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Okui T, Nakashima N. Sociodemographic characteristics of non-institutional births and the association with neonatal and infant mortality in Japan. J Gynecol Obstet Hum Reprod 2024; 53:102834. [PMID: 39147095 DOI: 10.1016/j.jogoh.2024.102834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/20/2024] [Accepted: 08/13/2024] [Indexed: 08/17/2024]
Abstract
OBJECTIVES In this study, the association of non-institutional births with neonatal and infant mortality in Japan was investigated as well as sociodemographic characteristics of non-institutional births. METHODS The Vital Statistics data in Japan (the birth data from 2012 to 2021 and mortality data from 2012 to 2022) were used. Births were classified into three types based on the place of birth and birth attendant: institutional births, non-institutional births with a physician or a midwife, and non-institutional births without a physician or a midwife. Modified Poisson regression was used in order to investigate the association between the type of birth and neonatal and infant mortality and the association between sociodemographic characteristics and the type of birth. RESULTS A total of 9,422,942 births were used in the analysis. The results of regression analysis investigating an association between the type of birth and neonatal and infant mortality showed that non-institutional births were positively associated with neonatal and infant mortality regardless of the attendance of a physician or a midwife. Furthermore, the results of regression analysis investigating predictors of non-institutional births showed that factors such as non-urban regions, older maternal age groups, and unmarried status of mothers were positively associated with the two types of non-institutional births, and non-Japanese mother was positively associated with non-institutional births without a physician or a midwife. CONCLUSIONS Non-institutional births were a predictor of neonatal and infant mortality regardless of the attendance of a physician or midwife, and some sociodemographic characteristics have been proven to be predictors of non-institutional births.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka city, Japan.
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka city, Japan
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Fajarina M, Terathongkum S, Lininger J. Factors influencing late antenatal care of Muslim pregnant women: A predictive correlational study in Aceh, Indonesia. BELITUNG NURSING JOURNAL 2024; 10:360-367. [PMID: 38947307 PMCID: PMC11211745 DOI: 10.33546/bnj.3339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2024] [Revised: 04/22/2024] [Accepted: 05/30/2024] [Indexed: 07/02/2024] Open
Abstract
Background Late antenatal care (ANC) has significant implications for maternal and infant morbidity and mortality among Muslim pregnant women in Indonesia. Existing literature has primarily focused on gestational weeks at the first ANC contact, with limited attention to the total number of ANC visits. Objective This study aimed to explore the factors predicting late antenatal care contact among Muslim pregnant women, including the gestational weeks of the first ANC contact and the total number of ANC visits in Aceh, Indonesia. Methods A predictive correlational study design was utilized. Eighty postpartum women who received late ANC were purposively sampled and included in the study. Data were collected in May 2023 using ANC knowledge, beliefs, and social support questionnaires. Statistical analyses included descriptive statistics, Spearman's rank correlation, Chi-Square tests, and binary logistic regression with the enter method. Results Pregnant women residing farther from home to ANC services were more likely to have their first ANC contact after 20 weeks than those with a shorter distance (AOR = 1.06; 95% CI: 1.02-1.10; p = 0.007). Additionally, women with a history of multiple abortions were more inclined to have four or more ANC visits compared to those with fewer abortions (AOR = 6.78; 95% CI: 1.64-28.09; p = 0.008). Conclusion Distance from home to healthcare services emerged as a significant barrier to ANC contact, while a history of abortion appeared to motivate pregnant women to seek ANC more frequently. To address these issues effectively, nurses should consider implementing telemedicine services for ANC provision, integrating information on pregnancy complications to better support pregnant women in their care journey.
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Affiliation(s)
- Mira Fajarina
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Sangthong Terathongkum
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
| | - Jiraporn Lininger
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
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López JD, Sriprasert I, Wilson ML. Editorial: Inequities and disparities in reproductive health: reproductive epidemiology. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1419178. [PMID: 38803453 PMCID: PMC11128666 DOI: 10.3389/frph.2024.1419178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Julia D. López
- Washington University School of Medicine, St. Louis, MO, United States
| | - Intira Sriprasert
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Melissa Lee Wilson
- Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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Rahmawati T, Hsieh HM. Appraisal of universal health insurance and maternal health services utilization: pre- and post-context of the Jaminan Kesehatan Nasional implementation in Indonesia. Front Public Health 2024; 12:1301421. [PMID: 38550326 PMCID: PMC10972875 DOI: 10.3389/fpubh.2024.1301421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 02/29/2024] [Indexed: 04/02/2024] Open
Abstract
Introduction The Indonesian government introduced universal health insurance through the National Social Security System (JKN) in 2014 to enhance overall healthcare. This study compares maternal health care (MHC) service utilization before and after JKN implementation in Indonesia. Method Using 2012 and 2017 data from Indonesia Demographic and Health Surveys (DHS), we conducted a two-period cross-sectional design study following the Anderson model. We assessed how the JKN policy and population characteristics influenced healthcare utilization for women aged 15-49 who had given birth in the last 5 years. Multivariable logistic regression models were used to assess the impact of the JKN policy and related factors. Result In two waves of Indonesia DHS with 14,782 and 15,021 subjects, this study observed a significant increase in maternal healthcare service utilization post-JKN implementation. Women were more likely to have at least four antenatal care visits (adjusted odds ratio, AOR = 1.17), receive skilled antenatal care (AOR = 1.49), obtain skilled birth assistance (AOR = 1.96), and access facility-based delivery (AOR = 2.45) compared with pre-JKN implementation. Conclusion This study revealed a significant positive impact of JKN on enhancing MHS utilization. The introduction of universal health insurance coverage likely reduced financial barriers for specific demographics, resulting in increased service utilization. Our study may offer valuable insights for Asian countries with similar demographics and health insurance implementations.
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Affiliation(s)
- Tati Rahmawati
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Adedokun ST, Uthman OA, Bisiriyu LA. Determinants of partial and adequate maternal health services utilization in Nigeria: analysis of cross-sectional survey. BMC Pregnancy Childbirth 2023; 23:457. [PMID: 37340350 DOI: 10.1186/s12884-023-05712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/16/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Access to health services during pregnancy, childbirth and the period after birth provides a substantial opportunity to limit cases of maternal mortality. In sub-Saharan Africa, the proportions of women who utilize health services remain below 70%. This study examined the factors associated with partial and adequate maternal health services utilization in Nigeria. METHODS This paper used data from 2018 Nigeria Demographic and Health Survey (DHS) comprising 21,792 women aged 15-49 years who had given births within five years of the survey. The study focused on antenatal care attendance, place of birth and postnatal care using a combined model. Multinomial logistic regression was applied in the analysis. RESULTS About 74% of the women attended antenatal care, 41% gave birth in health facilities and 21% attended postnatal care. While 68% of the women partially utilized health services, 11% adequately utilized the services. The odds of partially and adequately utilizing health services increased for ever married women, women with secondary or higher education, from richest households, living in urban area, having no problem either getting permission to visit health facility or reaching health facility. CONCLUSIONS This study has revealed the factors associated with partial and adequate utilization of maternal health services in Nigeria. Such factors include education, household wealth, marital status, employment status, residence, region, media exposure, getting permission to use health service, unwillingness to visit health facility without being accompanied and distance to health facility. Efforts aimed at improving maternal health services utilization should place emphasis on these factors.
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Affiliation(s)
- Sulaimon T Adedokun
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Olalekan A Uthman
- Warwick-Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, University of Warwick Medical School, Coventry, UK
- Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Luqman A Bisiriyu
- Department of Demography and Social Statistics, Obafemi Awolowo University, Ile-Ife, Nigeria
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Mkperedem AA, Ogunlade P, Igbolekwu C, Arisukwu O, Owa SO, Afolabi AO, Etta-Oyong SO. Perception among NHIS-HMO Enrolees of the Attitudes of Medical Personnel during Outpatient Care in Lagos Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1218. [PMID: 36673973 PMCID: PMC9859193 DOI: 10.3390/ijerph20021218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
The quality of healthcare services depends on the interactions between administrators, customers, and healthcare providers. This study seeks to examine how National Health Insurance Scheme (NHIS)-Health Maintenance Organization (HMO) enrolees perceive the attitudes of medical personnel while receiving outpatient care in Lagos hospitals. Mixed methods were used, i.e., distributing questionnaires and in-depth interviews with participants. Quantitative data were analysed using Statistical Product and Service Solutions (SPSS) version 20, and approaches that involved frequency statistics, factor analysis, contingency chi-square and correlation analysis were applied. The results indicate that the variables "humane" and "empathetic" have a direct impact on enrolees' perception and an indirect impact on motivation to adhere to medical advice among enrolees. This research has practical implications, especially in light of new initiatives of NHIS collaboration with HMO to deliver quality healthcare services to enrolees.
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Affiliation(s)
| | - Peter Ogunlade
- Department of Sociology, Landmark University, Omu-Aran 251103, Nigeria
| | - Chisaa Igbolekwu
- Department of Sociology, Landmark University, Omu-Aran 251103, Nigeria
| | - Ogadimma Arisukwu
- Department of Sociology, Landmark University, Omu-Aran 251103, Nigeria
| | - Stephen Olugbenga Owa
- Department of Food Science & Microbiology, Landmark University, Omu-Aran 251103, Nigeria
| | | | - Stephen Otu Etta-Oyong
- Department of Extension and Rural Development, Landmark University, Omu-Aran 251103, Nigeria
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Iliyasu Z, Umar AA, Gaya FS, Nass NS, Abdullahi HM, Kwaku AA, Amole TG, Tsiga-Ahmed FI, Galadanci HS, Salihu HM, Aliyu MH. 'We delivered at home out of fear': Maternity Care in Rural Nigeria During the COVID-19 Pandemic. Int J MCH AIDS 2023; 12:e632. [PMID: 37182114 PMCID: PMC10172809 DOI: 10.21106/ijma.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
Background and Objective The COVID-19 pandemic response overwhelmed health systems, disrupting other services, including maternal health services. The disruptive effects on the utilization of maternal health services in low-resource settings, including Nigeria have not been well documented. We assessed maternal health service utilization, predictors, and childbirth experiences amidst COVID-19 restrictions in a rural community of Kumbotso, Kano State, in northern Nigeria. Methods Using an explanatory mixed methods design, 389 mothers were surveyed in January 2022 using validated interviewer-administered questionnaires, followed by in-depth interviews with a sub-sample (n=20). Data were analyzed using logistic regression models and the framework approach. Results Less than one-half (n=165, 42.4%) of women utilized maternal health services during the period of COVID-19 restrictions compared with nearly two-thirds (n=237, 65.8%) prior to the period (p<0.05). Non-utilization was mainly due to fear of contracting COVID-19 (n=122, 54.5%), clinic overcrowding (n=43, 19.2%), transportation challenges (n=34, 15.2%), and harassment by security personnel (n=24, 10.7%). The utilization of maternal health services was associated with participant's post-secondary education (aOR=2.06, 95% CI:1.14- 11.40) (p=0.02), and employment type (civil service, aOR=4.60, 95% CI: 1.17-19.74) (p<0.001), business aOR=1.94, 95% CI:1.19- 4.12) (p=0.032) and trading aOR=1.62, 95% CI:1.19-2.94) (p=0.04)). Women with higher household monthly income (≥ N30,000, equivalent to 60 US Dollars) (aOR=1.53, 95% CI:1.13-2.65) (p=0.037), who adhered to COVID-19 preventive measures and utilized maternal health services before the COVID-19 pandemic were more likely to utilize those services during the COVID-19 restrictions. In contrast, mothers of higher parity (≥5 births) were less likely to use maternal health services during the lockdown (aOR=0.30, 95% CI:0.10-0.86) (p=0.03). Utilization of maternal services was also associated with partner education and employment type. Conclusion and Global Health Implications The utilization of maternal health services declined during the COVID-19 restrictions. Utilization was hindered by fear of contracting COVID-19, transport challenges, and harassment by security personnel. Maternal and partner characteristics, adherence to COVID-19 preventive measures, and pre-COVID maternity service utilization influenced attendance. There is a need to build resilient health systems and contingent alternative service delivery models for future pandemics.
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Affiliation(s)
- Zubairu Iliyasu
- Department of Community Medicine, Bayero University, Kano, Nigeria
- Corresponding author
| | - Amina A. Umar
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | - Fatima S. Gaya
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | - Nafisa S. Nass
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | | | - Aminatu A. Kwaku
- Department of Community Medicine, Bayero University, Kano, Nigeria
| | - Taiwo G. Amole
- Department of Community Medicine, Bayero University, Kano, Nigeria
- African Center of Excellence for Population Health and Policy, Bayero University, Kano, Nigeria
| | | | - Hadiza S. Galadanci
- African Center of Excellence for Population Health and Policy, Bayero University, Kano, Nigeria
- Department of Obstetrics and Gynaecology, Bayero University Kano, Nigeria
| | - Hamisu M. Salihu
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Muktar H. Aliyu
- Department of Health Policy & Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Tennessee, USA
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Matthew O, Osabohien R, Lakhani KH, Aderounmu B, Osadolor NE, Adediran O, Mabinuori O, Igharo AE. Women engagement in agriculture and human capital development in developing countries: An African sub-regional analysis. PLoS One 2022; 17:e0277519. [PMID: 36490246 PMCID: PMC9733838 DOI: 10.1371/journal.pone.0277519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/29/2022] [Indexed: 12/13/2022] Open
Abstract
Considering the relevant role played by women in agriculture in Africa, this study sets out to examine how women's engagement in agriculture contributes to human capital development in selected African countries. The study engagedpanel data of selected 33 African countries spanning the period of 2000 to 2019. The study applied the Pooled Ordinary Least Squares (POLS) and the fixed effects based on the Hausman specification. Findings show that engagement of women in agriculture, though significant, but negatively related to human capital development in Africa. The implication of this is that an increase in women's engagement in agriculture without the required level of education and training and access to agricultural resources may have a negative impact on human capital development. Therefore, the study recommended that it is necessary to train women in terms of agricultural skills needed to improve human capital development in Africa.
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Affiliation(s)
- Oluwatoyin Matthew
- Department of Economics and Development Studies, Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
| | - Romanus Osabohien
- Department of Economics and Development Studies, Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
- Honorary Research Fellow, ILMA University, Karachi, Pakistan
| | | | - Busayo Aderounmu
- Department of Economics and Development Studies, Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
| | | | - Oluwasogo Adediran
- Department of Economics and Development Studies, Centre for Economic Policy and Development Research (CEPDeR), Covenant University, Ota, Nigeria
| | - Oladotun Mabinuori
- Department of Economics, Accounting and Finance, Bells University of Technology, Ota, Nigeria
| | - Amechi E. Igharo
- Department of Economics and Developmental Studies, Havilla University, Nde-Ikom, Nigeria
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Anaba EA, Afaya A. Correlates of late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age: insights from the 2019 Ghana Malaria Indicator Survey. BMJ Open 2022; 12:e058693. [PMID: 35793917 PMCID: PMC9260762 DOI: 10.1136/bmjopen-2021-058693] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study assessed the correlates of late initiation and underutilisation of the WHO's recommended eight or more antenatal care visits among women in Ghana. DESIGN We analysed secondary data from 2163 women in the 2019 Ghana Malaria Indicator Survey, which collected data on malaria and antenatal care indicators among women of reproductive age across the previous 10 regions of Ghana. SETTING AND PARTICIPANTS Women of reproductive age across the 10 regions of Ghana. MAIN OUTCOME MEASURES Late initiation and underutilisation of the recommended eight or more antenatal care visits among women of reproductive age. RESULTS About half (49%) of the participants were between the ages of 25 and 34 years; mean (±SD)=30 (±7.10). The majority (57%) of the participants obtained less than eight antenatal care visits, while 32% initiated antenatal care visits after the first trimester. The significant factors associated with the late initiation of antenatal care visits were age, region and parity (p<0.05). Factors associated with underutilisation of the recommended eight or more antenatal care visits were marital status, wealth index, parity, region and place of residence (p<0.05). CONCLUSION A majority of the women underused antenatal care services. A significant minority of the women started antenatal care visits late. Socio-demographic factors, parity and socioeconomic factors were identified as the significant factors associated with the late initiation and underutilisation of antenatal care services. Maternal health interventions should prioritise young, multiparous and poor women.
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Affiliation(s)
- Emmanuel Anongeba Anaba
- Department of Population, Family and Reproductive Health, University of Ghana School of Public Health, Accra, Ghana
| | - Agani Afaya
- College of Nursing, Yonsei University, Seodaemun-gu, Seoul, South Korea
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
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Alibhai KM, Ziegler BR, Meddings L, Batung E, Luginaah I. Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations. Confl Health 2022; 16:33. [PMID: 35690840 PMCID: PMC9188725 DOI: 10.1186/s13031-022-00459-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 05/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND It is estimated that over 930 million people live in fragile and conflict-affected situations (FCAS) worldwide. These regions, characterized by violence, civil unrest, and war, are often governed by corrupt administrations who are unwilling to provide their citizens with basic human rights. Individuals living in FCAS face health inequities; however, women are disproportionally affected and face additional barriers to accessing sexual and reproductive services, including antenatal care (ANC). This systematic review aims to identify the factors that impact ANC usage in the 37 countries or regions classified as FCAS in 2020 by The World Bank. METHODS Using the PRISMA guidelines, a systematic search of five databases (SCOPUS, Web of Science, PubMed, EMBASE, and CINAHL) was conducted. Results were limited to human studies, written in English, and published between January 2002 and January 2022. Studies that identified factors affecting utilization of ANC or maternal health services were included for review and critically appraised using the National Institute of Health's Quality Assessment Tools. Findings were summarized using a narrative synthesis approach. RESULTS The database search yielded 26,527 studies. After title, abstract and full-text review, and exclusion of duplicate articles, 121 studies remained. Twenty-eight of the 37 FCAS were represented in the included studies. The studies highlighted that women in FCAS' are still not meeting the World Health Organization's 2002 recommendation of four ANC visits during pregnancy, a recommendation which has since been increased to eight visits. The most cited factors impacting ANC were socioeconomic status, education, and poor quality of ANC. Despite all studies being conducted in conflict-affected regions, only nine studies explicitly identified conflict as a direct barrier to accessing ANC. CONCLUSION This review demonstrated that there is a paucity in the literature examining the direct and indirect impacts of conflict on ANC utilization. Specifically, research should be conducted in the nine FCAS that are not currently represented in the literature. To mitigate the barriers that prevent utilization of maternal health services identified in this review, policy makers, women utilizing ANC, and global organizations should attempt to collaborate to enact policy change at the local level.
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Affiliation(s)
| | - Bianca R Ziegler
- DeGroote School of Medicine, McMaster University, 1280 Main Street W, Hamilton, ON, L8S 4L8, Canada
| | - Louise Meddings
- Faculty of Medicine, University of Ottawa, 451 Smyth Road, Ottawa, ON, K1H 8M5, Canada
| | - Evans Batung
- Department of Geography, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
- Environment Health and Hazards Lab, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
| | - Isaac Luginaah
- Department of Geography, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
- Environment Health and Hazards Lab, Western University, 1151 Richmond Street, London, ON, N6A 3K7, Canada
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Owais A, Wuehler S, Heidkamp R, Mehra V, Neufeld LM, Rogers LM, Saha KK. Critical assessment of the current indicator for antenatal iron‐containing supplementation coverage: Insights from a mixed‐methods study. MATERNAL & CHILD NUTRITION 2022; 18:e13314. [PMID: 35092159 PMCID: PMC8932708 DOI: 10.1111/mcn.13314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
Daily consumption of iron‐containing supplements is recommended for all pregnant women but there is no approved global standard indicator for assessing supplementation coverage. Furthermore, the validity of commonly used coverage indicators for iron‐containing supplement consumption is questionable. The WHO–UNICEF Technical Expert Advisory Group on Nutrition Monitoring, and partners, have systematically worked to identify a feasible and valid indicator of iron‐containing supplement coverage for reporting by countries. In 2019, we conducted key informant interviews with respondents in eight countries, fielded an online survey (in three languages using SurveyMonkey) to which 142 nutrition professionals from 52 countries responded, and used Demographic and Health Surveys (DHS) data from four countries to assess determinants of the quality of iron‐containing supplement coverage data. Less than half (45%) of online survey respondents were satisfied with the current methods for collecting iron‐containing supplement coverage data in their context. Recommended changes by study respondents include recall period <5 years, adding questions about counselling, including other beneficiary groups, and assessing supply chain functionality. The DHS analysis suggested an association between time since pregnancy and data quality. Data heaping on multiples of 30 was observed in 40%–75% of data. There is a clear demand for a revised indicator and measurement guidance for coverage of iron‐containing supplementation during pregnancy. Future research should continue the development and validation of a global indicator, to more precisely validate the quality of recall data, including the distinction between distribution and consumption using various question formulations. Health and nutrition professionals have described concerns with current methods for reporting coverage of daily iron‐containing supplementation in pregnant women. The long recall period (5 years) of commonly used iron‐containing supplement consumption indicators calls into question the validity of these indicators. Our study indicates that there is demand for a revised indicator and guidance for data collection.
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Affiliation(s)
- Aatekah Owais
- Nutrition International Ottawa Canada
- Centre for Global Child Health, Research Institute Hospital for Sick Children Toronto Canada
| | | | - Rebecca Heidkamp
- International Health, Bloomberg School of Public Health Johns Hopkins University Baltimore Maryland USA
| | - Vrinda Mehra
- Data and Analytics Section, Division of Data, Analysis, Planning and Monitoring UNICEF New York City New York USA
| | | | - Lisa M. Rogers
- Department of Nutrition and Food Safety World Health Organization Geneva Switzerland
| | - Kuntal Kumar Saha
- Department of Nutrition and Food Safety World Health Organization Geneva Switzerland
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Hu S, Yu F, Jiang H, Shang W, Miao H, Li S, Zhao J, Xiao H. Periodontal Inflamed Surface Area Is Associated With Increased Gestational Blood Pressure and Uric Acid Levels Among Pregnant Women From Rural North China. Front Cardiovasc Med 2022; 9:830732. [PMID: 35299983 PMCID: PMC8921456 DOI: 10.3389/fcvm.2022.830732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background Periodontal disease has been associated with gestational complications and both conditions have a high prevalence in rural populations from developing regions. A cross-sectional study was carried out to explore the relationship between periodontal inflamed surface area (PISA), blood pressure (BP), and, serum uric acid levels (UA) in a group of rural North Chinese pregnant women in the third trimester of pregnancy. Methods Three hundred and thirty-five rural women aged 20–34 years, with normal body mass index (BMI) were examined in a cross-sectional study during their third trimester of gestation. Exclusion criteria were history of pregnancy complications, multiple pregnancy, smoking habits, diabetes, hypertension or any known infectious disease. Socio-demographic variables, including age and socioeconomic status (SES), systolic blood pressure (SBP) and diastolic blood pressure (DBP) readings, serum UA levels, and PISA values were recorded. A structural equation model was implemented with two constructed latent variables including “Dem” (comprising of age and SES category to represent unobserved demographic variables) and, “BP” (comprising of SBP and DBP to account for measurement error and lack of multiple BP readings). The model accounted for co-variance of BP and UA, and implemented simultaneous regressions for BP and UA as outcomes, upon Dem and PISA values as exogenous variables. Results The median PISA score was 1,081.7 (IQR = 835.01), reflecting high levels of periodontal inflammation in the sample. SEM showed a significant association of PISA with BP (estimate = 0.011, 95% CI = 0.009–0.012 p < 0.001) and UA (estimate = 0.001, 95% CI = 0.001–0.001, p < 0.001). Conclusion Higher PISA values were significantly associated with higher blood pressure and uric acid levels among rural pregnant women in a cross-sectional sample from a center in North China after accounting for a latent demographic construct derived from age and SES.
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Affiliation(s)
- Shaonan Hu
- Innovation Center Computer Assisted Surgery, Leipzig University, Leipzig, Germany
| | - Feifan Yu
- School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States
| | - Hong Jiang
- Department of Obstetrics and Gynecology, Sichuan Academy of Medical Science, Sichuan Provincial People's Hospital, Chengdu, China
| | - Wei Shang
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Hui Miao
- Heping Hospital Affiliated to Changzhi Medical College, Changzhi, China
| | - Simin Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
- *Correspondence: Simin Li
| | - Jianjiang Zhao
- Shenzhen Stomatological Hospital, Southern Medical University, Shenzhen, China
- Jianjiang Zhao
| | - Hui Xiao
- Stomatological Hospital, Southern Medical University, Guangzhou, China
- Hui Xiao
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