammed
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Justice Kanor Tetteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, Ottawa, Canada.,The George Institute for Global Health, Imperial College London, London, UK
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Zegeye B, Adjei NK, Olorunsaiye CZ, Ahinkorah BO, Ameyaw EK, Seidu AA, Yaya S. Pregnant women's decision-making capacity and adherence to iron supplementation in sub-Saharan Africa: a multi-country analysis of 25 countries. BMC Pregnancy Childbirth 2021; 21:822. [PMID: 34903198 PMCID: PMC8667357 DOI: 10.1186/s12884-021-04258-7] [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] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anaemia and related complications during pregnancy is a global problem but more prevalent in sub-Sahara Africa (SSA). Women's decision-making power has significantly been linked with maternal health service utilization but there is inadequate evidence about adherence to iron supplementation. This study therefore assessed the association between household decision-making power and iron supplementation adherence among pregnant married women in 25 sub-Saharan African countries. METHODS We used data from the Demographic and Health Surveys (DHS) of 25 sub-Saharan African countries conducted between 2010 and 2019. Women's decision-making power was measured by three parameters; own health care, making large household purchases and visits to her family or relatives. The association between women's decision-making power and iron supplementation adherence was assessed using logistic regressions, adjusting for confounders. The results were presented as adjusted odds ratio (AOR) with 95% confidence intervals (CIs). RESULTS Approximately 65.4% of pregnant married women had made decisions either alone or with husband in all three decisions making parameters (i.e., own health care, making large household purchases, visits to her family or relatives). The rate of adherence to iron medication during pregnancy was 51.7% (95% CI; 48.5-54.9%). Adherence to iron supplementation was found to be higher among pregnant married women who had decision-making power (AOR = 1.46, 95% CI; 1.16-1.83), secondary education (AOR = 1.45, 95% CI; 1.05-2.00) and antenatal care visit (AOR = 2.77, 95% CI; 2.19-3.51). Wealth quintiles and religion were significantly associated with adherence to iron supplementation. CONCLUSIONS Adherence to iron supplementation is high among pregnant women in SSA. Decision making power, educational status and antenatal care visit were found to be significantly associated with adherence to these supplements. These findings highlight that there is a need to design interventions that enhance women's decision-making capacities, and empowering them through education to improve the coverage of antenatal iron supplementation.
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Affiliation(s)
- Betregiorgis Zegeye
- HaSET Maternal and Child Health Research Program, Shewarobit Field Office, Shewarobit, Ethiopia
| | - Nicholas Kofi Adjei
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | | | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland Australia
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, 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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Health facility delivery among women of reproductive age in Nigeria: Does age at first birth matter? PLoS One 2021; 16:e0259250. [PMID: 34735506 PMCID: PMC8568178 DOI: 10.1371/journal.pone.0259250] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 10/16/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND High maternal mortality ratio in sub-Saharan Africa (SSA) has been linked to inadequate medical care for pregnant women due to limited health facility delivery utilization. Thus, this study, examined the association between age at first childbirth and health facility delivery among women of reproductive age in Nigeria. METHODS The study used the most recent secondary dataset from Nigeria's Demographic and Health Survey (NDHS) conducted in 2018. Only women aged15-49 were considered for the study (N = 34,193). Bi-variate and multivariable logistic regression models were used to examine the association between age at first birth and place of delivery. The results were presented as crude odds ratios and adjusted odds ratios (aOR) with corresponding 95% confidence intervals (CIs). Statistical significance was set at p<0.05. RESULTS The results showed that the prevalence of health facility deliveries was 41% in Nigeria. Women who had their first birth below age 20 [aOR = 0.82; 95%(CI = 0.74-0.90)] were less likely to give birth at health facilities compared to those who had their first birth at age 20 and above. CONCLUSION Our findings suggest the need to design interventions that will encourage women of reproductive age in Nigeria who are younger than 20 years to give birth in health facilities to avoid the risks of maternal complications associated with home delivery. Such interventions should include male involvement in antenatal care visits and the education of both partners and young women on the importance of health facility delivery.
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Ganle JK, Ofori C, Dery S. Testing the effect of an integrated-intervention to promote access to sexual and reproductive healthcare and rights among women with disabilities in Ghana: a quasi-experimental study protocol. Reprod Health 2021; 18:206. [PMID: 34654455 PMCID: PMC8520222 DOI: 10.1186/s12978-021-01253-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 10/01/2021] [Indexed: 11/23/2022] Open
Abstract
Background There is evidence that women with disabilities (WWDs) experience the most difficulty accessing and using sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable interventions to reach WWDs with essential SRHR services. This study aims to test the effect of an integrated health facility and individual-level intervention on access to SRHRs information and services among sexually active WWDs aged 15–49 years in Ghana. Methods A quasi-experimental study design with four arms will be implemented in four districts in the Northern region of Ghana to test the effect of three inter-related interventions. The inventions are (1) capacity building in disability-centred SRHRs information and service delivery for healthcare providers, (2) support for WWDs to access disability-unfriendly healthcare infrastructure, and (3) one-on-one regular SRHRs education, information provision, and referral. The first two interventions are at the health-facility level while the third one is at the individual/family level. The first arm of the experiment will expose eligible WWDs to all three interventions. In the second arm, WWDs will be exposed to only the two-health facility-level interventions. The third arm will expose WWDs to only the individual level intervention. The forth arm will constitute the control group. A total of 680 (170 in each arm) sexually active women with physical disability and visual impairments will take part in the study over a period of 12 months. To assess the effect of the interventions on key study outcomes (i.e. awareness about, and use of modern contraceptive, ANC attendance, and skilled delivery among parous women), pre- and post-intervention surveys will be conducted. Difference-in-Difference analysis will be used to examine the effect of each intervention in comparison to the control group, while controlling for confounders. Cost-effectiveness analyses will also be conducted on the three-intervention arms vis a vis changes in key outcome measures to identify which of the three interventions is likely to yield greater impact with lower costs. Discussion Lack of access to SRHRs information and services for WWDs is not only a violation of their right to appropriate and quality SRH care but could also undermine efforts to achieve equitable healthcare access as envisaged under SDG 3. This research is expected to generate evidence to inform local health programmes to increase access to SRHRs among WWDs by strengthening local health system capacity to provide disability-sensitive SRHRs services. Trial registration Name of the registry: Pan African Clinical Trials Registry (PACTR). Trial ID: 14591. Date of registration: 02/01/2020. URL of trial registry record: https://pactr.samrc.ac.za/Researcher/TrialRegister.aspx?TrialID=14591 Women with disabilities (WWDs) experience a lot of difficulty accessing sexual and reproductive health and rights (SRHRs) services and information worldwide. However, there are currently no workable specific interventions to reach WWDs with essential SRHRs services. We propose to implement three interventions to enable WWDs in Ghana who are aged 15–49 years gain better access to SRHRs services and information. Our aim is show whether these interventions have beneficial effects by helping many more WWDs access and use SRHRs services and information like modern contraceptives. To achieve this objective, we will (1) train healthcare providers in ways to better provide SRHRs information and service to WWDs; (2) support WWDs to access disability-unfriendly healthcare infrastructure by creating access ramps at health facilities; (3) train and deploy community health volunteers to undertake one-on-one regular home visits to educate WWDs on SRHRs, provide information on SRHRs and refer WWDs to healthcare providers. A total of 680 sexually active women with physical and visual impairments will take part in the study over a period of 12 months. We will divide the women into four groups (170 in each group). The first group will be exposed to all the three interventions. The second group will be exposed to only interventions 1 and 2. The third group will be exposed to only intervention 3. The fourth group will not be exposed to any of the three interventions. Our study is expected to strengthen the local health system capacity to provide disability-sensitive SRHRs services.
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Affiliation(s)
- John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.
| | - Charlotte Ofori
- Regional Institute for Population Studies, University of Ghana, Legon, Accra, Ghana
| | - Samuel Dery
- Department of Biostatistics, School of Public Health, University of Ghana, Legon, Accra, Ghana
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Baatiema L, Tanle A, Darteh EKM, Ameyaw EK. Is quality maternal healthcare all about successful childbirth? Views of mothers in the Wa Municipality, Ghana. PLoS One 2021; 16:e0257401. [PMID: 34525128 PMCID: PMC8443026 DOI: 10.1371/journal.pone.0257401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction In spite of the countless initiatives of the Ghana government to improve the quality of maternal healthcare, Upper West Region still records poor childbirth outcomes. This study, therefore, explored women’s perception of the quality of maternal healthcare they receive in the Wa Municipality of the Upper West Region of Ghana. Materials and methods This is a qualitative cross-sectional study of 62 women who accessed maternal healthcare in the Wa Municipality of Ghana. We analysed the transcripts using the analytic inductive technique. An inter-coding technique (testing for inter-coding agreement) was employed. The iterative coding process resulted in a coding scheme with four main themes. We used peer-debriefing technique in ensuring credibility and trustworthiness. Results Logistics and equipment; referral service; empathic service delivery; inadequacy of care providers; affordability of service; satisfaction with services received; as well as experience and service delivery were the parameters used by the women in assessing quality maternity care. A number of gaps were reported in the healthcare system including limited healthcare providers, limited beds and inefficient referral system. Conversely, some of them reported that some healthcare providers offered empathetic healthcare. Contrary views were expressed with respect to satisfaction with maternity care. Conclusion Government and all stakeholders seeking to enhance quality of maternal health and accelerate the attainment of the third Sustainable Development Goal need to reconsider the financing of service delivery at health institutions. Indeed, our findings have illustrated that routine workshops on empathetic healthcare are required in efforts to increase the rate of facility-based childbirth, and thereby subside maternal mortality and all adverse pregnancy outcomes.
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Affiliation(s)
- Linus Baatiema
- Ghana Health Service, Upper West Regional Health Directorate, Wa, Ghana
- * E-mail:
| | - Augustine Tanle
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Eugene Kofuor Maafo Darteh
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Edward Kwabena Ameyaw
- Faculty of Health, The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, Australia
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Alyahya MS, Khader YS, Al-Sheyab NA, Shattnawi KK, Altal OF, Batieha A. Modifiable Factors and Delays Associated with Neonatal Deaths and Stillbirths in Jordan: Findings from Facility-Based Neonatal Death and Stillbirth Audits. Am J Perinatol 2021; 40:731-740. [PMID: 34058760 DOI: 10.1055/s-0041-1730434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE This study employed the "three-delay" model to investigate the types of critical delays and modifiable factors that contribute to the neonatal deaths and stillbirths in Jordan. STUDY DESIGN A triangulation research method was followed in this study to present the findings of death review committees (DRCs), which were formally established in five major hospitals across Jordan. The DRCs used a specific death summary form to facilitate identifying the type of delay, if any, and to plan specific actions to prevent future similar deaths. A death case review form with key details was also filled immediately after each death. Moreover, data were collected from patient notes and medical records, and further information about a specific cause of death or the contributing factors, if needed, were collected. RESULTS During the study period (August 1, 2019-February 1, 2020), 10,726 births, 156 neonatal deaths, and 108 stillbirths were registered. A delay in recognizing the need for care and in the decision to seek care (delay 1) was believed to be responsible for 118 (44.6%) deaths. Most common factors included were poor awareness of when to seek care, not recognizing the problem or the danger signs, no or late antenatal care, and financial constraints and concern about the cost of care. Delay 2 (delay in seeking care or reaching care) was responsible for nine (3.4%) cases. Delay 3 (delay in receiving care) was responsible for 81 (30.7%) deaths. The most common modifiable factors were the poor or lack of training that followed by heavy workload, insufficient staff members, and no antenatal documentation. Effective actions were initiated across all the five hospitals in response to the delays to reduce preventable deaths. CONCLUSION The formation of the facility-based DRCs was vital in identifying critical delays and modifiable factors, as well as developing initiatives and actions to address modifiable factors. KEY POINTS · Death review committees play key roles in identifying critical delays and modifiable factors.. · The "three-delay" model was successful in identifying preventable neonatal deaths and stillbirths.. · Death review committees are central in developing actions to reduce preventable deaths..
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Affiliation(s)
- Mohammad S Alyahya
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S Khader
- Medical Education and Biostatistics, Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nihaya A Al-Sheyab
- Allied Medical Sciences Department, Faculty of Applied Medical Sciences, Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Khulood K Shattnawi
- Department of Maternal and Child Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Altal
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Anwar Batieha
- Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Appiah F, Salihu T, Fenteng JOD, Darteh AO, Djan ET, Takyi M, Ayerakwah PA, Ameyaw EK. Factors influencing early postnatal care utilisation among women: Evidence from the 2014 Ghana Demographic and Health Survey. PLoS One 2021; 16:e0249480. [PMID: 33798224 PMCID: PMC8018634 DOI: 10.1371/journal.pone.0249480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 03/16/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Early postnatal care (EPNC) utilisation is crucial for averting maternal deaths as recommended by the World Health Organisation. About 30% of women do not obtain EPNC in Ghana and no national level study have investigated the determinants of EPNC. Therefore, this study aimed at assessing factors associated with EPNC uptake among women aged 15-49 in Ghana. MATERIALS AND METHODS The study utilised data from the women's file of the 2014 Ghana Demographic and Health Survey (GDHS) and sampled 1,678 women aged 15-49 who had complete data on EPNC. Descriptive computation of EPNC was done. Since EPNC (which is the main outcome variable for the study) was dichotomous, the binary logistic regression was used to determine factors influencing utilisation of EPNC at 95% two-tailed confidence interval. The results were presented as adjusted odds ratio (AOR). Stata version 14.0 was used for all the analyses. RESULTS Descriptively, the results indicated that 31% of women aged 15-49 sought EPNC. At the inferential level, women aged 40-44 were more likely to seek EPNC compared to those aged 15-19 [AOR = 3.66, CI = 1.25-10.67]. Islam women had higher odds of EPNC as compared with Christians [AOR = 1.70, CI = 1.23-2.35]. Comparatively, women of Mande ethnic group had higher propensity to seek EPNC than the Akan [AOR = 3.22, CI = 1.20-8.69]. Residents of the Greater Accra region were over 11 times probable to utilise EPNC compared with the residents of Western region. CONCLUSION The key determinants of EPNC were age, religion, ethnicity, marital status and region. Therefore, the Health Promotion and Education Unit and Reproductive and Child Health Department of the Ghana Health Service need to scale up EPNC sensitisation programmes and should target women aged 15-19, Christians and other category of women with less likelihood of EPNC in order to offset the disparities.
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Affiliation(s)
- Francis Appiah
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- Berekum College of Education, Berekum, Bono Region, Ghana
| | - Tarif Salihu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | | | | | | | - Matthew Takyi
- Berekum College of Education, Berekum, Bono Region, Ghana
| | | | - Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Ameyaw EK, Dickson KS, Adde KS. Are Ghanaian women meeting the WHO recommended maternal healthcare (MCH) utilisation? Evidence from a national survey. BMC Pregnancy Childbirth 2021; 21:161. [PMID: 33622274 PMCID: PMC7903775 DOI: 10.1186/s12884-021-03643-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background To achieve the Sustainable Development Goal target 3.1, the World Health Organisation recommends that all pregnant women receive antenatal care (ANC) from skilled providers, utilise the services of a skilled birth attendant at birth and receive their first postnatal care (PNC) within the first 24 h after birth. In this paper, we examined the maternal characteristics that determine utilisation of skilled ANC, skilled birth attendance (SBA), and PNC within the first 24 h after delivery in Ghana. Methods We used data from the 2014 Ghana Demographic and Health Survey. Women aged 15-49 with birth history not exceeding five before the survey were included in the study. A total of 2839 women were included. Binary logistic regression was employed at a 95% level of significance to determine the association between maternal factors and maternal healthcare (MCH) utilisation. Bivariate and multivariate regression was subsequently used to assess the drivers. Results High proportion of women had ANC (93.2%) with skilled providers compared to the proportion that had SBA (76.9%) and PNC within the first 24 h after delivery (25.8%). Only 21.2% utilised all three components of MCH. Women who were covered by national health insurance scheme (NHIS) had a higher likelihood (AOR = 1.31, CI = 1.04 – 1.64) of utilising all three components of MCH as compared to those who were not covered by NHIS. Women with poorer wealth status (AOR = 0.72, CI = 0.53 – 0.97) and those living with partners (AOR = 0.65, CI = 0.49 – 0.86) were less likely to utilise all three MCH components compared to women with poorest wealth status and the married respectively. Conclusion The realisation that poorer women, those unsubscribed to NHIS and women living with partners have a lower likelihood of utilising the WHO recommended MCH strongly suggest that it is crucial for the Ministry of Health and the Ghana Health Service to take pragmatic steps to increase education about the importance of having ANC with a skilled provider, SBA, and benefits of having the first 24 h recommended PNC.
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Affiliation(s)
- Edward Kwabena Ameyaw
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.
| | - Kwamena Sekyi Dickson
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
| | - Kenneth Setorwu Adde
- Department of Population and Health, College of Humanities and Legal Studies, University of Cape Coast, Cape Coast, Ghana
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Oh J, Moon J, Choi JW, Kim K. Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013. BMJ Open 2020; 10:e036516. [PMID: 33243786 PMCID: PMC7692971 DOI: 10.1136/bmjopen-2019-036516] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To identify factors associated with the continuum of maternal, newborn and child health care in The Gambia. DESIGN A secondary statistical analysis using Demographic and Health Survey conducted in 2013. SETTING The Gambia. PARTICIPANTS 1308 married women (or with a partner) whose most recent children were aged 12-23 months at the time of the survey. OUTCOME MEASURES The main outcome was continuum of care for maternal, newborn and child health. The modified composite coverage index was calculated to express the completion level of continuum of care. RESULTS The following factors were associated with the continuum of maternal, newborn and child health care: women's autonomy in decision-making of her own healthcare (β=0.063, p=0.015), having higher educated husbands (β=0.138, p<0.001), listening to the radio at least once a week (β=0.078, p=0.006), having a child with birth order less than 5 (β=0.069, p=0.037), initiating the first antenatal care within 16 weeks of pregnancy (β=0.170, p<0.001), having been informed of signs of pregnancy complications (β=0.057, p=0.029), living in rural areas (β=-0.107, p=0.006) and having higher burden due to distance to health facility (β=-0.100, p<0.001), with an explanatory power of 15.5% (R2=0.155). CONCLUSIONS Efforts on future policies and programmes should focus on the concept of continuum of care considering the associated factors. In particular, more attention should be given to providing country-wide family planning and education to women, men and community members in The Gambia.
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Affiliation(s)
- Jiyoung Oh
- Department of Environmental and Global Health, Graduate School of Public Health, Korea University, Seoul, Republic of Korea
- Global Health Strategy Center, Institute for Environmental Health, Korea University, Seoul, Seongbuk-gu, Republic of Korea
| | - Juyoung Moon
- Department of Environmental and Global Health, Graduate School of Public Health, Korea University, Seoul, Republic of Korea
- Global Health Strategy Center, Institute for Environmental Health, Korea University, Seoul, Seongbuk-gu, Republic of Korea
| | - Jae Wook Choi
- Department of Environmental and Global Health, Graduate School of Public Health, Korea University, Seoul, Republic of Korea
- Global Health Strategy Center, Institute for Environmental Health, Korea University, Seoul, Seongbuk-gu, Republic of Korea
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyunghee Kim
- Global Health Strategy Center, Institute for Environmental Health, Korea University, Seoul, Seongbuk-gu, Republic of Korea
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Lorenze DL. Women's Lived Experiences of Giving Birth in Ghana: A Metasynthesis of the Literature. INTERNATIONAL JOURNAL OF CHILDBIRTH 2020. [DOI: 10.1891/ijcbirth-d-20-00015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDThe purpose of this metasynthesis is to analyze women's lived experiences of giving birth in Ghana during and after the Millennium Development Goals (MDGs), when health policy in Ghana was changed to urge women to birth in health services with skilled attendants.METHODAn interpretive phenomenological framework guided the review of the literature. Three electronic databases were searched as well as reference lists and author searches. Articles that met the screening criteria for inclusion were coded and thematically analyzed, then drawn together to construct the essence of women's experiences of giving birth in Ghana.RESULTSSeven themes were constructed from the data and these were poor quality health services, maltreatment by midwives, mixed emotions about pregnancy and childbirth, supernatural fears, women wanting safe births with skilled birth attendants, uncertainty about reaching a health facility, and decision-making hierarchy. There were three counter themes and these were women wanting a home birth with a traditional midwife, defiance against dominant decision-makers by some women, and a belief that “not all nurses are bad.”CONCLUSIONGhanaian women have heeded the MDGs and health policy messages to birth with skilled attendants, but in reality, they are not always accessible, available, appropriate, or of high quality. Maternal health services still need much improvement including more resources such as staff, essential services, medicines, and quality assurance standards.
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Ahinkorah BO. Non-utilization of health facility delivery and its correlates among childbearing women: a cross-sectional analysis of the 2018 Guinea demographic and health survey data. BMC Health Serv Res 2020; 20:1016. [PMID: 33167985 PMCID: PMC7650152 DOI: 10.1186/s12913-020-05893-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/02/2020] [Indexed: 12/31/2022] Open
Abstract
Background Many childbearing women in sub-Saharan African countries like Guinea still face challenges accessing and utilizing health facility delivery services and opt to deliver at home. This study examined the non-utilization of health facility delivery and its associated factors among childbearing women in Guinea. Methods Data from the 2018 Guinea Demographic and Health Survey was used in this study. Data of 5406 childbearing women were analysed using STATA version 14.2 by employing a multilevel logistic regression approach. The results were presented using adjusted odds ratios (aOR) at 95% confidence interval (CI). Results More than three-quarters (47.6%) of childbearing women in Guinea did not deliver at health facilities. Women who had no formal education (aOR = 1.52, 95% CI = 1.09–2.12), those whose partners had no formal education (aOR = 1.25, 95% CI =1.01–1.56), those whose pregnancies were unintended (aOR = 1.40, 95% CI =1.13–1.74) and those who were Muslims (aOR = 2.87, 95% CI =1.17–7.08) were more likely to deliver at home. Furthermore, women with parity four or more (aOR = 1.78, 95% CI =1.34–2.37), those who listened to radio less than once a week (aOR = 5.05, 95% CI =1.83–13.89), those who never watched television (aOR = 1.46, 95% CI =1.12–1.91), those with poorest wealth quintile (aOR = 4.29, 95% CI =2.79–6.60), women in female-headed households (aOR = 1.38, 95% CI =1.08–1.78) and rural dwellers (aOR = 3.86, 95% CI =2.66–5.60) were more likely to deliver at home. Conclusion This study has identified low socio-economic status, inadequate exposure to media, having an unplanned pregnancy and religious disparities as key predictors of home delivery among childbearing women in Guinea. The findings call for the need to enhance advocacy and educational strategies like focus group discussions, peer teaching, mentor-mentee programmes at both national and community levels for women to encourage health facility delivery. There is also the need to improve maternal healthcare services utilization policies to promote access to health facility delivery by reducing costs and making health facilities available in communities.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.
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20
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Ganle JK, Apolot RR, Rugoho T, Sumankuuro J. 'They are my future': childbearing desires and motivations among women with disabilities in Ghana - implications for reproductive healthcare. Reprod Health 2020; 17:151. [PMID: 33023601 PMCID: PMC7539488 DOI: 10.1186/s12978-020-01000-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 09/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research has highlighted widespread public mis/perceptions that portray women with disabilities (WWDs) as asexual, less likely to marry, and often not interested in childbearing. However, evidence from high-income settings shows that many WWDs are sexually active and do have or want to have children. Notwithstanding this, very few studies have focused on understanding childbearing desires and motivations among WWDs in low-income settings. This qualitative research explored childbearing desires and motivations among WWDs in Ghana. METHODS A cross-sectional qualitative study was conducted with WWDs aged 18-49 years in Northern Ghana. The distribution of participants by disability types were as follows: physical disability/impairment (n = 37); visual impairment (n = 11); speech and hearing impairment (n = 14); epilepsy (n = ten); and albinism (n = five). A pre-tested open-ended thematic topic guide was designed and used to conduct in-depth interviews. Interviews were tape-recorded and later transcribed for analysis. Transcripts were coded using QSR NVivo 11 software. Thematic content analysis techniques were used to analyse and present the data. RESULTS Nearly all the WWDs interviewed were sexually active, desiring to have children, and intended to have as many children as they could support. Strong desire to experience the joy of motherhood; fear of social insecurity; fear of old age economic insecurity; desire to challenge stigma and negative stereotypes about disability, sexuality and motherhood; and desire for self-actualisation, were key motivations for childbearing. CONCLUSION Our findings challenge existing negative public perceptions about the status of WWDs in relation to sexuality, childbearing and motherhood. More importantly, our findings suggest that if the Sustainable Development Goals related to universal access to sexual and reproductive healthcare are to be attained, WWDs must be targeted with quality sexual and reproductive healthcare information and services.
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Affiliation(s)
- John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Legon, P.O. Box LG 13, Accra, Ghana. .,Stellenbosch Institute for Advanced Study (STIAS), Wallenberg Research Centre at Stellenbosch University, Stellenbosch, 7600, South Africa.
| | - Rebecca Racheal Apolot
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Makerere University, Kampala, Uganda
| | - Tafadzwa Rugoho
- Department of Development Studies, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Joshua Sumankuuro
- School of Community Health, Faculty of Science, Charles Sturt University, Bathurst, New South Wales, Australia
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Antabe R, Kansanga M, Sano Y, Kyeremeh E, Galaa Y. Utilization of breast cancer screening in Kenya: what are the determinants? BMC Health Serv Res 2020; 20:228. [PMID: 32183801 PMCID: PMC7079358 DOI: 10.1186/s12913-020-5073-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 03/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer accounts for 23% of all cancer cases among women in Kenya. Although breast cancer screening is important, we know little about the factors associated with women's breast cancer screening utilization in Kenya. Using the Andersen's behavioural model of health care utilization, we aim to address this void in the literature. METHODS We draw data on the Kenya Demographic and Health Survey and employ univariate, bivariate, and multivariate analyses. RESULTS We find that women's geographic location, specifically, living in a rural area (OR = 0.89; p < 0.001) and the North Eastern Province is associated with lower odds of women being screened for breast cancer. Moreover, compared to the more educated, richer and insured, women who are less educated, poorer, and uninsured (OR = 0.74; p < 0.001) are less likely to have been screened for breast cancer. CONCLUSION Based on these findings, we recommend place and group-specific education and interventions on increasing breast cancer screening in Kenya.
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Affiliation(s)
- Roger Antabe
- Department of Geography, Western University, 1151 Richmond Street, Social Science Building, London, Ontario, N6A 3K7, Canada
| | - Moses Kansanga
- Department of Geography, Western University, 1151 Richmond Street, Social Science Building, London, Ontario, N6A 3K7, Canada
| | - Yujiro Sano
- Department of Sociology, Western University, 1151 Richmond Street, Social Science Building, London, Ontario, N6A 3K7, Canada
| | - Emmanuel Kyeremeh
- Department of Geography, Western University, 1151 Richmond Street, Social Science Building, London, Ontario, N6A 3K7, Canada
| | - Yvonne Galaa
- Department of Planning, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, KNUST, Kumasi, Ghana.
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Ndugga P, Namiyonga NK, Sebuwufu D. Determinants of early postnatal care attendance: analysis of the 2016 Uganda demographic and health survey. BMC Pregnancy Childbirth 2020; 20:163. [PMID: 32178635 PMCID: PMC7076947 DOI: 10.1186/s12884-020-02866-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/09/2020] [Indexed: 02/08/2023] Open
Abstract
Background The first 2 days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first 2 days after childbirth can help avert maternal mortality because it allows early detection of problems that could result in adverse maternal health outcomes. Unfortunately, knowledge of the uptake of early postnatal care (EPNC), which is imperative for informing policies aimed at reducing maternal mortality, remains low in Uganda. Therefore, the purpose of this study is to investigate the determinants of early postnatal care attendance among Ugandan women. Methods This study was based on nationally representative data from the 2016 Uganda Demographic and Health Survey. The study sample comprised 5471 women (age 15–49) who delivered a child in the 2 years preceding the survey. We used logistic regression to identify factors associated with use of early postnatal care. Results Our findings showed that 50% of mothers used EPNC services for their most recent delivery in the 2 years preceding the survey. Women’s residence, education level, religion, wealth status, marital status, occupation, antenatal care attendance, place of delivery, birth order, perceived accessibility of health facilities, and access to mass media messages were associated with greater use of EPNC. The percentage of women receiving EPNC was much higher among women who delivered at a health facility, either a public facility (63%) or private facility (65%), versus only 9% among women who delivered at home. Multivariate analysis showed that delivery at a health facility was the most important determinant of early postnatal care attendance. Conclusions To increase mothers’ use of EPNC services and improve maternal survival in Uganda, programs could promote and strengthen health facility delivery and ensure that EPNC services are provided to all women before discharge. Even so, the fact that only about two-thirds of women who delivered at a health facility received early postpartum care shows substantial room for improvement. Interventions should target women who deliver at home, women who attend fewer than four antenatal care visits, and women with a primary education.
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Affiliation(s)
- Patricia Ndugga
- Department of Population Studies, School of Statistics and Planning, Makerere University, Kampala, Uganda.
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Budu HI, Abalo EM, Bam VB, Agyemang DO, Noi S, Budu FA, Peprah P. "I prefer a male nurse to a female nurse": patients' preference for, and satisfaction with nursing care provided by male nurses at the Komfo Anokye teaching hospital. BMC Nurs 2019; 18:47. [PMID: 31641337 PMCID: PMC6802348 DOI: 10.1186/s12912-019-0369-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 09/16/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although most male nurses join the profession for self-actualisation, the cultural and societal stereotyping of male nurses as “He-Man”, “gay” and “troublemakers”, and their marginalisation at the hospital during certain personal and intimate care procedures, tend to deepen the existing gender discrimination prevalent within the nursing profession. This study therefore assessed patients’ preference for, and satisfaction with nursing care provided by male nurses at the medical and surgical wards of Komfo Anokye Teaching Hospital [KATH]. Methods An inferential cross-sectional study design, in which the prevalence of a condition among an identified population is determined, was used. Using convenience sampling, 150 respondents who meet certain practical criteria and are available and willing to participate were sampled. Data from a context-based research instrument on the opinion, preference and satisfaction of patients with male nursing were analysed using χ2 test, Mann Whitney U test, ordinal logistic regression and logistic regression. Results The study indicates that more females than males had ever been attended to by a male nurse for the period considered by the study, and females described male nurses as polite and courteous and were comfortable with their treatment. Being single [OR = 0.111, 95% CI (0.013–0.928)] and professing Islamic faiths [OR = 36.533, 95% CI (2.116–630.597)] were functions of respondents’ preference for a male nurse. Significantly too, affiliating to a religious sect (OR = 2.347, 95% CI [0.076–1.630]) and being educated (OR = 1.387, 95% CI [0.040–0.615]), were associated with higher odds of falling in one of the higher categories of satisfaction with nursing care provided by male nurses as against the lower categories. Conclusion Although marital status, religious affiliation and educational level were the significant predictors of patients’ preference for, and satisfaction with care provided by male nurses, the effect of the other variables should not be overlooked. The finding disproves assertions on the negative effect of religion on male nurses. It is recommended that public awareness be created on the role of male nurses in the healthcare delivery system to promote acceptance of gender diversity in the nursing profession.
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Affiliation(s)
- Hayford Isaac Budu
- 1Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Mawuli Abalo
- 2Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Victoria Bubunyo Bam
- 1Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Deus Osei Agyemang
- 1Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Shirley Noi
- 1Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - Prince Peprah
- 2Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Preferences for formal and traditional sources of childbirth and postnatal care among women in rural Africa: A systematic review. PLoS One 2019; 14:e0222110. [PMID: 31553722 PMCID: PMC6760778 DOI: 10.1371/journal.pone.0222110] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/21/2019] [Indexed: 11/19/2022] Open
Abstract
Background The underutilization of formal, evidence-based maternal health services continues to contribute to poor maternal outcomes among women living in rural Africa. Women’s choice of the type of maternal care they receive strongly influences their utilization of maternal health services. There is therefore a need to understand rural women’s preferred choices to help set priorities for initiatives attempting to make formal maternal care more responsive to women’s needs. The aim of this review was to explore and identify women’s preferences for different sources of childbirth and postnatal care and the factors that contribute to these preferences. Methods A systematic literature search was conducted using the Ovid Medline, Embase, CINAHL, and Global Health databases. Thirty-seven studies that elicited women’s preferences for childbirth and postnatal care using qualitative methods were included in the review. A narrative synthesis was conducted to collate study findings and to report on patterns identified across findings. Results During the intrapartum period, preferences varied across communities, with some studies reporting preferences for traditional childbirth with traditional care-takers, and others reporting preferences for a formal facility-based childbirth with health professionals. During the postpartum period, the majority of relevant studies reported a preference for traditional postnatal services involving traditional rituals and customs. The factors that influenced the reported preferences were related to the perceived need for formal or traditional care providers, accessibility to maternal care, and cultural and religious norms. Conclusion Review findings identified a variety of preferences for sources of maternal care from intrapartum to postpartum. Future interventions aiming to improve access and utilization of evidence-based maternal healthcare services across rural Africa should first identify major challenges and priority needs of target populations and communities through formative research. Evidence-based services that meet rural women’s specific needs and expectations will increase the utilization of formal care and ultimately improve maternal outcomes across rural Africa.
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Adewuyi EO, Khanal V, Zhao Y, David L, Bamidele OD, Auta A. Home childbirth among young mothers aged 15-24 years in Nigeria: a national population-based cross-sectional study. BMJ Open 2019; 9:e025494. [PMID: 31537553 PMCID: PMC6756611 DOI: 10.1136/bmjopen-2018-025494] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To estimate the prevalence and identify factors associated with home childbirth (delivery) among young mothers aged 15-24 years in Nigeria. DESIGN A secondary analysis of cross-sectional data from the 2013 Nigeria Demographic and Health Survey (NDHS). SETTING Nigeria. PARTICIPANTS A total of 7543 young mothers aged 15-24 years. OUTCOME MEASURE Place of delivery. RESULTS The prevalence of home delivery among young mothers aged 15-24 years was 69.5% (95% CI 67.1% to 71.8%) in Nigeria-78.9% (95%CI 76.3% to 81.2%) in rural and 43.9% (95%CI 38.5% to 49.5%, p<0.001) in urban Nigeria. Using the Andersen's behavioural model, increased odds of home delivery were associated with the two environmental factors: rural residence (adjusted OR, AOR: 1.39, 95% CI 1.06 to 1.85) and regions of residence (North-East: AOR: 1.97, 95% CI 1.14 to 3.34; North-West: AOR: 2.94, 95% CI 1.80 to 4.83; and South-South: AOR: 3.81, 95% CI 2.38 to 6.06). Three of the enabling factors (lack of health insurance: AOR: 2.34, 95% CI 1.16 to 4.71; difficulty with distance to healthcare facilities: AOR: 1.48, 95% CI 1.15 to 1.88; and <4 times antenatal attendance: AOR: 3.80, 95% CI 3.00 to 4.85) similarly increased the odds of home delivery. Lastly, six predisposing factors-lack of maternal and husband's education, poor wealth index, Islamic religion, high parity and low frequency of listening to radio-were associated with increased odds of home delivery. CONCLUSIONS Young mothers aged 15-24 years had a higher prevalence of home delivery than the national average for all women of reproductive age in Nigeria. Priority attention is required for young mothers in poor households, rural areas, North-East, North-West and South-South regions. Faith-based interventions, a youth-oriented antenatal care package, education of girls and access to health insurance coverage are recommended to speed up the reduction of home delivery among young mothers in Nigeria.
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Affiliation(s)
- Emmanuel O Adewuyi
- Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Pharmacy Department, 2 Division Hospital, Ibadan, Nigeria
| | | | - Yun Zhao
- Department of Epidemiology and Biostatistics, Curtin University Bentley Campus, Perth, Western Australia, Australia
| | - Lungcit David
- Department of Nursing, College of Nursing and Midwifery Vom, Jos, Nigeria
| | | | - Asa Auta
- School of Pharmacy and Biomedical sciences, University of Central Lancashire, Preston, UK
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Sheferaw ED, Kim YM, van den Akker T, Stekelenburg J. Mistreatment of women in public health facilities of Ethiopia. Reprod Health 2019; 16:130. [PMID: 31455400 PMCID: PMC6712647 DOI: 10.1186/s12978-019-0781-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 07/25/2019] [Indexed: 11/29/2022] Open
Abstract
Background Recent evidence suggests that mistreatment of women during childbirth is a global challenge facing health care systems. This study seeks to explore the prevalence of mistreatment of women in public health facilities of Ethiopia, and identify associated factors. Methods A two-stage cross sectional sampling design was used to select institutions and women. The study was conducted in hospitals and health centers across four Ethiopian regions. Quantitative data were collected from postpartum women. Mistreatment was measured using four domains: (1) physical abuse, (2) verbal abuse, (3) failure to meet professional standards of care, and (4) poor rapport between women and providers. Percentages of mistreatment and odds ratios for the association between its presence and institutional and socio demographic characteristics of women were calculated using bivariate and multivariable logistic regression modeling. Results A total of 379 women were interviewed, of whom 281 (74%) reported any mistreatment. Physical and verbal abuse were reported by 7 (2%) and 31 (8%) women interviewed respectively. Failure to meet professional standards of care and poor rapport between women and providers were reported by 111 (29%) and 274 (72%) women interviewed respectively. Multivariable logistic regression analysis revealed that the odds of reporting mistreatment were higher among women with four or more previous births (aOR = 3.36 95%CI 1.22,9.23, p = 0.019) compared to women with no previous childbirth, Muslim women (aOR = 3.30 95%CI 1.4,7.77, p = 0.006) and women interviewed in facilities with less than 17 births per MNH staff in a month (aOR = 3.63 95%CI 1.9,6.93, p < 0.001). However, the odds of reporting mistreatment were lower among women aged 35 and older (aOR = 0.22 95%CI 0.06, 0.73, p = 0.014) and among women interviewed between 8 and 42 days after childbirth (aOR = 0.37 95%CI 0.15, 0.9, p = 0.028). Conclusion Mistreatment during childbirth in Ethiopia is commonly reported. Health workers need to consider provision of individualized care for women and monitor their experiences in order to adjust quality of their services. Electronic supplementary material The online version of this article (10.1186/s12978-019-0781-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ephrem D Sheferaw
- Jhpiego Ethiopia, Addis Ababa, Ethiopia. .,Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Global Health, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands.
| | - Young-Mi Kim
- Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Global Health, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands.,Jhpiego, Baltimore, USA
| | - Thomas van den Akker
- Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands
| | - Jelle Stekelenburg
- Department of Health Sciences, University of Groningen, University Medical Centre Groningen, Global Health, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands.,Department of Obstetrics and Gynecology, Leeuwarden Medical Center, Henri Dunantweg 2, 8934, AD, Leeuwarden, The Netherlands
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Gender of Provider-Barrier to Immigrant Women's Obstetrical Care: A Narrative Review. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2019. [PMID: 28625284 DOI: 10.1016/j.jogc.2017.01.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To explore the preference for female obstetrician/gynaecologists among immigrant women, and providers' understandings of these preferences, to identify challenges and potential solutions. METHODS Five databases (Medline, Embase, CINAHL, Global Health, and Scopus) were searched using combinations of search terms related to immigrant, refugee, or Muslim women and obstetrics or gynaecological provider gender preference. STUDY SELECTION Peer reviewed, English-language articles were included if they discussed either patient or provider perspectives of women's preference for female obstetrics or gynaecological care provider among immigrant women in Western and non-western settings. After screening, 54 met inclusion criteria and were reviewed. DATA EXTRACTION Studies were divided first into those specifically focusing on gender of provider, and those in which it was one variable addressed. Each category was then divided into those describing immigrant women, and those conducted in a non-Western settings. The research question, study population, methods, results, and reasons given for preferences in each article were then examined and recorded. CONCLUSION Preference for female obstetricians/gynaecologists was demonstrated. Although many will accept a male provider, psychological stress, delays, or avoidance in seeking care may result. Providers' views were captured in only eight articles, with conflicting perspectives on responding to preferences and the health system impact.
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Adewuyi EO, Auta A, Khanal V, Tapshak SJ, Zhao Y. Cesarean delivery in Nigeria: prevalence and associated factors-a population-based cross-sectional study. BMJ Open 2019; 9:e027273. [PMID: 31213450 PMCID: PMC6596937 DOI: 10.1136/bmjopen-2018-027273] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To investigate the prevalence and factors associated with caesarean delivery in Nigeria. DESIGN This is a secondary analysis of the nationally representative 2013 Nigeria Demographic and Health Survey (NDHS) data. We carried out frequency tabulation, χ2 test, simple logistic regression and multivariable binary logistic regression analyses to achieve the study objective. SETTING Nigeria. PARTICIPANTS A total of 31 171 most recent live deliveries for women aged 15-49 years (mother-child pair) in the 5 years preceding the 2013 NDHS was included in this study. OUTCOME MEASURE Caesarean mode of delivery. RESULTS The prevalence of caesarean section (CS) was 2.1% (95% CI 1.8 to 2.3) in Nigeria. At the region level, the South-West had the highest prevalence of 4.7%. Factors associated with increased odds of CS were urban residence (adjusted OR (AOR): 1.51, 95% CI 1.15 to 1.97), maternal age ≥35 years (AOR: 2.12, 95% CI 1.08 to 4.11), large birth size (AOR: 1.39, 95% CI 1.10 to 1.74) and multiple births (AOR: 4.96, 95% CI 2.84 to 8.62). Greater odds of CS were equally associated with maternal obesity (AOR: 3.16, 95% CI 2.30 to 4.32), Christianity (AOR: 2.06, 95% CI 1.58 to 2.68), birth order of one (AOR: 3.86, 95% CI 2.66 to 5.56), husband's secondary/higher education level (AOR: 2.07, 95% CI 1.29 to 3.33), health insurance coverage (AOR: 2.01, 95% CI 1.37 to 2.95) and ≥4 antenatal visits (AOR: 2.84, 95% CI 1.56 to 5.17). CONCLUSIONS The prevalence of CS was low, indicating unmet needs in the use of caesarean delivery in Nigeria. Rural-urban, regional and socioeconomic differences were observed, suggesting inequitable access to the obstetric surgery. Intervention efforts need to prioritise women living in rural areas, the North-East and the North-West regions, as well as women of the Islamic faith.
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Affiliation(s)
- Emmanuel O Adewuyi
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, School of Biomedical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
- Pharmacy Department, 2 Division Hospital, Ibadan, Oyo State, Nigeria
| | - Asa Auta
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | | | - Samson J Tapshak
- Department of Obstetrics and Gynaecology, Chivar Specialist Hospital, and Urology Centre Ltd, Abuja, Nigeria
| | - Yun Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Perth, Western Australia, Australia
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Gebreyesus H, Mamo A, Teweldemedhin M, Gidey B, Hdush Z, Birhanu Z. Experiences of homeless women on maternity health service utilization and associated challenge in Aksum town, Northern Ethiopia. BMC Health Serv Res 2019; 19:359. [PMID: 31170981 PMCID: PMC6554879 DOI: 10.1186/s12913-019-4201-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Homeless women are a highly vulnerable group for risks of pregnancy and childbirth-related complications. They may also face multiple challenges to access and utilize maternity healthcare services. This study was aimed to explore the experience of homeless women on maternity healthcare service utilization and associated challenges in Aksum Town, Northern Ethiopia. METHODS An exploratory qualitative study was employed using in-depth interviews among 22 study participants from February to March 2016. Purposive sampling was used to recruit 12 homeless mothers who gave birth when being homeless in the last 12 months and 10 healthcare providers as key informants. Data were captured using audio recorders and field notes and transcribed, translated verbatim and thematic analysis approach was facilitated using ATLAS.ti7 software. RESULTS The finding reveals that homeless women did not use any of the basic maternity health care services, namely antenatal care, skilled birth attendance, and postnatal care. Lack of permanent place and awareness, and fear of stigma and discrimination were some reasons hindering homeless women from using the services. CONCLUSIONS Even though maternity health service utilization is the most crucial intervention to reduce maternal and newborn deaths, this finding shows that maternity health service utilization among homeless women was limited. Socio-cultural, socioeconomic and healthcare-related factors contributed to the non-use of these services. Efforts should be made to address the challenges faced by homeless women to utilize maternity health services.
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Affiliation(s)
- Hailay Gebreyesus
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia.
| | - Abebe Mamo
- Department of Health, Behavior and Society, Institutes of Health, Jimma University, Jimma, Ethiopia
| | - Mebrahtu Teweldemedhin
- Department of Medical Laboratory Science, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Berihu Gidey
- Department of Public Health, College of Health Sciences, Aksum University, Aksum, Ethiopia
| | - Znabu Hdush
- Department of Public Health, Mekelle University, Mekelle, Ethiopia
| | - Zewdie Birhanu
- Department of Health, Behavior and Society, Institutes of Health, Jimma University, Jimma, Ethiopia
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Yuan B, Li J, Wang Z, Wu L. Household Registration System, Migration, and Inequity in Healthcare Access. Healthcare (Basel) 2019; 7:healthcare7020061. [PMID: 30979025 PMCID: PMC6627074 DOI: 10.3390/healthcare7020061] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/03/2019] [Accepted: 04/09/2019] [Indexed: 11/16/2022] Open
Abstract
This study investigates the influence of the household registration system on rural–urban disparity in healthcare access (including healthcare quality, blood pressure check, blood test, vision test, dental examination, and breast exam), using data from a large-scale nationwide life history survey that covered 150 counties across 28 provinces and municipalities in China. In contrast to the findings of many previous studies that emphasize the disparity in the residence place as the cause of rural–urban disparity in healthcare access, this study finds that the residence place just has a very limited influence on healthcare access in China, and what really matters is the household registration type. Our empirical results show that people with a non-rural household registration type generally have better healthcare access than those with a rural one. For rural residents, changing the registration type of their household (from rural to non-rural) can improve their healthcare access, whereas changing the residence place or migrating from rural to urban areas have no effect. Therefore, mere rural-to-urban migration may not be a valid measure to eliminate the rural–urban disparity in healthcare access, unless the institution of healthcare resource allocation is reformed.
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Affiliation(s)
- Bocong Yuan
- Faculty of Economics and Management, Sun Yat-sen University, West Xingang Rd. 135, Guangzhou 510275, China.
| | - Jiannan Li
- Faculty of Economics and Management, Sun Yat-sen University, West Xingang Rd. 135, Guangzhou 510275, China.
| | - Zhaoguo Wang
- Faculty of Economics and Management, Sun Yat-sen University, West Xingang Rd. 135, Guangzhou 510275, China.
| | - Lily Wu
- Faculty of Economics and Management, Sun Yat-sen University, West Xingang Rd. 135, Guangzhou 510275, China.
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Kpienbaareh D, Atuoye KN, Ngabonzima A, Bagambe PG, Rulisa S, Luginaah I, Cechetto DF. Spatio-temporal disparities in maternal health service utilization in Rwanda: What next for SDGs? Soc Sci Med 2019; 226:164-175. [PMID: 30856605 DOI: 10.1016/j.socscimed.2019.02.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 12/17/2018] [Accepted: 02/24/2019] [Indexed: 11/16/2022]
Abstract
The Sustainable Development Goals (SDGs) in part aim to further improve maternal health outcomes by reducing spatial disparities in utilization of critical services such as antenatal and assisted delivery, with emphasis on decentralization and integration of strategies. Yet, our understanding of within country spatial disparities in maternal health services (MHS) utilization over time has been scant. By fitting multiple regression models to a pooled dataset of the 2010/11 and 2014/15 Rwanda Demographic and Health Surveys (n = 12,273), and employing post-estimation margins analysis, we examined spatial differentiation of MHS trends prior to the SDGs in Rwanda. Our study found that women in 2014/15 were more likely to utilize antenatal services and assisted delivery (OR = 1.757, p ≤ 0.001) compared with 2010/11, but with nuanced spatial variations. Compared with Nyarugenge, women in nineteen out of the twenty-nine remaining districts were more likely to report utilization of antenatal services and skilled birth delivery, while the probability of accessing four or more antenatal services in seven districts declined between 2010/11 and 2014/15. Physical, financial and socio-cultural factors were associated with maternal health service utilization over the period. Based on our findings, we present policy suggestions for improving utilization of MHS in Rwanda and in similar contexts in the SDGs period.
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Affiliation(s)
| | - Kilian N Atuoye
- Department of Geography, Western University, London, Ontario, Canada
| | - Anaclet Ngabonzima
- TSAM Project, KG, 28 Ave., House #58, Kimihurura, Kigali, Rwanda, Canada
| | | | | | - Isaac Luginaah
- Department of Geography, Western University, London, Ontario, Canada
| | - David F Cechetto
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5C1, Canada
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Ganle JK, Mahama MS, Maya E, Manu A, Torpey K, Adanu R. Understanding factors influencing home delivery in the context of user-fee abolition in Northern Ghana: Evidence from 2014 DHS. Int J Health Plann Manage 2019; 34:727-743. [PMID: 30657200 DOI: 10.1002/hpm.2731] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/19/2018] [Indexed: 11/07/2022] Open
Abstract
User-fee exemption for skilled delivery services has been implemented in Ghana since 2003 as a way to address financial barriers to access. However, many women still deliver at home. Based on data from the 2014 Ghana Demographic and Health Survey, we estimated the prevalence of home delivery and determined the factors contributing to homebirths among a total of 622 women in the Northern region in the context of the user-fee exemption policy in Ghana. Binary and multivariate logistic regression analyses were employed. Results suggest home delivery prevalence of 59% (365/622). Traditional birth attendants attended majority of home deliveries (93.4%). After adjusting for potential confounders, making less than four antenatal care visits (aOR = 2.42; CI = 1.91-6.45; p = 0.001), being a practitioner of traditional African religion (aOR = 16.40; CI = 3.10-25.40; p = 0.000), being a Muslim (aOR 2.10; CI = 1.46-5.30; p = 0.042), not having a health insurance (aOR = 1.85; CI = 1.773-4.72; p = 0.016), living in a male-headed household (aOR = 2.07; CI = 1.02-4.53; p < 0.01), and being unexposed to media (aOR = 3.10; CI = 1.12-5.38; p = 0.021) significantly predicted home delivery. Our results suggest that unless interventions are implemented to address other health system factors like insurance coverage, and socio-cultural and religious beliefs that hinder uptake of skilled care, the full benefits of user-fee exemption may not be realized in Ghana.
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Affiliation(s)
- John Kuumuori Ganle
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Musah Salifu Mahama
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Ernest Maya
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Abubakar Manu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Kwasi Torpey
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
| | - Richard Adanu
- Department of Population, Family and Reproductive Health, School of Public Health, University of Ghana, Accra, Ghana
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Siddique AB, Perkins J, Mazumder T, Haider MR, Banik G, Tahsina T, Islam MJ, Arifeen SE, Rahman AE. Antenatal care in rural Bangladesh: Gaps in adequate coverage and content. PLoS One 2018; 13:e0205149. [PMID: 30452444 PMCID: PMC6242304 DOI: 10.1371/journal.pone.0205149] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 09/20/2018] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Antenatal care (ANC) has long been considered a critical component of the continuum of care during pregnancy, with the potential to contribute to the survival and thriving of women and newborns. Although ANC utilization has increased in over the past decades, adequate coverage and content of ANC contacts have fallen under increased scrutiny. The objectives of this article are to describe the coverage and content of ANC contacts in the context of rural Bangladesh. METHODS A community-based, cross-sectional household survey was conducted in two sub-districts of Netrokona district, Bangladesh in 2016. A total of 737 women with a recent birth outcome were interviewed. Respondents reported on the ANC contacts and the content of these contacts. Descriptive statistics were used to report coverage and content of ANC contacts stratified by covariates. Chi-square tests were performed to explore whether the estimates are different among different categories and significant differences were reported at p<0.05. RESULTS Around 25% of women attended at least four ANC contacts, with only 11% initiating ANC in the first trimester of pregnancy. Blood pressure was measured in almost all of the ANC contacts (92%), and abdominal examination performed in 80% and weight measured in 85% of ANC contacts. Urine tests were conducted in less than half of the ANC contacts, whereas blood screening tests and ultrasound were conducted in 45% contacts. Health care providers counselled women on danger signs in only 66% of the ANC contacts. Overall, the content of facility-based ANC contacts were better than home-based ANC contacts across all components. CONCLUSIONS Adequate coverage of ANC remains poor in Netrokona, Bangladesh and important gaps remain in the content of ANC contacts when women attend these services.
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Affiliation(s)
- Abu Bakkar Siddique
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Janet Perkins
- Health Department, Enfants du Monde, Geneva, Switzerland
| | - Tapas Mazumder
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Rifat Haider
- Department of Health Promotion, Education and Behavior, Norman J Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Goutom Banik
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Tazeen Tahsina
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Md Jahurul Islam
- National Newborn Health Program & Integrated Management of Childhood Illness, Directorate General of Health Services, Ministry of Health and Family Welfare (MOH&FW), Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Solanke BL, Rahman SA. Multilevel analysis of factors associated with assistance during delivery in rural Nigeria: implications for reducing rural-urban inequity in skilled care at delivery. BMC Pregnancy Childbirth 2018; 18:438. [PMID: 30409121 PMCID: PMC6225672 DOI: 10.1186/s12884-018-2074-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 10/25/2018] [Indexed: 11/25/2022] Open
Abstract
Background Studies have observed rural-urban inequity in the use of skilled delivery in Nigeria. A number of studies have explicitly examined associated factors of assistance during delivery in rural areas. However, the studies so far conducted in rural Nigeria have investigated mainly individual-level characteristics with near exclusion of community-level characteristics. Also, most of the studies that have investigated community-level influence on use of maternal healthcare services in Nigeria did not isolate rural areas for specific research attention. The objective of this study was to investigate the individual-level and community-level characteristics associated with assistance during delivery in rural Nigeria. Methods The study analysed women data of 2013 Nigeria Demographic and Health Survey. A weighted sample size of 12,665 rural women was analysed. The outcome variable was assistance during delivery, dichotomised into ‘skilled assistance’ and ‘unskilled assistance’. The explanatory variables are selected individual-level characteristics (maternal education, parity, age at first birth, religion, healthcare decision, employment status, access to mass media, and means of transportation); and selected community-level characteristics (community literacy level, community childcare burden, proportion of women employed outside agriculture, proportion of women who perceived distance to facility as a big problem, community poverty level, and geographical region). The mixed-effects logistic regression was applied. Results During the most recent deliveries, 23.0% of rural women utilised skilled assistance compared with 77.0% who utilised unskilled assistance. Maternal education, parity, religion, healthcare decision, access to mass media, and means of transportation were the individual-level characteristics that revealed significant effects on the likelihood of utilising skilled assistance during delivery, while community literacy level, community poverty level, community perception of distance to health facility, and geographic region were the community-level characteristics that revealed significant effects on the odds of using skilled assistance during delivery. Results of Intra-Class Correlation (ICC) supported significant community-level effects on the likelihood of using skilled assistance during delivery. Conclusions Assistance during delivery is influenced by individual-level and community-level characteristics. Health policies and programmes seeking to reduce rural-urban inequity in skilled delivery should endeavour to identify and address important factors at both the individual and community levels of the social environment.
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Affiliation(s)
- Bola Lukman Solanke
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Semiu Adebayo Rahman
- Department of Demography and Social Statistics, Faculty of Social Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
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Shakibazadeh E, Namadian M, Bohren MA, Vogel JP, Rashidian A, Nogueira Pileggi V, Madeira S, Leathersich S, Tunçalp Ӧ, Oladapo OT, Souza JP, Gülmezoglu AM. Respectful care during childbirth in health facilities globally: a qualitative evidence synthesis. BJOG 2017; 125:932-942. [PMID: 29117644 PMCID: PMC6033006 DOI: 10.1111/1471-0528.15015] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2017] [Indexed: 11/26/2022]
Abstract
Background What constitutes respectful maternity care (RMC) operationally in research and programme implementation is often variable. Objectives To develop a conceptualisation of RMC. Search strategy Key databases, including PubMed, CINAHL, EMBASE, Global Health Library, grey literature, and reference lists of relevant studies. Selection criteria Primary qualitative studies focusing on care occurring during labour, childbirth, and/or immediately postpartum in health facilities, without any restrictions on locations or publication date. Data collection and analysis A combined inductive and deductive approach was used to synthesise the data; the GRADE CERQual approach was used to assess the level of confidence in review findings. Main results Sixty‐seven studies from 32 countries met our inclusion criteria. Twelve domains of RMC were synthesised: being free from harm and mistreatment; maintaining privacy and confidentiality; preserving women's dignity; prospective provision of information and seeking of informed consent; ensuring continuous access to family and community support; enhancing quality of physical environment and resources; providing equitable maternity care; engaging with effective communication; respecting women's choices that strengthen their capabilities to give birth; availability of competent and motivated human resources; provision of efficient and effective care; and continuity of care. Globally, women's perspectives of what constitutes RMC are quite consistent. Conclusions This review presents an evidence‐based typology of RMC in health facilities globally, and demonstrates that the concept is broader than a reduction of disrespectful care or mistreatment of women during childbirth. Innovative approaches should be developed and tested to integrate RMC as a routine component of quality maternal and newborn care programmes. Tweetable abstract Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies. Understanding respectful maternity care – synthesis of evidence from 67 qualitative studies.
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Affiliation(s)
- E Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Namadian
- Social Determinants of Health Research Centre, Zanjan University of Medical Sciences, Zanjan, Iran
| | - M A Bohren
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Vogel
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A Rashidian
- Department of Information, Evidence and Research, Eastern Mediterranean Region, World Health Organization, Cairo, Egypt.,Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - V Nogueira Pileggi
- GLIDE Technical Cooperation and Research, Ribeirão Preto, São Paulo, Brazil.,Department of Paediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - S Madeira
- Social Department of Ribeirão Preto, Medical School, University of São Paulo, São Paulo, Brazil
| | - S Leathersich
- King Edward Memorial Hospital for Women, Subiaco, WA, Australia
| | - Ӧ Tunçalp
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - O T Oladapo
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - J P Souza
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
| | - A M Gülmezoglu
- Department of Reproductive Health and Research, including UNDP/UNFPA/UNICEF/WHO/World Bank Special Program of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland
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Adewuyi EO, Zhao Y, Auta A, Lamichhane R. Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey. Scand J Public Health 2017; 45:675-682. [PMID: 28653565 DOI: 10.1177/1403494817705562] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIM The aim of this study was to assess the rural-urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. METHODS Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural-urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. RESULTS In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively ( p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while 'Traditionalist/other' religion and maternal age < 20 years increased it. CONCLUSION The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study.
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Affiliation(s)
- Emmanuel O Adewuyi
- 1 Federal Ministry of Defense, 2 Division Hospital, Adekunle Fajuyi Cantonment, Ibadan, Oyo State, Nigeria.,2 Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Bentley Campus, Perth, Australia
| | - Yun Zhao
- 2 Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Bentley Campus, Perth, Australia
| | - Asa Auta
- 3 School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | - Reeta Lamichhane
- 2 Department of Epidemiology and Biostatistics, School of Public Health, Curtin University, Bentley Campus, Perth, Australia
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Evaluating Religious Influences on the Utilization of Maternal Health Services among Muslim and Christian Women in North-Central Nigeria. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3645415. [PMID: 27006944 PMCID: PMC4783534 DOI: 10.1155/2016/3645415] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 01/18/2016] [Indexed: 12/03/2022]
Abstract
Introduction. Uptake of antenatal services is low in Nigeria; however, indicators in the Christian-dominated South have been better than in the Muslim-dominated North. This study evaluated religious influences on utilization of general and HIV-related maternal health services among women in rural and periurban North-Central Nigeria. Materials and Methods. Targeted participants were HIV-positive, pregnant, or of reproductive age in the Federal Capital Territory and Nasarawa. Themes explored were utilization of facility-based services, provider gender preferences, and Mentor Mother acceptability. Thematic and content approaches were applied to manual data analysis. Results. Sixty-eight (68) women were recruited, 72% Christian and 28% Muslim. There were no significant religious influences identified among barriers to maternal service uptake. All participants stated preference for facility-based services. Uptake limitations were mainly distance from clinic and socioeconomic dependence on male partners rather than religious restrictions. Neither Muslim nor Christian women had provider gender preferences; competence and positive attitude were more important. All women found Mentor Mothers highly acceptable. Conclusion. Barriers to uptake of maternal health services appear to be minimally influenced by religion. ANC/PMTCT uptake interventions should target male partner buy-in and support, healthcare provider training to improve attitudes, and Mentor Mother program strengthening and impact assessment.
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