scholarly journals Persistence of the inverse care law in maternal health service utilization: An examination of antenatal care and hospital delivery in Ghana

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Coretta M.P. Jonah
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Know How ◽  
The Past ◽  
Inverse Care Law ◽  
Maternal Health Outcomes

The gap in maternal health outcomes, access and utilization between the haves and have-nots continues to be a challenge globally despite improvements over the past decade. Though Ghana has experienced steady gains in maternal health access and utilization over the years, maternal outcomes, on the other hand, remain poor. In this regard, it is essential to know how various groups in the population achieved improvements and whether some women continue to be disproportionately disadvantaged. The paper performs an analysis of cross-sectional data from the 2017 Ghana maternal health survey to examine the existence of the inverse care law in maternal health services in Ghana. Using descriptive techniques and multivariate logistic regression models the study reveals a pro-rich and pro-urban gradient in the use of hospital facilities for delivery and antenatal care attendance — also, regions known for their high levels of poverty feature significantly lower rates of hospital deliveries. The paper concludes by stressing that unless policies are changed to accommodate these groups, overall gains in maternal health will continue to be incremental.

scholarly journals Association between male involvement during antenatal care and use of maternal health services in Mwanza City, Northwestern Tanzania: a cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e036211
Author(s):  
Clara C Natai ◽  
Neema Gervas ◽  
Frybert M Sikira ◽  
Beatrice J Leyaro ◽  
Juma Mfanga ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Male Involvement ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Growth Monitoring ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mwanza City

BackgroundMale involvement in antenatal care (ANC) is among interventions to improve maternal health. Globally male involvement in ANC is low and varies in low-income and middle-income countries including Tanzania where most maternal deaths occur. In Sub-Sahara, men are chief decision makers and highly influence maternal health. In Tanzania information is limited regarding influence of male involvement during ANC on utilisation of maternal health services.ObjectivesTo determine the effect of male involvement during ANC on use of maternal health services in Mwanza, Tanzania.DesignA cross-sectional study conducted from June to July 2019.SettingThis study was conducted at seven randomly selected health facilities providing reproductive, maternal and child health (RCH) services in Mwanza City.ParticipantsIncluded 430 postpartum women who delivered 1 year prior to the study and attending for RCH services (growth monitoring, vaccination, postpartum care).Outcome measures4 or more ANC visits, skilled birth attendant (SBA) use during childbirth and postnatal care (PNC) utilisation 48 hours after delivery.MethodsInterviews and observation of the women’s ANC card were used to collect data. Data was entered, cleaned and analysed by SPSS.ResultsThe mean age of participants was 25.7 years. Of 430 women, 54.4% reported their partners attended ANC at least once, 69.7% reported they attended for four or more ANC visits during last pregnancy, 95% used SBAs during childbirth and 9.2% attended PNC within 48 hours after delivery. Male involvement during ANC was significantly associated with four or more ANC visits (Crude Odds Ratio (COR): 1.90; 95% CI: 1.08–3.35) but not with SBA use or PNC utilisation.ConclusionMale involvement in ANC is still low in Mwanza, as 46% of the partners had not attended with partners at ANC. Alternative strategies are needed to improve participation. Studies among men are required to explore the barriers of participation in overall RCH services.

scholarly journals A study on demographic and obstetric profile, its relation with present antenatal practices and prevalence of anaemia in pregnant women attending tertiary care hospital

2021 ◽  
Vol 8 (5) ◽  
pp. 2233
Author(s):  
Nitin A. Lodha
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Maternal Health Services ◽  
Study Data ◽  
Care Hospital ◽  
Chi Square ◽  
Cross Sectional

Background: Antenatal care is the care of a woman during pregnancy. The primary aim of antenatal care is to achieve at the end of pregnancy a healthy mother and a healthy baby. To improve maternal health, barriers which limit access to quality maternal health services must be identified and addressed at all levels of health system. Objectives were to determine demographic and obstetric factors affecting utilization of ANC service and prevalence of anaemia among pregnant women.Methods: This is cross-sectional descriptive study carried out in tertiary care hospital, using structured questionnaire, interviews were conducted with married pregnant women age between 18-45 years, who visited ANC clinic. Total 170 pregnant women visited hospital during a period was included in study. Data was analysed using MS excel and Epi info. Chi –square test was applied.Results: Maximum number of study subjects (42.9%) from age 23-27 years. 66.5% were Hindu, 56.5% study subjects from joint family. 14.7% were illiterate. 45.3% were primigravida, 54.7% were multigravida. 71.1% study subjects were from third trimester of pregnancy. 94.7% were taken at least one dose of Tetanus Toxoids. Iron folic acid tablets were taken by 87.6%. Prevalence of anaemia was 55.8%.Conclusions: Majority of pregnant women came for antenatal check-up, but regularity was not seen in most of cases. The presence study has brought out no significant socio-cultural barrier like women’s literacy, socio economic class and parity of women affecting the utilization of services.

scholarly journals Health Extension Workers Involvement in the Utilization of Focused Antenatal Care Service in Rural Sidama Zone, Southern Ethiopia: A Cross-Sectional Study

2019 ◽  
Vol 6 ◽  
pp. 233339281983513 ◽  
Author(s):  
Achamyelesh Gebretsadik ◽  
Million Teshome ◽  
Mekdes Mekonnen ◽  
Akalewold Alemayehu ◽  
Yusuf Haji
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Antenatal Care ◽  
Multivariate Logistic Regression Analysis ◽  
Maternal Health Services ◽  
Child Health Services ◽  
Outcome Variable ◽  
Health Extension Workers ◽  
Cross Sectional ◽  
Focused Antenatal Care

Background: Health extension workers (HEWs) are primarily been assigned in rural areas of Ethiopia to provide maternal and child health services. Few studies have been done to investigate HEWs’ contributions towards maternal health services. This study describes HEWs involvement in the utilization of focused antenatal care (FANC). Methods: A population-based cross-sectional survey was conducted between January 21 and February 4, 2017. Mothers (2300) who gave birth in the last 6 months (0-6 months) in randomly selected 30 kebeles in the rural Sidama zone, participated in the study. A face-to-face interview was done using a structured questionnaire adapted from the Saving Newborn Lives Program. The main outcome variable was FANC utilization. Descriptive statistics and multivariate logistic regression analysis were used using SPSS statistical software. Results: The FANC was used by 525 (24.36%; 95% confidence interval [CI]: 22.5%-26.2%) women. Health extension workers accounted for 244 (46.47%; 95% CI: 43.5-47.7%) of mothers. The FANC utilization was less likely among those who were illiterate (adjusted odds ratio [AOR]: .32; 95% CI: .18-.57) and those who attended first cycle (AOR: .41; 95% CI: .23-.74), those who attended secondary cycle (AOR: .47; 95% CI: .27-.82), primipara (AOR: 0.53; 95% CI: .35-.83), and those who gave birth at home (AOR: .66; 95% CI: .51-.84). Mothers who had knowledge of pregnancy danger signs (AOR: 1.42; 95% CI: 1.2-1.7) and exposure to mass media (AOR: 1.35; 95% CI: 1.1-1.66) were more likely to utilize FANC. Conclusions: FANC utilization in this study was low compared to other studies. The HEWs had a major contribution to the services. However, it is low when compared to the plan set by the state ministry of health. The existing health extension program could be strengthened by increasing the number of HEWs. Empowering rural mothers through continuous education program to enhance the utilization of maternal health services.

WOMEN’S EDUCATION AND UTILIZATION OF MATERNAL HEALTH SERVICES IN AFRICA: A MULTI-COUNTRY AND SOCIOECONOMIC STATUS ANALYSIS

2017 ◽  
Vol 50 (6) ◽  
pp. 725-748 ◽  
Author(s):  
Zacharie Tsala Dimbuene ◽  
Joshua Amo-Adjei ◽  
Dickson Amugsi ◽  
Joyce Mumah ◽  
Chimaraoke O. Izugbara ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Service Utilization ◽  
Women's Education ◽  
Health Service Utilization ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Care Visit ◽  
Socioeconomic Strata

SummaryThere is an abundant literature on the relationship between women’s education and maternal and child outcomes, including antenatal and postnatal care, onset of antenatal care and skilled birth attendance. However, few studies have adopted the ‘equity’ lens, despite increasing evidence that inequities between rich and poor are increasing although maternal and child mortality is declining. This study examined the differential effects of women’s education within different socioeconomic strata in Africa. The most recent Demographic and Health Surveys (DHS) conducted in the Democratic Republic of the Congo, Egypt, Ghana, Nigeria and Zimbabwe were used. In each country, the original sample was stratified into three socioeconomic groups: poor, middle and rich. For each maternal health service utilization variable, the gross and net effects of women’s education, controlling for age, parity, religion, marital status, health insurance, access to health facilities, partner’s education and current place of residence, were estimated using logistic regression, taking into account the complex sampling design of the DHS. The findings revealed country-specific variations in maternal health service utilization, and for most indicators there was a clear gradient among socioeconomic strata: women living in better-off households exhibited greater access to, and utilization of, maternal health services. Multivariate analyses revealed that women’s education had a positive association with type of antenatal care provider, timing and frequency of antenatal care visits, place of delivery and presence of a skilled birth attendant at delivery. Many other factors were found to be significantly associated with maternal health service utilization. For instance, parity had a negative and significant association with timing of first antenatal care visit. Likewise, partner’s education was positively and statistically associated with timing of first antenatal care visit. It is argued that an over-generalization of the association between women’s education and maternal health service utilization can be misleading. Efforts to improve maternal health service utilization in Africa must adopt an ‘equity’ approach, taking into account the specific needs of sub-populations.

scholarly journals Utilization of Health Facility–Based Delivery Service Among Mothers in Gindhir District, Southeast Ethiopia: A Community-Based Cross-Sectional Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110560
Author(s):  
Demisu Zenbaba ◽  
Biniyam Sahiledengle ◽  
Diriba Dibaba ◽  
Mitiku Bonsa
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health Facility ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Delivery Service ◽  
The Past ◽  
Southeast Ethiopia ◽  
Delivery Services

Facility-based delivery service is recognized as intermediation to reduce complications during delivery. Current struggles to reduce maternal mortality in low-and-middle income countries, including Ethiopia, primarily focus on deploying skilled birth attendants and upgrading emergency obstetric care services. This study was designed to assess utilization of health facility–based delivery service and associated factors among mothers who gave birth in the past 2 years in Gindhir District, Southeast Ethiopia. A community-based cross-sectional study design was conducted in Gindhir District from March 1 to 30, 2020, among 736 randomly selected mothers who gave birth in the past 2 years. A multistage sampling technique was used to select the study participants and a pretested, structured questionnaire was used to collect data through face-to-face interviews. The collected data were managed and analyzed using SPSS version 23. Of the 736 mothers interviewed, 609 (82.7%), 95% CI: 80.1, 85.5%, of them used health facilities to give birth in the past 2 years for their last delivery. Mothers who lived in rural areas had 4 or more ANC visits, received 3 or more doses of the TT vaccine, and had good knowledge of maternal health services were found to have a statistically significant association with facility-based delivery service utilization. In Gindhir District, mothers have been using health facility–based delivery services at a high rate for the past 2 years. Higher ANC visits and TT vaccine doses, as well as knowledge of maternal health services and being a rural resident, were all linked to using health facility–based delivery services. As a result, unrestricted assistance must be provided to mothers who have had fewer ANC visits and have poor knowledge on maternal health services.

scholarly journals Factors affecting utilization and satisfaction of maternal health care services among mothers of neonates in Paropakar maternity and women’s hospital

2021 ◽  
Vol 8 (11) ◽  
pp. 5234
Author(s):  
Shristi Neupane ◽  
Janak Thapa ◽  
Narayan Bahadur Mahotra ◽  
Lok Raj Bhandari
Keyword(s):  
Maternal Health ◽  
Antenatal Care ◽  
Health Care Services ◽  
Care Service ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Maternal Health Service ◽  
Ethical Review ◽  
P Value ◽  
Cross Sectional

Background: Knowledge and use of maternal health service is an effectual way to reduce the risk of maternal morbidity and mortality which can be influenced by multiple factors. Maternal service utilization thus plays an important role during pregnancy, childbirth, and the postpartum period. The aim of the study was to analyse antenatal services as proxy indicator for study purpose.Methods: A descriptive cross-sectional study was conducted in post-natal ward of Paropakar maternity and women’s hospital after ethical approval from the Ethical Review Board of the Nepal Health Research Council and Institutional Review Committee of Paropakar maternity and women's hospital and 210 samples were collected by a simple random sampling method. Statistical analysis was done using SPSS 16.0.Results: Out of 210 participants, only 100 (47.6%) had antenatal care as per protocol. The median age of the women delivering in hospital was 25 years. Women having household income more than 10,000 (OR=2.125, 95% CI=1.065-4.241, p=0.032), impact of mass media for utilization of antenatal care service (OR=14.261, 95% CI=4.881-41.670, p value<0.001), and women’s taking an hour or less to reach health facility (OR=2.763, 95% CI=1.293-5.903, p value=0.009) were found to be statistically significant.Conclusions: Majority of women in the study didn’t utilized full antenatal care service as per protocol. There is a need for different community based maternal and child health programs targeting the reproductive aged women and adolescent groups. 

scholarly journals Women’s autonomy and maternal health service utilization among the women’s having less than two years age children in Rautahat district, Nepal

2021 ◽  
Vol 7 (9) ◽  
pp. 427
Author(s):  
Sanjaya Kumar Shah ◽  
Neelima Yadav ◽  
Richa Shah ◽  
Ramesh Bhatta ◽  
Rajesh Karki ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Antenatal Care ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Simple Random Sampling ◽  
Cross Sectional Study ◽  
Maternal Health Service ◽  
Cross Sectional ◽  
Care Visit

<p class="abstract"><strong>Background:</strong> Maternal health refers to the health of women during pregnancy, childbirth and the postpartum period. Despite various attempts and schemes made by government. maternal mortality remains as one of the biggest public health challenges in Nepal. The aim of the study was to assess the association of women autonomy with maternal health service utilization among the women having 2 years children in Paroha municipality ward no. 3 and 4, Rautahat, Nepal.</p><p class="abstract"><strong>Methods:</strong> Cross sectional study was conducted. Simple random sampling was used to select respondents. Data were collected through face to face interview. Data were entered in Epi data and analyzed using SPSS. Chi square test was applied to test the significance of association at 95% confidence interval.  </p><p class="abstract"><strong>Results:</strong> Majority (76.8%) of the respondents had antenatal care visit and more than half of them had four or more antenatal care visits. similarly, overwhelming majority (88.4%) of the birth were institutional delivery. Almost (91%) of the women had postnatal care visit for their last child. The study indicates that almost (95.5%) of the decisions were made without the involvement of the women. Most of women had medium level autonomy in all aspect (score= 17-32). Autonomy was positively associated with use of maternal health services i.e.; ANC visit (p=0.000), place of delivery (p=0.036), PNC visit (p=0.045).</p><p class="abstract"><strong>Conclusions:</strong> Findings of the study show that if women autonomy will be higher, there will be increase in maternal service utilization. Whereas autonomy has link with better education and employment opportunity of the women.</p>

scholarly journals A cross-sectional study on utilization of maternal health services and its determinants among rural population of district Sitapur, Uttar Pradesh

2021 ◽  
Vol 8 (8) ◽  
pp. 3999
Author(s):  
Arslan Neyaz ◽  
Jaideep K. Chaubey ◽  
Malik S. Ahmed ◽  
Virendra Kumar ◽  
Kripashankar Nayak
Keyword(s):  
Maternal Health ◽  
Health Service ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Institutional Delivery ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Maternal Health Service ◽  
Sectional Study ◽  
Cross Sectional

Background: In India, despite substantial improvements in maternal health over the last decade or so, still condition is even poor in rural areas. As per National health policy 2017, target is to reduce MMR to 100 by 2020 and sustaining antenatal coverage at 100%, institutional delivery 80% and skilled attendance of birth 100% by 2025.The study is conducted with the objective to assess the pattern of maternal health service utilization and to identify the factors affecting it.Methods: A community based cross-sectional study was conducted at field practice area of Rural Health Training Centre, Hind Institute Of Medical Sciences, Sitapur with a sample of 208 women selected using systematic random sampling. SPSS Statistics 20.0 was used for data entry and calculation of statistical tests.Results: ANC utilization was found to be 70.7% whereas minimum recommended ANC visits were 50%. Only 54.8% deliveries were found to be institutional whereas 59.1% women received at least one postnatal check-up in our study. Most common reason for not utilizing ANC, Institutional delivery and PNC services was found to be tradition, availability of trained person and no need respectively. A highly significant association was found between maternal health service utilization and woman’s education, partner’s education, partner’s occupation, birth order and standard of living index (p<0.05).Conclusions: This study established that educating the population, empowering women, promoting maternal health service utilization in multipara’s and improving the socio-economic status of the family would yield greater results in increasing the use of maternal health services. 

scholarly journals The association between male involvement in institutional delivery and women’s use of institutional delivery in Debre Tabor town, North West Ethiopia: Community based survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249917
Author(s):  
Kassanesh Melese Tessema ◽  
Kebadnew Mulatu Mihirete ◽  
Endalkachew Worku Mengesha ◽  
Azezu Asres Nigussie ◽  
Awoke Giletew Wondie
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Institutional Delivery ◽  
Male Involvement ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Male Partners ◽  
Community Based ◽  
Cross Sectional ◽  
The Impact

Background Maternal deaths remain high in Ethiopia mainly due to poor maternal health service utilization. Despite men are the chief decision-makers and economically dominant in Ethiopia, the impact of their involvement on maternal health services utilization is not clear. This study aimed to assess the association between male involvement and women’s use of institutional delivery, and factors influencing male partners’ involvement in institutional delivery. Methods A community based cross-sectional study was conducted between March and May, 2019. A total of 477 married men who have children less than one year of age were interviewed. Face-to-face interviews using a pre-tested and structured questionnaire were used for data collection. Bivariate and multiple logistic regressions were carried out. SPSS version 23 was used for data analysis. Results Overall 181 (37.9%) husbands/partners were involved in institutional delivery for the most recent child birth. Male partners involvement in institutional delivery was strongly associated with an increased odds of attending institutional delivery by spouse [AOR: 66.2, 95% CI: 24.8, 177.0]. Education [AOR: 0.33, 95% CI: 0.18–0.59], knowledge on maternal health [AOR: 1.67, 95% CI: 1.11–2.50], favourable attitude towards institutional delivery [AOR: 1.83, 95% CI: 1.23–2.71], and no fear while supporting spouse [AOR: 2.65, 95% CI: 1.28–5.50] were positively associated with male partners involvement in institutional delivery. Conclusion Male partner’s involvement in institutional delivery was inadequate. This study reported a significant beneficial impact of male involvement on maternal health through improved utilisation of institutional delivery. Therefore, maternal health interventions should target husbands as consumers of maternal health services, and healthcare/government policies that isolate or discourage men from having active engagement in maternal health should be improved.

scholarly journals Factors Influencing the Utilisation of Maternal Health Services: The Perspective of Rural Women in Ghana

2013 ◽  
Vol 3 (2) ◽  
pp. 121 ◽  
Author(s):  
Anita Anima Daniels ◽  
Albert Ahenkan ◽  
Kwabena Adu Poku
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Outcomes ◽  
Rural Women ◽  
Rural Areas ◽  
Maternal Health Services ◽  
Individual Characteristics ◽  
Cross Sectional ◽  
Maternal Health Outcomes

Maternal mortality is a global issue and WHO recommends the use of maternal health services to help improve the health of women and babies during pregnancy and childbirth. Considering global and national interest in improving maternal health and the fact that Ghana is still battling with reducing maternal mortality, understanding the factors affecting the use of maternal services in rural areas is crucial as the women are seen as more vulnerable due to inequity issues. This study sets to examine the factors that influence the utilisation of antenatal and delivery services among rural women in Ghana, focusing on individual and area factors. A descriptive cross sectional study was carried out in three rural communities using Akuapim North District of Ghana as a case study.. The study adopted the quantitative approach. Structured interviews were used in data collection with the help of interview schedules. Two hundred and ninety-six (296) respondents were sampled using both probability and non probability techniques. Findings reveal that the use of the MHS is inadequate in relation to the WHO standards. Individual characteristics such as age, marital status and family size and the cost and time taken to a health facility were significantly associated with all the maternal health outcomes. Poor access to vehicles hindered women from delivery in a health institution and getting assistance from trained medical personnels. However, no significant association was established between education of respondents and the maternal health outcomes. It is recommended that the Ministry of Health engages in inter-sectoral collaboration to help ensure health equity.Effective integration of TBAs in providing care is needed to help improve utilisation of maternal services in rural areas

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