scholarly journals Bayesian Multilevel Analysis of Utilization of Antenatal Care Services in Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Cheru Atsmegiorgis Kitabo ◽  
Ehit Tesfu Damtie
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Maternal Mortality ◽  
Binary Logistic Regression ◽  
Household Wealth ◽  
Random Coefficient ◽  
Multilevel Logistic Regression ◽  
Random Coefficient Model ◽  
Care Services ◽  
Sub Saharan

In sub-Saharan Africa, 72% of pregnant women received an antenatal care visit at least once in their pregnancy period. Ethiopia has one of the highest rates of maternal mortality in sub-Saharan African countries. So, this high maternal mortality levels remain a major public health problem. According to EDHS, 2016, the antenatal care (ANC), delivery care (DC), and postnatal care (PNC) were 62%, 73%, and 13%, respectively, indicating that ANC is in a low level. The main objective of this study was to examine the factors that affect the utilization of antenatal care services in Ethiopia using Bayesian multilevel logistic regression models. The data used for this study comes from the 2016 Ethiopian Demographic and Health Survey which was conducted by the Central Statistical Agency (CSA). The statistical method of data analysis used for this study is the Bayesian multilevel binary logistic regression model in general and the Bayesian multilevel logistic regression for the random coefficient model in particular. The convergences of parameters are estimated by using Markov chain Monte-Carlo (MCMC) using SPSS and MLwiN software. The descriptive result revealed that out of the 7171 women who are supposed to use ANC services, 2479 (34.6%) women were not receiving ANC services, while 4692 (65.4%) women were receiving ANC services. Moreover, women in the Somali and Afar regions are the least users of ANC. Using the Bayesian multilevel binary logistic regression of random coefficient model factors, place of residence, religion, educational attainment of women, husband educational level, employment status of husband, beat, household wealth index, and birth order were found to be the significant factors for usage of ANC. Regional variation in the usage of ANC was significant.

scholarly journals Bivariate binary analysis on composite index of anthropometric failure of under-five children and household wealth-index

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Demeke Lakew Workie ◽  
Lijalem Melie Tesfaw
Keyword(s):  
Logistic Regression ◽  
Composite Index ◽  
Binary Logistic Regression ◽  
Wealth Index ◽  
Household Wealth ◽  
Education Level ◽  
Multiple Birth ◽  
Under Five ◽  
Under Five Children ◽  
Study Results

Abstract Background Malnutrition is the most common cause of mortality and morbidity of children in low and middle income countries including Ethiopia and household wealth index shares the highest contribution. Thus, in this study it is aimed to conduct bivariate binary logistic regression analysis by accounting the possible dependency of child composite index anthropometric failure and household wealth index. Methods In this study the data from Ethiopian Demographic and Health Survey (EDHS) 2016 involved 9411 under five children was considered. Child Composite Index Anthropometric Failure (CIAF) measures the aggregate child undernourished derived from the conventional anthropometric indices (stunting, underweight and wasting). The correlation between CIAF and wealth index was checked and significant correlation found. To address the dependency between the two outcome variables bivariate binary logistic regression was used to analyze the determinants of child CAIF and household wealth index jointly. Results Study results show that region, place of residence, religion, education level of women and husband/partner, sex of child, source of drinking water, household size and number of under five children in the household, mothers body mass index, multiple birth and anemia level of child had significant association with child CIAF. Female children were 0.82 times less likely to be CIAF compared to male and multiple birth children were more likely to be CIAF compared to single birth. Children from Oromia, Somalie, Gambela, SNNPR, Harari and Addis Ababa region were 0.6, 0.56, 0.67, 0.52, 0.6 and 0.44 times less likely to be CIAF compared to Tigray. A household from rural area were 15.49 times more likely poor compared to a household. The estimated odds of children whose mothers attended primary, and secondary and higher education was 0.82, and 0.52 times respectively the estimated odds of children from mothers who had never attended formal education. Conclusion The prevalence of children with composite index anthropometric failure was high and closely tied with the household wealth index. Among the determinants, region, religion, family education level, and anemia level of child were statistically significant determinants of both CIAF and household wealth index. Thus, the authors recommend to concerned bodies and policymakers work on household wealth index to reduce the prevalence of child composite anthropometric failure.

scholarly journals The impact of antenatal care on under‐five mortality in Ethiopia: a difference‐in‐differences analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Samuel Oduse ◽  
Temesgen Zewotir ◽  
Delia North
Keyword(s):  
Antenatal Care ◽  
Child Survival ◽  
First Trimester ◽  
Sub Saharan Africa ◽  
P Value ◽  
Difference In Differences ◽  
Under Five ◽  
Care Services ◽  
Sub Saharan ◽  
The Impact

Abstract Background Sub-Saharan Africa, as opposed to other regions, has the highest under-five mortality rates yet makes the least improvement in reducing under-five mortality. Despite the decline, Ethiopia is among the top ten countries contributing the most to global under-five mortalities. This article examines the impact of the number of antenatal care and the timing of first antenatal care on child health outcomes. We specifically investigated if the utilization of antenatal care services positively affects the reduction of under-five mortality. Methods We employ a difference-in-differences design with propensity score matching to identify direct causal effects of antenatal care on under-five mortality based on the Ethiopian Demographic Health Survey data of 2011 and 2016. Our sample includes 22 295 women between the ages of 14–49 who had antenatal care visits at different times before delivery. Results The study revealed 1 481 cases of reported under-five mortality. 99.0% of that under-five mortality cases are women who had less than eight antenatal care visits, while only 1% of that is by women who had eight or more antenatal care visits. Antenatal care visit decreases the likelihood of under-five mortality in Ethiopia by 45.2% (CI = 19.2–71.3%, P-value < 0.001) while the timing of first antenatal care within the first trimester decreases the likelihood of under-five mortality by 10% (CI = 5.7–15.6%, P-value < 0.001). Conclusions To achieve a significant reduction in the under-five mortality rate, Intervention programs that encourages more antenatal care visits should be considered. This will improve child survival and help in attaining Sustainable Development Goal targets.

scholarly journals Does Antenatal Care Translate into Skilled Birth Attendance? Analysis of 2014 Ghana Demographic and Health Survey

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Linus Baatiema ◽  
Edward Kwabena Ameyaw ◽  
Aliu Moomin ◽  
Mukaila Mumuni Zankawah ◽  
Doris Koramah
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Health Survey ◽  
Tertiary Education ◽  
Binary Logistic Regression ◽  
Skilled Birth Attendance ◽  
Demographic And Health Survey ◽  
Rural Setting ◽  
Binary Logistic Regression Analysis ◽  
Birth Attendance

Background. Despite the high antenatal care attendance rate in Ghana, skilled birth attendance is relatively low. There is limited evidence on whether antenatal care attendance translates into skilled birth attendance in the Ghanaian research discourse. This study investigates whether antenatal care attendance translates into skilled birth. Methods. We extracted data from the 2014 Ghana Demographic and Health Survey. Data were analysed using descriptive and binary logistic regression analyses at 5% confidence interval. Results. The descriptive findings indicated a vast variation between antenatal care attendance and skilled birth attendance. Skilled birth attendance was consistently low across almost all sociodemographic characteristics as compared to antenatal care attendance. The binary logistic regression analysis however indicated higher inclination toward skilled birth attendance among women who had at least four antenatal care visits [OR=5.87, CI=4.86-7.08]. The category of women noted to have higher tendencies of skilled birth attendance was those with higher/tertiary education [OR=9.13, CI=2.19-37.93], the rich [OR=4.27, CI=3.02-6.06], urban residents [OR=2.35, CI=1.88-2.93], women with maximum of four children [OR=1.36, CI=1.08-1.72], and those using modern contraceptives [OR=1.24, CI=1.03-1.50]. Conclusion. We recommend that interventions to enhance skilled birth attendance must target women who do not achieve at least four antenatal visits, those with low wealth standing, those not using contraceptives, and women without formal education. Again, an in-depth qualitative study is envisaged to deepen the understanding of these dynamics in the rural setting.

scholarly journals Association between antenatal care utilization pattern and timely initiation of postnatal care checkup: Analysis of 2016 Ethiopian Demographic and Health Survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258468
Author(s):  
Gizachew Tadesse Wassie ◽  
Minyichil Birhanu Belete ◽  
Azimeraw Arega Tesfu ◽  
Simachew Animen Bantie ◽  
Asteray Assmie Ayenew ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Maternal Mortality ◽  
Health Survey ◽  
Postnatal Care ◽  
Public Health Intervention ◽  
Demographic And Health Survey ◽  
Reproductive Age ◽  
Care Utilization ◽  
Timely Initiation ◽  
Care Services

Background Despite significant public health intervention, maternal mortality remains high in low- and middle-income countries, including Ethiopia. Effective postnatal care is a critical service to reduce maternal mortality. In Ethiopia, only 17% of mothers received postnatal care services in 2016. Objective This study examined the association between antenatal care and timely postnatal care checkup among reproductive-age women in Ethiopia. Methods The study used the 2016 Ethiopian Demographic and Health Survey data. The current study included 4,081 women who give birth in the two years preceding the survey. Chi-square test and multivariable logistic regression analyses were used to examine the association between antenatal care and timely initiation of postnatal care. Results Postnatal care services within 2 days of delivery were received by 16.5% of women. Women who had at least four timely antenatal care visits had higher odds of timely postnatal checkups compared to women who had no antenatal care [adjusted Odds Ratio (aOR): 2.50; 95% CI 1.42–4.42]. Women who had at least four antennal care visits without timely initiation also had higher odds of postnatal check-up than their counterparts (aOR: 2.46; 95%CI: 1.22–4.97). Other factors significantly associated with timely initiation of PNC were secondary and above education (aOR: 1.64; 95%CI: 1.03–2.60), perceived distance to the nearby health facility as a significant barrier (aOR: 1.55; 95%CI: 1.15–2.09), primiparous (aOR: 0.34; 95%CI: 0.19–0.61) and institutional delivery (aOR: 14.55; 95%CI: 2.21–95.77). Conclusion The prevalence of timely initiation of postnatal care in Ethiopia is very low. Women who received recommended antenatal care services had higher odds of timely initiation of postnatal care. Thus, strengthening the existing maternal and child health programs to adhere to the recommended ANC care guidelines may improve the timely initiation of postnatal care.

scholarly journals Maternal outcome following uterine rupture and its associated factors among mothers who delivered at Felege-Hiwot referral hospital, Amhara-Ethiopia

2018 ◽  
Vol 5 (1) ◽  
pp. 9 ◽  
Author(s):  
Alemtsehay Wesson ◽  
Enyew Assefa
Keyword(s):  
Developing Countries ◽  
Logistic Regression ◽  
Antenatal Care ◽  
Uterine Rupture ◽  
Associated Factors ◽  
Binary Logistic Regression ◽  
Maternal Outcome ◽  
Referral Hospital ◽  
Felege Hiwot Referral Hospital ◽  
Ruptured Uterus

<p class="abstract"><strong>Background:</strong> Ruptured uterus is one of the major causes of maternal and prenatal morbidities and mortalities in developing countries, particularly in Africa. Ethiopia is one of developing countries where maternal and prenatal mortalities are still high. The major objective of this study was to determine maternal outcomes of uterine rupture and its associated factors.</p><p class="abstract"><strong>Methods:</strong> The study design was facility based retrospective cross-sectional study from all mothers who visit from 01 September 2011 to 31 August 2015 at Felege-Hiwot referral hospital delivery room for delivery service with ruptured uterus was conducted in the study. A total of 312 cases were enrolled in the study<em>. </em>The table, graph and binary logistic regression was found to be more appropriate for analyzing the data.  </p><p class="abstract"><strong>Results:</strong> More than<em> </em>39% mothers had severe complication. The common complication was severe anemia 24.4% followed by severe shock 14.7%. There were also 2.7% maternal deaths. The binary logistic regression model showed that incidence and its complication of uterine rupture in this study were remarkably high. Antenatal care visit, duration of labor and admission to laparotomy time and hospital stay had strong association with maternal outcome.</p><p class="abstract"><strong>Conclusions:</strong> Improving access to antenatal care, proper monitoring of labor and early referral of high risk patients will contribute to the reduction of unfavorable maternal outcome.</p>

scholarly journals Implementing Skilled Midwifery Services in Dhaka City Urban Area: Experience from Community Based Safe Motherhood Project, Bangladesh

1970 ◽  
Vol 29 (1) ◽  
pp. 10-15
Author(s):  
S Tasnim ◽  
A Rahman ◽  
F Rahman ◽  
N Kabir ◽  
F Islam ◽  
...  
Keyword(s):  
Health Care ◽  
Antenatal Care ◽  
Maternal Mortality ◽  
Institutional Delivery ◽  
Obstetric Care ◽  
Dhaka City ◽  
Care Providers ◽  
Birth Attendants ◽  
Care Services ◽  
And Control

In Bangladesh majority of deliveries are attended by unskilled traditional birth attendants and maternal mortality is still quite high. Global evidence suggests that most critical intervention for reduction of maternal mortality is to ensure skilled attendance at birth. The objective of this study was to explore the effect of strengthening obstetric care services through implementation of skilled Midwives at selected urban centres in terms of utilization of antenatal and delivery care in the community. A quasi experimental community trial was conducted during January 2000 to June 2003. Ten health centers were selected from the maternity care centers of urban primary health care project in Dhaka city, matched into comparable pair and assigned randomly as intervention and control centers. The intervention consisted of deployment of 10 skilled midwives in pair to provide obstetric care services in five intervention centre and the community. Essential drugs and logistics were supplied to both intervention and control centers for optimizing the function. A total of 6077 mothers having less than one year child were interviewed. There was significant improvement from baseline in the utilization of antenatal care services (6.1 vs. 2.1%, p<0.001), availing antenatal visits 5 times or more (13.4% vs. 8.1%, p<0.001), consultation with skilled health care providers for pregnancy complication (9.3% vs. 5.7 %, p<0.001), institutional delivery (7.3% vs. 4.1%, p<0.001) and delivery by skilled birth attendant (9.4% vs. 5.8%, p<0.001) between intervention and control area respectively. The intervention of deployment of skilled midwives improved utilization of ANC, increased institutional delivery and delivery by skilled birth attendants. The program can be scaled up to see its impact on maternal health. Key words: skilled midwife; emergency obstetric care; urban health care; antenatal care DOI: 10.3329/jbsp.v29i1.7165J Bangladesh Coll Phys Surg 2011; 29:10-15

scholarly journals Antenatal care use and its determinants among migrant women during the first delivery: a nation-wide cross-sectional study in China

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xue Tang ◽  
Lulu Ding ◽  
Yuejing Feng ◽  
Yi Wang ◽  
Chengchao Zhou
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Multivariate Logistic Regression Model ◽  
Migrant Women ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Primiparous Women

Abstract Background Reasonable use of antenatal care (ANC) services by pregnant women played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. This study aimed to investigate the ANC use, and to explore the factors associated with ANC use among migrant women during the first delivery in China. Methods This study used the data of National Health and Family Planning Commission of People Republic of China in 2014. A total of 1505 migrant primiparous women were included in our current analysis. Frequencies and proportions were used to describe the data. Chi-square tests and multivariate binary logistic regression models were performed to explore the determinants that affect the number of times migrant women used ANC during their first delivery. Results Of the 1505 participants, 279 (18.54%) women received the ANC less than 5 times, and 1226 (81.46%) women used the ANC at least 5 times during the first delivery. The multivariate logistic regression model showed that migrant primiparous women with college and above education(P < 0.05;OR = 2.57;95%CI = 1.19–5.55), from the households with higher monthly income (P < 0.01;OR = 2.01;95%CI = 1.30–3.13), covered by maternity insurance(P < 0.01;OR = 2.01;95%CI = 1.28–3.18), with maternal health records (P < 0.001;OR = 2.44;95%CI = 1.61–3.69), migrating across county (P < 0.05;OR = 2.57;95%CI = 1.14–5.81), having migration experience before pregnancy(P < 0.05;OR = 1.37;95%CI = 1.03–1.81) were more likely to use ANC for at least five times. Conclusions This study demonstrated that there were still some migrant maternal women (18.54%) who attended the ANC less than 5 times. Targeted policies should be developed to improve the utilization of ANC among migrant pregnant women.

Faktor yang Berhubungan dengan Kejadian Anemia pada Ibu Hamil di Wilayah Kerja Puskesmas Mpunda Kota Bima

2021 ◽  
Vol 9 (2) ◽  
pp. 121-129
Author(s):  
Nurhaidah Nurhaidah ◽  
Rostinah Rostinah
Keyword(s):  
Logistic Regression ◽  
Antenatal Care ◽  
Maternal Mortality ◽  
Pregnant Women ◽  
Health Workers ◽  
Consumption Pattern ◽  
P Value ◽  
Chi Square ◽  
The Sustainable Development ◽  
Knowledge Variable

The results of the Indonesian Health Demographic Survey in 2017 show that the maternal mortality rate that occurs in Indonesia is 305 / 100.000 live births. This figure is still high and quite far from the target of the Sustainable Development Goals program. One of the factors contributing to the high maternal mortality in Indonesia is due to bleeding caused by anemia during pregnancy. The purpose of this study was to determine the factors associated with anemia in pregnant women. The population in this study were all pregnant women who performed pregnancy examinations at the Mpunda Public Health Center in Bima City for the period of April-May 2020. The number of sample data was 121 using purposive collection techniques. Data analysis was performed using the chi-square test and logistic regression. The results showed that there was a relationship between knowledge and Antenatal Care (ANC) visits with a p value of 0.028 and 0.022. Meanwhile, age, parity and consumption pattern of Fe tablets did not correlate with the incidence of anemia in pregnant women with p value > 0.05. The logistic regression test results show that the knowledge variable has the greatest influence on the incidence of anemia in pregnant women with an OR value of 2.385. It is hoped that health workers will provide information about the importance of conducting regular antenatal care and intensify the provision of information counseling and education about anemia, so that pregnant women are expected to be able to prevent, detect and manage anemia independently.

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