scholarly journals What Influences Where They Give Birth? Determinants of Place of Delivery among Women in Rural Ghana

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Kwamena Sekyi Dickson ◽  
Kenneth Setorwu Adde ◽  
Hubert Amu
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Rural Areas ◽  
Maternal Education ◽  
Wealth Quintile ◽  
Empirical Literature ◽  
Ecological Zone ◽  
Wealth Status ◽  
Place Of Delivery ◽  
Rural Ghana

Background. There is a paucity of empirical literature in Ghana on rural areas and their utilisation of health facilities. The study examined the effects of the sociodemographics of rural women on place of delivery in the country. Methods. The paper made use of data from the 2014 Ghana Demographic and Health Survey. Women from rural areas who had given birth within five years prior to the survey were included in the analysis. Descriptive analyses and binary logistic regression were used to analyse the data. Results. Wealth, maternal education, ecological zone, getting money for treatment, ethnicity, partner’s education, parity, and distance to a health facility were found as the determinants of place of delivery among women in rural Ghana. Women in the richest wealth quintile were three times (OR = 3.04, 95% CI = 0.35–26.4) more likely to deliver at a health facility than the poorest women. Conclusions. It behoves the relevant stakeholders including the Ghana Health Service and the Ministry of Health to pay attention to the wealth status, maternal education, ecological zone, ethnicity, partner’s education, parity, and distance in their planning regarding delivery care in rural Ghana.

scholarly journals Predictors of home births among rural women in Ghana: analysis of data from the 2014 Ghana Demographic and Health Survey

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Eugene Budu
Keyword(s):  
Maternal Health ◽  
Health Survey ◽  
Rural Women ◽  
Rural Areas ◽  
Statistical Significance ◽  
Northern Region ◽  
Demographic And Health Survey ◽  
Wealth Status ◽  
Home Births ◽  
Factors Associated

Abstract Background Home births is one of the factors associated with maternal mortality. This study examined the predictors of home births among rural women in Ghana. Methods Data for this study was obtained from the 2014 Demographic and Health Survey (DHS) of Ghana. For the purpose of this study, a sample size of 2,101 women in the rural areas who had given birth within five years prior to the survey and had responses on variables was considered. Data processing, management and analysis were carried out using STATA version 14.0. This study carried out bivariate and multivariate analyses and results were tested at 95% confidence interval. The Adjusted odds ratios were used to present the results and the level of statistical significance was assessed using 95% confidence intervals. Results Home births was found to be high among women who resided in the Northern region compared to those in the Western region [AOR, 1.81 CI = 1.10–2.98]. Similarly, the likelihood of home birth was high among women with four or more births [AOR, 1.46 CI = 1.03–2.05] and Traditionalists [AOR, 2.50 CI = 1.54–4.06]. Conversely, giving birth at home was low among women with higher level of education [AOR = 0.58, CI = 0.43–0.78], those with rich wealth status [AOR = 0.19, CI = 0.10–0.38], those with four or more ANC visits [AOR = 0.11, CI = 0.15–0.23] and those who were covered by NHIS [AOR = 0.58, CI = 0.46–0.72]. Conclusions Over the years, there have been efforts by governments in Ghana to make maternal health services free in the country. However, a substantial proportion of women still undergo home births. To reduce the utilization of home births in Ghana, it is essential that government and non-governmental organisations make the cost of delivery services part of the free maternal health care policy and take into consideration the factors associated with the high rates of home births among rural women in Ghana.

scholarly journals Prevalence and Determinants of Rural-Urban Utilization of Skilled Delivery Services in Northern Ghana

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-13 ◽  
Author(s):  
Mahama Saaka ◽  
Jones Akuamoah-Boateng
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Rural Areas ◽  
Urban Areas ◽  
Northern Region ◽  
Northern Ghana ◽  
Skilled Delivery ◽  
Birth Attendance ◽  
Delivery Services ◽  
Study Population

Background. There are wide differences in the uptake of skilled delivery services between urban and rural women in the northern region of Ghana. This study assessed the rural-urban differences in the prevalence of and factors associated with uptake of skilled delivery in the northern region of Ghana. Methods. The study population comprised postpartum women who had delivered within the last three months prior to the study. The dataset was analyzed using the chi-square test and multivariable logistic regression. Results. The odds of skilled birth attendance (SBA) adjusted for confounding variables in urban areas were higher compared with their rural counterparts (AOR = 1.59; CI: 1. 07–2.37; p=0.02). The determinants of skilled delivery were similar but of different levels and strength in rural and urban areas. The main drivers that explained the relatively high skilled delivery coverage in the urban areas were higher frequency of antenatal care (ANC) attendance, proximity (physical access) to health facility, and greater proportion of women attaining higher educational level of at least secondary school. Distance from health facility less than 4 km was the greatest independent contributor to the variance in skilled delivery in the urban areas, whereas frequency of ANC attendance was the greatest independent contributor in the rural areas. Conclusions. This study identified underlying determinants accounting for rural-urban differences in skilled delivery, and covariate effect was more dominant than coefficient effect. Therefore, urban-rural differences in SBA outcomes were primarily due to differences in the levels of critical determinants rather than the nature of the determinants themselves. Therefore, improving skilled delivery outcomes in this study population and other similar settings will not require different policy frameworks and interventions in dealing with rural-urban disparities in SBA outcomes. However, context-specific tailored approaches and strategies including targeting mechanisms have to be designed differently to reduce the rural-urban differences.

scholarly journals Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

2021 ◽  
Author(s):  
Mohammad Zahidul Islam ◽  
M Mofizul Islam ◽  
Md Mostafizur Rahman ◽  
Md Nuruzzaman Khan
Keyword(s):  
Health Facility ◽  
Rural Women ◽  
Birth Interval ◽  
Wealth Quintile ◽  
World Health ◽  
Short Intervals ◽  
Live Births ◽  
Factors Associated ◽  
Modern Contraceptives ◽  
Short Birth Interval

Background: The Sustainable Development Goals target significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth interval (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce these adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. Methods: The Bangladesh Demographic and Health Survey 2017/18 and Bangladesh Health Facility Data 2017 were linked and analysed. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization. We used descriptive statistics to summarise characteristics of respondents and multilevel Poisson regression to assess the predictors of SBI. Results: Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20-34 years (PR, 0.14, 95% CI, 0.11-0.17) and more than or equal to 35 years (PR, 0.03, 95% CI, 0.02-0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61, 95% CI, 0.45-0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women for whom the children born from the second most pregnancies died (PR, 5.23, 95% CI, 4.18-6.55), those who were living in Chattogram (PR, 1.52, 95% CI, 1.12-2.07) or Sylhet (PR, 2.83, 95% CI, 2.08-3.86) divisions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34, 95% CI, 0.22-0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85, 95% CI, 1.33-2.18) for every kilometer increase in the distance of nearby health facilities from homes of women. Conclusion: More than a quarter of live births in Bangladesh occurred in short intervals. This relatively high prevalence is a challenge for Bangladesh in reducing pregnancy-related adverse consequences, including maternal and child mortality. Policies and programmes are needed to increase awareness of SBI and associated adverse health outcomes and expand access to modern contraceptives.

scholarly journals Socioeconomic inequalities in access to skilled birth attendance among urban and rural women in low-income and middle-income countries

2018 ◽  
Vol 3 (6) ◽  
pp. e000898 ◽  
Author(s):  
Gary Joseph ◽  
Inácio Crochemore Mohnsam da Silva ◽  
Aluísio J D Barros ◽  
Cesar G Victora
Keyword(s):  
Rural Women ◽  
Rural Areas ◽  
South Sudan ◽  
Urban Women ◽  
Wealth Quintile ◽  
Skilled Birth Attendance ◽  
Socioeconomic Inequalities ◽  
Rural Residence ◽  
Birth Attendance ◽  
Urban Rural

IntroductionRapid urbanisation is one of the greatest challenges for Sustainable Development Goals. We compared socioeconomic inequalities in urban and rural women’s access to skilled birth attendance (SBA) and to assess whether the poorest urban women have an advantage over the poorest rural women.MethodsThe latest available surveys (DemographicHealth Survey, Multiple Indicators Cluster Surveys) of 88 countries since 2010 were analysed. SBA coverage was calculated for 10 subgroups of women according to wealth quintile and urban-rural residence. Poisson regression was used to test interactions between wealth quintile index and urban-rural residence on coverage. The slope index of inequality (SII) and concentration index were calculated for urban and rural women.Results37 countries had surveys with at least 25 women in each of the 10 cells. Average rural average coverage was 72.8 % (ranging from 17.2% % in South Sudan to 99.9 % in Jordan) and average urban coverage was 80.0% (from 23.6% in South Sudan to 99.7% in Guyana. In 33 countries, rural coverage was lower than urban coverage; the difference was significant (p<0.05) in 15 countries. The widest urban/rural coverage gap was in the Central African Republic (32.8% points; p<0.001). Most countries showed narrower socioeconomic inequalities in urban than in rural areas. The largest difference was observed in Panama, where the rural SII was 77.1% points larger than the urban SII (p<0.001). In 31 countries, the poorest rural women had lower coverage than the poorest urban women; in 20 countries, these differences were statistically significant (p<0.05).ConclusionIn most countries studied, urban areas present a double advantage of higher SBA coverage and narrower wealth-related inequalities when compared with rural areas. Studies of the intersectionality of wealth and residence can support policy decisions about which subgroups require special efforts to reach universal coverage.

scholarly journals Determinants of low immunization coverage among children aged 12-23 months in narok south narok county kenya

2020 ◽  
Vol 10 (2) ◽  
pp. 52-66
Author(s):  
Richard Kipkemoi Lang’at ◽  
Samwel Odiwour ◽  
Maxwell Philip Omondi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Facility ◽  
Vaccination Coverage ◽  
Maternal Education ◽  
Immunization Coverage ◽  
World Health ◽  
P Value ◽  
Place Of Delivery ◽  
Vaccine Preventable Diseases

Childhood immunization remains one the primary health care core component and the most effective public health interventions for controlling and eliminating life-threatening vaccine preventable diseases in the world. According to 2014 Kenya National Demographic and Health Survey (KDHS), a few children of ages 12 to 23 months in Kenya presented below average in terms of vaccination coverage of children who are fully immunized. Delayed vaccinations would increase the risk for vaccine preventable diseases in the community, therefore the information obtained from this study is to help policy makers come up with sound strategies to increase immunization coverage from 57%- 90% as recommended by World Health Organization. The broad objective of the study was to determine reasons influencing low vaccination coverage between children of ages 12 to 23 months in Narok South sub-county, Narok County in Kenya. This is to contribute to the reduction of morbidity and mortality caused by infectious diseases of public health importance related to vaccine preventable disease. Methods: This was a cross-sectional descriptive study. The study used mixed methods, both quantitative and qualitative. A structured questionnaire was used to collect data on social demographic and social cultural factors, maternal health care utilization and knowledge. Key informative Interviews and Focus Group Discussions were used to collect qualitative data on 454 mothers/caretakers with children aged between 12-23 months reached in Narok South sub county. Results: The total number of mothers/caregivers who were interviewed were 454, with a response of 100%. Results of immunization coverage; BCG 73%, OPV1 59%, OPV2 51%, OPV3 49%, Penta1 58%, Penta2 51%, Penta3 50%, Measles 54% and Fully Immunized Children 47%. Further, 47% of the children in the sub-county were fully immunized and 53% were unimmunized. The SD mean for mothers/caregivers and children 31.4 and 17.0 respectively and over 70% of the mothers/caregivers had no formal education. There were significant association predictors with immunization coverage included maternal education (X2 =11.75, df=4 p value=0.02), distance to health facility (X2 =62.30, df=2 p value=0.00), also, there was strong significant association with childbirth ranking (OR=1.218, p value=0.04). Bivariate analysis, there was an association with mothers/caregivers’ who had more than one visits with fully immunized children (χ2=13.54, df =2 and p value =0.001), source of the immunization information OR=0.75 and p value=0.02 and, ultimately, there was association between mother’s/caregiver place of delivery with non-fully immunized children (X2=74.40,df=1 p value=0.01). Predictors of non-fully immunized children in the study population were; place of delivery, family size, education level, source of income, none attendance of Antenatal clinics, distance to the health facility, source of the vaccination information was associated with incomplete fully immunized children. Conclusion: The immunization coverage for the fully immunized child in the sub county was very low 47%, compared to national 77%. Key players in the immunization sector should identify children who are at risk, deploy reach every child strategy, encourage pregnant mothers to attend ANC, expand outreach services, increase funds allocation to health sector and build more health facilities to improve immunization coverage.

scholarly journals Too many yet too few caesarean section deliveries in Bangladesh: an ongoing public health challenge to improve maternal and child health

2021 ◽  
Author(s):  
Md Nuruzzaman Khan ◽  
Md Awal Kabir ◽  
Asma Ahmad Shariff ◽  
Md Mostafizur Rahman
Keyword(s):  
Caesarean Section ◽  
Rural Women ◽  
Maternal Education ◽  
Economic Condition ◽  
Wealth Quintile ◽  
Health Facilities ◽  
Outcome Variable ◽  
Place Of Residence ◽  
Double Burden ◽  
The Government

AbstractBackgroundCaesarean section (CS) use is on the rise in Bangladesh, particularly among women in improved socio-economic condition. However, the deficit use of CS remains common among disadvantage women in terms of employment, education, wealth quintile, and place of residence. This increases risks of long-term obstetric complications as well as maternal and child deaths. We aimed to determine the interaction effects of women’s disadvantage characteristics on CS use in Bangladesh.MethodsTotal of 27,093 women data analysed extracted from five rounds of Bangladesh Demographic and Health Survey, conducted between 2004 and 2017/18. The inclusion criteria used to select these women were: (i) having at least one child within three prior to the survey, (ii) reported delivery methods and place, and (iii) do not have twin or more ordered pregnancy for the most recent live birth. The major exposure variables were type of health facilities, divisions, place of residence, economic status, and maternal education. Other factors considered were factors at the individual and household level. The outcome variable was CS use, coded as use (1) and non-use (0). Multilevel logistic regression model was used to determine association of CS with socio-demographic characteristics and the interactions of the working status and wealth quintile with place of residence.ResultsWe reported a 751% increase of CS use over the last 13 years — from 3.88% in 2004 to 33% in 2017/18. Nearly, 80% of these occurred in the private health facilities followed by the government health facilities (15%). Rural women with no engagement of formal income generating activity showed 11% (OR, 0.89, 95% CI, 0.71-0.99) lower use of CS in 2004. This association was further strengthened with the year passes, and a 51% (OR, 0.49, 0.03-0.65) lower in CS use was reported in 2017/18. Similarly, around 12%-83% lower likelihoods of CS use were found among rural poor and poorer women.ConclusionBangladesh is facing a double burden of CS, that is a group of women with improved socio-economic condition using this life saving procedure without medical necessity while their counterpart of disadvantage characteristics could not access this service. Improved monitoring from the government along with support to use CS services for the disadvantage groups on necessity are important.

Breaking the Cycle? Education and the Intergenerational Transmission of Violence

2020 ◽  
Vol 102 (2) ◽  
pp. 252-268 ◽  
Author(s):  
Bilge Erten ◽  
Pinar Keskin
Keyword(s):  
Intergenerational Transmission ◽  
Rural Women ◽  
Rural Areas ◽  
Maternal Education ◽  
Child Physical Abuse ◽  
Compulsory Schooling ◽  
Intergenerational Transmission Of Violence ◽  
Physically Abused ◽  
Potential Channels ◽  
One Year

We estimate the causal effects of education on the intergenerational transmission of violence against children by exploiting an extension of compulsory schooling in Turkey. Using a regression-discontinuity design, we find that the reform increased maternal education by one year, with stronger effects for women raised in rural areas. The increase in education among rural women led to a reduction in the perpetration of child physical abuse but only by mothers who were physically abused by their own families during childhood. Exploring potential channels, we document that these women were also more likely to experience improved mental health outcomes.

scholarly journals Correlate of Post-natal care utilization in rural Ethiopia: An evidence from Secondary data analysis of Ethiopian Demographic Health survey 2016.

2019 ◽  
Author(s):  
REKIKU Fikre Abebe ◽  
Berhan Tsegaye Negash ◽  
Zelalem Tenaw bogale ◽  
wegene Jemebere Beru ◽  
Getnet Kassahun Molla
Keyword(s):  
Health Survey ◽  
Rural Women ◽  
Postnatal Care ◽  
Wealth Quintile ◽  
Outcome Variable ◽  
Care Utilization ◽  
Demographic Health Survey ◽  
Place Of Delivery ◽  
The Past ◽  
The Government

Abstract Abstract Background: Postnatalcareutilizationis the most neglected care in Ethiopian,despite a large proportion of maternal and neonatal deaths occurs during postnatal period. Evidence suggested that utilization of postnatal care averts major complications of the fetus and mother.But,proportion of rular women utilization of postnatal care is low in Ethiopia. Information about prevalence and factors which determine utilization of postnatal care utlization in rular women in Ethiopia is mandatory for policy making, and program design to enhance its utilization. Objective: Theobjective of this study was to determine the prevalence of utilization of postnatal care and to identify its determinant factorsamong rural women who gave birth in the past five yearsbefore Ethiopian demographic health survey, in 2016. Method: This study utilized data from Ethiopian demographic health survey2016 for analysis. It is a national two stage, cross sectional study. It analyzed data for rural women who gave birth at least one time in the past five year before data survey time. Logistic regression was applied to identify explanatory variables associated with outcome variable. Adjusted odds ratio with 95% confidence interval was computed and P-value< 0.05 was considered as statistically significant. Result:The prevalenceof postnatal care utilizationamong rural women was 11.4%.Place of delivery[AOR=4.3, 95%CI, 1.4-5.2], ANCvisit [AOR=2.1, 95%CI, 1.1-3.9] and Women in the richest wealth quintile [AOR=2.97, 95%CI, 1.9-4.5] were factors associated with postnatal care service utilization among rural women in Ethiopia in 2016. Conclusion and recommendation: This study showed that prevalence of postnatal care utlization was low. Being in richest wealth quintile, history of ANC vist and place of delivery were positive predictors of postnatal care utlization among rural women. Regardless of proven strategies utilized to maximize utilization of postnatal care utlization by the government of Ethiopia, this study showed that prevalence is low in rural areas. Therefore, community awareness creation, increasing institutional coverage by expanding maternity waiting area and besides, the government should design and implement income increasing package among rural women.

scholarly journals Determinants of early postnatal care attendance: analysis of the 2016 Uganda Demographic and Health Survey

2020 ◽  
Author(s):  
Patricia Ndugga ◽  
Noor Kassim Namiyonga ◽  
Deogratious Sebuwufu
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Health Survey ◽  
Postnatal Care ◽  
Demographic And Health Survey ◽  
Public Facility ◽  
Wealth Status ◽  
Place Of Delivery ◽  
Early Postpartum ◽  
Nationally Representative

Abstract Background The first two days after childbirth present the highest risk of dying for a mother. Providing postnatal care within the first two 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 5,471 women (age 15–49) who delivered a child in the 2 years preceding the survey. We used logistic regression to identify factors associated with the 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. Key words Early postnatal care, Uganda, Demographic and Health Survey, place of delivery

scholarly journals Factors Contributing to Antenatal Care and Delivery Practices in Village Development Committees of Ilam District, Nepal

2014 ◽  
Vol 11 (1) ◽  
pp. 60-65 ◽  
Author(s):  
PMS Pradhan ◽  
S Bhattarai ◽  
IS Paudel ◽  
K Gaurav ◽  
PK Pokharel
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Maternal Education ◽  
Skilled Birth Attendant ◽  
Reproductive Age ◽  
Cross Sectional ◽  
Place Of Delivery ◽  
Delivery Practices ◽  
Antenatal Visits ◽  
At Home

Background Proper antenatal care and good delivery practice helps to prevent the complications of childbirth and ensures a wholesome maternal and child health in the future. Almost half of the births in the developing countries take place without a skilled birth attendant. Objectives To assess the antenatal care (ANC) and delivery practices in the Village Development Committees (VDC) of Ilam district, Nepal and to identify the relationship with the socio-demographic factors. Method Cross sectional study of 262 mothers of reproductive age group having at least one child of less than five years of age, selected by simple random sampling, was carried out over different VDCs of Ilam by face to face interview using semi-structured questionnaire. Results Among 262 mothers, 34.7% were married before the age of 18 years. 69.5% of the mothers had attended four antenatal care visits. Nearly 47% of the deliveries were conducted at home out of which only 33.6% were conducted by skilled birth attendant. Number of children and maternal education were found to significantly affect the ANC visit and place of delivery. Age at marriage and age at first pregnancy were significantly associated with the place of delivery. Conclusion Large proportion of mothers still do not have adequate antenatal visits and this is supported by the fact that nearly half of the deliveries were conducted at home. Motivation and incentives are required for pregnant mothers especially in rural areas regarding importance of adequate antenatal visits and delivery in health institutions. Population policies should be aimed at reducing proportion of women marrying and giving birth in their teens. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11029 Kathmandu University Medical Journal Vol.11(1) 2013: 60-65

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