Frequency Of Antenatal Care Research Articles

English

Maternal mortality is a concern worldwide with higher disparities of 1 in 16 in developing compared to 1 in 2800 in developed countries. Kenya’s maternal mortality ratio has increased from 414 per 100,000 live births in 2003 to 488 per 100,000 live births in 2009. In 2010 the figure increased to 530 per 100,000 live births. The purpose of the study was to explore the effectiveness of dialogue in improving health facility deliveries in Rachuonyo District. The main objective of the study was to explore the effectiveness of dialogue in improving health facility deliveries. A prospective longitudinal research was conducted collecting baseline and post intervention data. Data was collected using semi structured in depth interview guides based on the causes of maternal deaths. Data collection and analysis were done concurrently to help increase insights and clarify parameters under study till saturation of information. A manual for training CHWs was developed based on gaps identified from baseline data. Community health workers were trained on the community dialogue model addressing gaps identified from baseline phase. Implementation of the dialogue model was conducted by the trained community health workers at the health facility and at the community within households. Baseline findings of study included inadequate equipment and staff at the health facility, late gestation at first visit, limited knowledge on complications, expected date of delivery, frequency of antenatal care (ANC) visits and basic items collected in preparation for arrival of the baby. A post intervention evaluation was done with post natal mothers taken through dialogue to assess effectiveness of dialogue. Findings showed improved knowledge on complications, expected date of delivery, frequency of ANC visits, basic items collected in preparation for arrival of the baby and the role of the husband in relation to the care of the mother. The study concluded that inadequate staffing, supplies and equipment contribute to low uptake of skilled attendant deliveries at the health facility. Mothers had inadequate information on birth preparedness before the intervention and this improved after the intervention. The study recommended facility improvement on provision of adequate staffing, supplies and equipments. There is need for task shifting of health education role from health workers to local community health workers (CHWs) because they were overwhelmed with integration of services and unable to provide adequate birth preparedness information to mothers. Key words: Antenatal care, health facility delivery, community health worker, community.

Magnitude and Determinants of Utilization of Skilled Birth Attendance among Women of Child Bearing Age in Sidama Zone, Southeast Ethiopia

Background: Skilled birth attendance is correlated with lower maternal mortality rates globally. Providing skilled care during pregnancy and delivery reduces maternal deaths. Objective: This study was aimed to estimate the prevalence of skilled birth attendance and factors affecting it. Methods: A community based cross sectional study was conducted from April 18 to 28, 2014 in Loka-Abaya district, southeast Ethiopia. Multistage sampling technique was used for selection of study participants. A pretested semi-structured questionnaire was used to collect data. Bivirate and multivariate logistic regression analysis was used to identify the determinants of skilled birth. Results: A total of 550 women participated in the study. The mean age of the subjects was 18.61 ± 2.269 years. 41.2% of the subjects attended 1-6 grade schooling. 26.8% of the mothers gave birth at health facilities. Only 13.9% of the mothers encountered at least one complication. The study showed that age and educational status of the mothers and husbands, frequency of antenatal visit, birth order, and maternal knowledge and prior experience of delivering at a health facility were independent predictors of skilled birth attendance. Conclusions: The study revealed that the prevalence of utilization of skilled birth attendance for the recent birth was low. Younger age, educational status of mothers and their husbands, lesser birth order, frequency of antenatal care, previous experience of delivery at health institutions and maternal knowledge had positively affected skilled birth attendance. Thus it is recommended that the responsible bodies should strive to improve the awareness and health seeking behavior of mothers.

Magnitude and Determinants of Utilization of Skilled Birth Attendance Among Women of Child Bearing Age in Sidama Zone, Southeast Ethiopia

Background: Skilled birth attendance is correlated with lower maternal mortality rates globally. Providing skilled care during pregnancy and delivery reduces maternal deaths. Methods: A community based cross sectional study was conducted from April 18 to 28, 2014 in Loka-Abaya district, southeast Ethiopia. Multistage sampling technique was used for selection of study participants. A pretested semi-structured questionnaire was used to collect data. Bivirate and multivariate logistic regression analysis was used to identify the determinants of skilled birth. Results: A total of 550 women participated in the study. The mean age of the subjects was 18.61 ± 2.269 years. 41.2% of the subjects attended 1-6 grade schooling. 26.8% of the mothers gave birth at health facilities. Only 13.9% of the mothers encountered at least one complication. The study showed that age and educational status of the mothers and husbands, frequency of antenatal visit, birth order, and maternal knowledge and prior experience of delivering at a health facility were independent predictors of skilled birth attendance. Conclusions: The study revealed that the prevalence of utilization of skilled birth attendance for the recent birth was low. Younger age, educational status of mothers and their husbands, lesser birth order, frequency of antenatal care, previous experience of delivery at health institutions and maternal knowledge had positively affected skilled birth attendance. Thus it is recommended that the responsible bodies should strive to improve the awareness and health seeking behavior of mothers.

Antenatal care services and neonatal tetanus: An outlook at the northeastern Nigeria

Abstract Background Neonatal tetanus (NNT) is considered as one of the most underreported diseases in the developing countries, seen in the newborn within the first 28 days of life. In the 1989 World Health Assembly and the 1990 world summit for children, WHO/UNICEF together with partner agencies to set up a strategic framework for the elimination of the disease by 1995 and subsequently reviewed to 2015. In spite the global success recorded in the NNT elimination strategy, it is disheartening to note that Nigeria is still among the 25 remaining countries that are yet to achieve the global NNT elimination target as set by the WHO. Study Design Retrospective study. Methods Quantitative cross-sectional study involving mothers who gave birth to children with NNT within their first 28 days of life. The study used secondary data collected between January 2008 and December 2013. Results Using SPSS 22, single sample proportions test and chi-square test of independence was conducted to determine if significant differences in frequency of antenatal care existed between mothers who indicated receiving care and those who did not. Result found that a significant difference did exist; z-statistic (N = 273) = 4.50, p Conclusion There is need for the Nigerian government to prioritize its activities to encourage and ensure that women within the childbearing age are fully vaccinated with the tetanus toxoid, that pregnant women receive quality ANC services and deliver in functional hospitals.

The Influence of Intrafamilial Power on Maternal Health Care in Mali: Perspectives of Women, Men And Mothers-in-Law

Evidence from diverse settings suggests that women often have limited control over their own reproductive health decisions. To increase uptake of preventive services and behaviors, it is important to understand how intrafamilial power dynamics and the attitudes of women, their husband and their mother-in-law are associated with maternal health practices. In 317 households in two rural districts of central Mali, women who had given birth in the previous year, their husband and their mother-in-law each completed a survey gauging their attitudes toward constructs of gender, power and health. Bivariate and multivariable logistic regression analyses were conducted to identify associations with four maternal health outcomes: antenatal care frequency, antenatal care timing, institutional delivery and postnatal care. In multivariable analyses, the preferences and opinions of mothers-in-law were associated with the maternal health behaviors of their daughters-in-law. Women's own perceptions of their self-efficacy, the value of women in society and the quality of services at the local health facility were also independently associated with their preventive and health-seeking practices. Husbands' preferences and opinions were not associated with any outcome. Interventions focusing on women or couples may be insufficient to advance women's reproductive health in patriarchal societies such as Mali. Future research and programmatic efforts need to address gender norms and consider the influence of other family members, such as mothers-in-law.

Factors influencing timing and frequency of antenatal care in Uganda

Over 99% of mothers who die of complications related to pregnancy and childbirth each year are found in developing countries.3 In Uganda, maternal mortality is estimated at 435 deaths per 100,000 live births. We sought to understand the factors influencing frequency and timing of antenatal care in Uganda in order to inform policy on the key aspects that need to be influenced. We used data from the Uganda Demographic and Health Survey (UDHS) 2006 and employed both descriptive and quantitative approaches (probit estimation). After a probit estimation, we generated marginal effects to interpret the results as probabilities of utilisation of antenatal care given particular background characteristics. On average, only 17% and 47% of mothers initiate the first antenatal visit in the first trimester and attain at least four antenatal visits, respectively. The timing and frequency of antenatal visits were significantly associated with education of the mother and her partner, wealth status, regional disparities, religious differences, access to media, maternal autonomy in taking a health decision, occupations of the mother and her partner, timing of pregnancy, birth histories, and birth order. Efforts are needed to educate girls beyond secondary level, establishment village outreach clinics with qualified staff to attract the hard-to-reach women, and to ensure universal access to prenatal care services irrespective of the ability to pay. Media penetration should also be increased amongst the population and this channel can be used to disseminate a standard piece of information concerning what pregnant women should expect and do during the prenatal period.

Maternal Health Care Utilization Among Ever Married Youths in Kyimyindaing Township, Myanmar

This study aimed to identify maternal care services utilization among ever married female youths (15-24 years) in Kyimyindaing Township, Yangon, Myanmar. A quantitative cross-sectional survey was conducted. A total of 196 ever married females who had delivered at least one child were included. Multistage sampling was employed. Face to face interviews using a structured questionnaire were carried out. Respondents were asked about their maternal care services utilization at the last pregnancy. Bivariate and logistic regression analyses were applied to determine the factors associated with utilization of maternal care services. Overall 96% of respondents received antenatal care (ANC) at least once and 79% had at least 4 ANC visits. The mean number of antenatal visits increased with women's education level. The majority received late ANC regardless of residence, age, education and family income. Nearly 39% delivered at home, especially in rural areas and 79% of home deliveries were attended by traditional birth attendants (TBAs). Only 56.6% of women received at least one postnatal care visit. Inadequate postnatal care (<6 times) was identified (82.6%). Place of residence, women's education and ANC frequency were the key determinants for a delivery place and postnatal care. Despite relatively high antenatal care attendance, most women practiced home deliveries and received inadequate postnatal care. Maternal health services need to be focused on rural women and women with little or no education. Quality ANC should be the entry point of safe delivery and postnatal care. Further intensification of information, education and communication activities on "safe motherhood" is needed.

Perinatal outcome of primiparous teenagers in northern Namibia

Internationally, teenagers are at risk for pregnancy-related morbidity and mortality. We assessed the obstetric and perinatal outcomes of teenage pregnancies compared with their older counterparts in northern Namibia. We made a retrospective study using birth records from February 2002 to August 2002. The data collected included perinatal mortality, delivery mode, birth weight, in-hospital days and frequency of antenatal care (ANC) attendance. They were compared with primiparous women in different age groups (n = 612). No differences were found in obstetric and perinatal outcomes between the three different age groups. Overall ANC attendance was high. The perinatal outcome for pregnant teenagers was comparable with their older counterparts in northern Namibia. In this region, ANC succeeds in reaching pregnant teenagers and teenage pregnancies are not at an increased risk for obstetric complications.

The antenatal care debate

The antenatal care debate has focused on the frequency of antenatal care, its content, continuity, quality, organization, effectiveness and impact on morbidity and mortality. Established antenatal care schedules have been called into question. Randomized controlled trials comparing reduced schedules with routine antenatal care have shown similar or better outcomes for the reduced protocols. Furthermore, midwives, with or without physicians, can provide continuous maternity care comparable to obstetrician-led care. Some women disliked the new protocol, but a reduced protocol of high quality provided by competent midwives is cost-effective, spares scarce physicians and ensures women's satisfaction. It is recommended globally.