scholarly journals A Qualitative Study on the Pathways to Evidence-Based Antenatal Care in Periurban Ghana

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
Jones Asafo Akowuah ◽  
Peter Agyei-Baffour ◽  
Benedict Osei Asibey
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Scale Up ◽  
Hospital Staff ◽  
Maternal Health Care ◽  
Sub Saharan Africa ◽  
Transport Cost ◽  
Health Staff ◽  
The Government

Maternal health care has become a major concern on international fora in the 21st century. Even though major interventions have been taken to scale up maternal health care locally, nationally, and globally, adequate utilisation has not been achieved due to system-induced setbacks, especially in sub-Saharan Africa. The study explored the facilitators and barriers to antenatal care use in periurban Ghana. Seventeen (17) respondents consisting of four mothers receiving ANC services, four mothers receiving postnatal care with their ANC experience, four midwives, and four nurses with the District Public Health Nurse were involved in the study. The exploratory case study design was used with respondents comprising two focus groups and interview participants. Using thematic analysis, the results revealed that restrictive factors like travel time, long waiting time, transport cost, service cost, quality of service, and attitude of hospital staff still act as constraining factors even after the introduction of free maternal health care. The study concludes that practices like focused ANC and routine monitoring to facilities among others have increased utilisation. The study therefore recommends that to ensure adequate utilisation, the government and other stakeholders should offer support to the less-privileged mothers. Again, services should be easily available at facilities to pregnant women even if they are to be bought. It is further recommended that antenatal care services should be reoriented and clinical psychologists should be placed at all health centres to empower health staff on the best attitude towards clients. Interventions if mainstreamed into the national maternal health policy could be useful.

scholarly journals Utilization pattern and associated factors of maternal health care services in Haryana, India: a study based on district level household survey data

2018 ◽  
Vol 7 (3) ◽  
pp. 1154 ◽  
Author(s):  
Shinjini Ray ◽  
Pravat Bhandari ◽  
Jang Bahadur Prasad
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Institutional Delivery ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
District Level ◽  
Care Services ◽  
Maternal Health Care Services

Background: Maternal health was one of the most important millennium development goals (MDGs), India didn’t achieve by the year 2015. Since, India is a multicultural, social and multiregional country, where some of the regions have good social and demographic achievement while some are poor. Haryana is one of them, which has 146 maternal mortality ratio. The level of receiving antenatal care (ANC) in Haryana is quite low as compared to other states of India. Objective of present study was to Understand the extent of use of maternal health care services in Haryana as well as examining the role of antenatal care and other socio-economic factors on the utilization of maternal health services.Methods: Bivariate analysis, chi-square test, and binary logistic regression have been used based on district level household and facility survey-4 data.Results: The utilization of ANC (any and full), institutional delivery and post-delivery treatment seeking varies among women by literacy, age at first marriage, age at women and place of residence. Literate women are two times more likely to access ANC [odds ratio (OR)=1.97 (any ANC), 1.95 (full ANC), p<0.01] and 1.52 times more likely to prefer institutional delivery [OR=1.52, p<0.01].Conclusions: Empowering women through the encouragement of mother’s education should be one of the most fundamental strategies to promote maternal health care services and reduce inequalities.

scholarly journals Assessing the role of women’s autonomy and acceptability of intimate-partner violence in maternal health-care utilization in 63 low- and middle-income countries

2019 ◽  
Vol 48 (5) ◽  
pp. 1580-1592 ◽  
Author(s):  
Pooja Sripad ◽  
Charlotte E Warren ◽  
Michelle J Hindin ◽  
Mahesh Karra
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Partner Violence ◽  
Maternal Health Care ◽  
Care Utilization ◽  
Women’S Autonomy ◽  
Women's Autonomy ◽  
Maternal Health Care Utilization ◽  
Care Services

Abstract Background Our study investigates the associations between women’s autonomy and attitudes toward the acceptability of intimate-partner violence against women (IPVAW) and maternal health-care utilization outcomes. Methods We combine data from 113 Demographic and Health Surveys conducted between 2003 and 2016, which give us a pooled sample of 765 169 mothers and 777 352 births from 63 countries. We generate composite scores of women’s autonomy (six-point scale with reference: no contribution) and acceptability of IPVAW (five-point scale with reference: no acceptance) and assess the associations between these measures and women’s use of antenatal care services and facility delivery in pooled and unique country samples. Results A change in a woman’s autonomy score from ‘no contribution to any decision-making domain’ (a composite autonomy score of 0) to ‘contribution to all decision-making domains’ (a score of 6) is associated with a 31.2% increase in her odds of delivering in a facility and a 42.4% increase in her odds of receiving at least eight antenatal care visits over the course of her pregnancy. In contrast, a change in a woman’s attitude towards acceptability of IPVAW from ‘IPVAW is not acceptable under any scenario’ (a score of 0) to ‘IPVAW is acceptable in all scenarios’ (a score of 5) is associated with an 8.9% decrease in her odds of delivering in a facility and a 20.3% decrease in her odds of receiving eight antenatal care visits. Conclusions Our findings suggest that strong and significant associations exist between autonomy, acceptability of IPVAW and utilization of maternal health-care services.

DECOMPOSING THE SOCIOECONOMIC INEQUALITY IN UTILIZATION OF MATERNAL HEALTH CARE SERVICES IN SELECTED COUNTRIES OF SOUTH ASIA AND SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (6) ◽  
pp. 749-769 ◽  
Author(s):  
Srinivas Goli ◽  
Dipty Nawal ◽  
Anu Rammohan ◽  
T. V. Sekher ◽  
Deepshikha Singh
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Care Services ◽  
Socioeconomic Inequalities ◽  
Maternal Health Care ◽  
Health Care Use ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Care Services ◽  
Maternal Health Care Services

SummaryThe gap in access to maternal health care services is a challenge of an unequal world. In 2015, each day about 830 women died due to complications of pregnancy and childbirth. Almost all of these deaths occurred in low-resource settings, and most could have been prevented. This study quantified the contributions of the socioeconomic determinants of inequality to the utilization of maternal health care services in four countries in diverse geographical and cultural settings: Bangladesh, Ethiopia, Nepal and Zimbabwe. Data from the 2010–11 Demographic and Health Surveys of the four countries were used, and methods developed by Wagstaff and colleagues for decomposing socioeconomic inequalities in health were applied. The results showed that although the Concentration Index (CI) was negative for the selected indicators, meaning maternal health care was poorer among lower socioeconomic status groups, the level of CI varied across the different countries for the same outcome indicator: CI of −0.1147, −0.1146, −0.2859 and −0.0638 for <3 antenatal care visits; CI of −0.1338, −0.0925, −0.1960 and −0.2531 for non-institutional delivery; and CI of −0.1153, −0.0370, −0.1817 and −0.0577 for no postnatal care within 2 days of delivery for Bangladesh, Ethiopia, Nepal and Zimbabwe, respectively. The marginal effects suggested that the strength of the association between the outcome and explanatory factors varied across the different countries. Decomposition estimates revealed that the key contributing factors for socioeconomic inequalities in maternal health care varied across the selected countries. The findings are significant for a global understanding of the various determinants of maternal health care use in high-maternal-mortality settings in different geographical and socio-cultural contexts.

scholarly journals Understanding Barriers and Facilitators of Maternal Health Care Utilization in Central Myanmar

2020 ◽  
Vol 17 (5) ◽  
pp. 1464
Author(s):  
Maja Aleksandra Milkowska-Shibata ◽  
Thin Thin Aye ◽  
San Myint Yi ◽  
Khin Thein Oo ◽  
Kyi Khaing ◽  
...  
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Maternal Mortality Ratio ◽  
Maternal Health Care ◽  
Traditional Birth Attendants ◽  
Barriers And Facilitators ◽  
Care Utilization ◽  
Study Objective ◽  
Birth Attendants

The study objective was to examine barriers and facilitators of maternal health services utilization in Myanmar with the highest maternal mortality ratio in Southeast Asia. Data for 258 mothers with children under five were extracted from a community health survey administered between 2016 and 2017 in Mandalay, the largest city in central Myanmar, and analyzed for associations between determinants of maternal health care choices and related outcomes. The study showed that late antenatal care was underutilized (41.7%), and antenatal care attendance was significantly associated with geographical setting, household income, education, and access to transportation (p ≤ 0.05). Less than one-third of women gave birth at home and 18.5% of them did so without the assistance of traditional birth attendants. Household education level was a significant predictor for home delivery (p < 0.01). Utilization of postnatal care services was irregular (47.9%–70.9%) and strongly associated with women’s places of delivery (p < 0.01). Efforts geared towards improving maternal health outcomes should focus on supporting traditional birth attendants in their role of facilitating high-quality care and helping women reach traditional health facilities, as well as on maternal health literacy based on culturally appropriate communication.

scholarly journals Access to Maternal Health Care for Native Canadians on Reserves in Northern Canada

2016 ◽  
Vol 3 (1) ◽  
pp. 21-25
Author(s):  
David M Beking
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Mortality Rates ◽  
Maternal Health Care ◽  
Cultural Norms ◽  
Native Canadians ◽  
Native Canadian ◽  
Canadian Population ◽  
New Models

The history of abuse and isolation of Native Canadian populations has created a gap in maternal health care, resulting in infant mortality rates (IMRs) of 12 per 1000 births for on-reserve populations compared to 5.8 per 1000 births for the general Canadian population. This discrepancy is deemed a population health issue, as Native Canadian people constitute roughly 3% of the Canadian population, but have infant mortality rates similar to other third world countries. Currently, there are multiple government and non-government organizations in charge of providing maternal health care for on-reserve populations. A lack of a unified communication system linking these organizations creates a gap in the delivery of services and compromises the prenatal care in Native Canadians. The current method of caring for high risk pregnancies on Northern Canadian reserves is to fly the mothers out of their home community to a hospital that is both far away from their families and completely foreign to them. This practice contrasts with the cultural norms of the Native Canadian population, where expecting women receive antenatal care from elder women within their community. New models of care, in which midwives are the primary providers of antenatal care within a given community, have recently been implemented in Northern Quebec and other isolated areas of Canada. The midwives work with women elders of the community to provide a full system of maternal care. These new models show great promise in improving our current system of maternal health care for Native Canadians by providing more efficient and accessible antenatal care while also incorporating cultural norms of the communities.  

scholarly journals Determinants of utilization of maternal health care services among mothers in Harare, Zimbabwe

2019 ◽  
Author(s):  
Eunice Nyarambi ◽  
Paddington Tinashe Mundagowa ◽  
Prosper Chonzi ◽  
Elizabeth Chadambuka
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Care Delivery ◽  
Maternal Health Care ◽  
Health Facilities ◽  
Related Factors ◽  
Care Services ◽  
Maternal Health Care Services

Abstract Background: Provision of quality maternal health care services is an essential component in ensuring a healthy mother-baby dyad both pre- and post-delivery. In Africa, antenatal care, postnatal care, and skilled birth attendances are very low when compared to high-income countries. The continent has a high burden of maternal and infant morbidity as well as mortality rates. According to the Harare Annual Report of 2016, the number of women seeking maternal health care services was gradually declining from 2014 and pregnant women reported various challenges in accessing health care services. Methods: A 1 to 1 case-control study was conducted in Harare West South Western District using pretested interviewer-administered questionnaires. The study was carried out at all three clinics in the district and a total of 73 cases and 73 controls were selected using a systematic random sampling method. Quantitative data were analyzed using Epi Info statistical package and qualitative data was analyzed thematically. Results: The median ages for cases and controls were 29 and 24 years, respectively and the age-group 19 to 24 years constituted the majority of participants (41%). Predictors of utilization of services were young age ( < 24 years), birth order of < 2, maternal and paternal occupation, and religion. Enabling factors included: asking for permission to seek care, absence of transport challenges, a shorter distance to the health facility, affordability of health services, and a higher household income. Besides the shortage of skilled staff at the clinics, mothers endured long waiting hours to be served. The majority of the cases (78.1 %) and controls (72.6%) preferred to be attended by male nurses. Mothers were required to pay a $25 fee for booking and city medical staff rarely visited the clinics. Conclusion: The utilization of maternal health care services in Harare is dependent on the individual, household, and system-related factors. There was a need to articulate policies and design maternal health care programs that target socially and economically marginalized women. Creating women-friendly health facilities with extended hours for the antenatal care, delivery care and post-natal care services for mothers can help to decongest the health facilities.

scholarly journals Assessment of utilization of maternal health care services in rural field practice areas of VIMS, Ballari

2017 ◽  
Vol 5 (1) ◽  
pp. 170
Author(s):  
Neeta P. N. ◽  
Sameena A. R. B. ◽  
Suresh C. M. ◽  
Gangadhar Goud ◽  
Bharat . ◽  
...  
Keyword(s):  
Higher Education ◽  
Health Care ◽  
Maternal Health ◽  
Antenatal Care ◽  
Postnatal Care ◽  
Health Care Services ◽  
Maternal Health Care ◽  
Care Services ◽  
Field Practice ◽  
Maternal Health Care Services

Background: Maternal mortality and morbidity remains high even though national programs exist for improving maternal and child health in India. This could be related to several factors, an important one being non-utilization or delay in seeking care of maternal health-care services, especially amongst the rural poor and urban slum population due to either lack of awareness or access to health-care services. Our study was aimed to know the utilization of maternal health care services during antenatal and post natal period and factors affecting them.Methods: A Community based cross sectional study was carried in the rural field practice areas of VIMS, Ballari (three primary health centres (PHC) Kudithini, Koluru, Kurugodu) among all married women in the age group of 15-45 years who were in the post natal period (less than 2 months) at time of interview. A total 152 women were included in the study by door to door survey, among all the 3 PHC’s. The women absent during the survey were excluded.Results: Only 101 (66.44%) of women utilized antenatal care and 18 (11.8%) utilized post natal care (at least three postnatal visits) from the health care facility. Mothers who were of Muslim religion, <20 years of age, higher education of participant as well as husband, higher occupation status, high SES, less parity had higher odds of utilizing antenatal care. Health education by the health worker regarding post natal services to women ranged from 62.5-90.8%. Mothers of Muslim religion, higher education, higher occupation status, normal vaginal delivery and home delivery had higher odds of utilizing postnatal servicesConclusions: The study shows unacceptably low utilization of postnatal care services. It shows the coverage of postnatal care services is inadequate. This is an important message to health service providers and policy makers to strengthening not only antenatal health services and institutional deliveries but also postnatal care services to reduce maternal and neonatal morbidity and mortality. 

scholarly journals Traditional practices influencing the use of maternal health care services in Indonesia

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257032
Author(s):  
Ni Ketut Aryastami ◽  
Rofingatul Mubasyiroh
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Maternal Health Services ◽  
Community Empowerment ◽  
Maternal Health Care ◽  
Health Care Facilities ◽  
Traditional Practices ◽  
Birth Attendance

Background Maternal Mortality Ratio (MMR) in Indonesia is still high, 305, compared to 240 deaths per 100,000 in South East Asian Region. The use of Traditional Birth Attendance (TBA) as a cascade for maternal health and delivery, suspected to be the pocket of the MMR problem. The study aimed to assess the influence of traditional practices on maternal health services in Indonesia. Methods We used two data sets of national surveys for this secondary data analysis. The samples included 14,798 mothers whose final delivery was between January 2005 and August 2010. The dependent variables were utilization of maternal healthcare, including receiving antenatal care (ANC≥4), attended by skilled birth attendance (SBA), and having a facility-based delivery (FBD). The independent variables were the use of traditional practices, type of family structure, and TBA density. We run a Multivariate logistic regression for the analysis by controlling all the covariates. Results Traditional practices and high TBA density have significantly inhibited the mother’s access to maternal health services. Mothers who completed antenatal care were 15.6% lost the cascade of facility-based delivery. The higher the TBA population, the lower cascade of the use of Maternal Health Services irrespective of the economic quintile. Mothers in villages with a high TBA density had significantly lower odds (AOR = 0.30; CI = 0.24–0.38; p<0.01) than mothers in towns with low TBA density. Moreover, mothers who lived in an extended family had positively significantly higher odds (AOR = 1.33, CI = 1.17–1.52; p<0.01) of using maternal health services. Discussion Not all mothers who have received proper antenatal delivered the baby in health care facilities or preferred a traditional birth attendance instead. Traditional practices influenced the ideal utilization of maternal health care. Maternal health care utilization can be improved by community empowerment through the maternal health policy to easier mothers get delivery in a health care facility.

scholarly journals A Review on Antenatal Care in Developing Country Like India

2021 ◽  
Vol 8 (5) ◽  
pp. 397-403
Author(s):  
Irin Ephrem ◽  
Ateendra Jha ◽  
A. R Shabaraya
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Maternal Health ◽  
Antenatal Care ◽  
Rural Areas ◽  
Maternal Education ◽  
Health Centre ◽  
Well Being ◽  
Maternal Health Care ◽  
Urban And Rural Areas

Antenatal care is the ‘care before birth’ to promote the well-being of mother and fetus, and it is essential to reduce maternal morbidity and mortality, low-weight births and perinatal mortality. The care for the mother during pregnancy, during delivery, and after delivery is important for the wellbeing of the mother and the child. Maternal health-care vary within developing countries, which shows differences between affluent and poor women, and between women living in urban and rural areas. Health care service provision in India is very diverse, with rural services achieving considerably less coverage than their urban counterparts. It was found that following factors affects the antenatal care utilization maternal education, husband’s education, marital status, availability, cost, household income, women’s employment, media exposure and having a history of obstetric complications. If a woman visited health centre three or more than three times, her chances were 31 percent higher to deliver in an institution. Poorer women may prefer home-based delivery care. Lack of affordability might explain the large poor–rich inequalities in professional delivery attendance within urban and rural areas. Traditional beliefs and ideas about pregnancy also influence on antenatal care use. Older women would have accumulated knowledge on maternal health care and therefore would likely have more self-confidence on pregnancy and childbirth and thus, may give less importance to obtaining institutional care. Incomplete access and underutilization of modern healthcare services are major causes for poor health in the developing countries. There is a need of enhancing community awareness about the importance for educating women about early detection of complications during pregnancy and promptly seeking care, and about the importance of giving birth in a health facility. Keywords: Antenatal Care, Developing Countries.

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