Maternal Health Care Utilization Research Articles

Impact evaluation of invisible intimate partner violence on maternal healthcare utilization in Pakistan

IntroductionExisting research has shown that intimate partner violence (IPV) may hinder maternal access to healthcare services, thereby affecting maternal and child health. However, current studies have ignored whether emotional intimate partner violence (EV) could negatively affect maternal healthcare use. This study aims to evaluate the impact of invisible IPV on maternal healthcare utilization in Pakistan.MethodsWe analyzed nationally representative data from the Pakistan Demographic and Health Survey database from 2012–2013 and 2017–2018. Exposure to physical intimate partner violence (PV) and EV was the primary predictor. Based on women’s last birth records, outcomes included three binary variables indicating whether women had inadequate antenatal care (ANC) visits, non-institutional delivery, and lack of postnatal health check-ups. A logistic regression model was established on weighted samples.ResultsExposure to EV during pregnancy was significantly associated with having inadequate ANC visits (aOR = 2.16, 95% CI: 1.06 to 4.38, p = 0.033) and non-institutional delivery (aOR = 2.24, 95% CI: 1.41 to 3.57, p = 0.001). Lifetime exposure to EV was associated with increased risks of inadequate ANC visits (aOR = 1.48, 95% CI: 1.00 to 2.19, p = 0.049). Lifetime exposure to low-scale physical intimate partner violence (LSPV) (adjusted OR (aOR) = 1.73, 95% CI: 1.29 to 2.31, p < 0.001) was associated with increased risks of having no postnatal health check-ups.ConclusionsPregnant women who experienced EV and LSPV are at greater risk of missing maternal healthcare, even if the violence occurred before pregnancy. Therefore, in countries with high levels of IPV, early screening for invisible violence needs to be integrated into policy development, and healthcare providers need to be trained to identify EV and LSPV.

Examining the Period-Based Changes in the Effect of Socioeconomic Status in Maternal Healthcare Utilization Across Regional and Residential Contexts in Postcolonial Tanzania (1991–2016)

ABSTRACT Applying dependency theory, this manuscript uses data from the six cross-sectional Tanzania Demographic Health Surveys from 1991 to 2016 (n = 30,028) to explore temporal variations in the effect of socioeconomic status (SES) on maternal healthcare (MHC) utilization across different residences and regions. Research in this area is nonexistent in Tanzania. The results suggest a notable gap in using Tanzanian MHC based on SES and location (i.e. residence, regions). Results suggest that women from underserved groups, such as those living in rural areas or all-other (i.e. unprivileged) regions with lower SES, may have less access to MHC in the underdeveloped world. There were statistically significant socioeconomic variations in MHC use observed between residencies and regions, with stronger differences seen between residencies than regions. These findings further highlight the idea that lower use of MHC in the Global South is inseparable from economic dependency on metropolitan and Global North countries. This research calls for policymakers to recognize the roles of interactions between location and socioeconomic inequalities as factors exacerbated by higher dependency when crafting policies to modify healthcare utilization among women in underdeveloped countries.

RURAL WOMEN PERCEPTIONS OF DIGITAL MEDIA INFLUENCE ON AWARENESS CREATION ABOUT MATERNAL HEALTH INFORMATION IN PUNJAB, PAKISTAN

In rural settings, access to maternal health information is often limited, contributing to disparities in maternal healthcare utilization and outcomes. The main objective of the study is to find the rural women perceptions of digital media influence on awareness creation about maternal health information in Punjab, Pakistan. This cross-sectional study was conducted at the University of Lahore from August 2023 to January 2024. Data was collected from 350 participants using convenience sampling methods. Data collection involved the administration of structured surveys to participants, either in-person or through electronic means, depending on their accessibility and preferences. The survey instrument was designed to capture demographic information, including age, education level, household income, and parity, as well as assess participants' access to digital media, frequency of usage, preferred platforms, and perceived usefulness of digital media for obtaining maternal health information. Data was collected from 350 participants. The mean age of the participants was 32.9±6.5 years Education levels varied, with 60% having primary education, 30% secondary, and 10% tertiary education. Regarding household income, 70% fell below the poverty line, while 30% were above it. Participants reported relatively high mean scores for their engagement with digital media platforms. Social media received the highest mean score of 3.8, followed by search engines with a mean score of 3.5, and maternal health websites/apps with a slightly lower mean score of 3.2. It is concluded that digital media, particularly social media platforms, play a significant role in providing access to maternal health information among rural women, despite variations in access and perceived usefulness across demographic groups.

Prevention of Anaemia in Pregnancy: A Five-Year Scoping Review

Abstract: Approximately 50% of pregnant women globally suffer from pregnancy-related anaemia, which is a serious issue for reproductive health and can lead to a number of complications, including low birth weights, premature deliveries, foetal deformities, and feto-maternal mortality. Aim: This study aimed to evaluate the suggested strategies to prevent anaemia in pregnancy through a 5-year scoping review (November, 2017 to November, 2022). Methods: A comprehensive list of keyword combinations linked to anemia prevention in pregnancy and pertinent approaches to inform the search strategy were evaluated. Significant events, including pregnancy and anemia, were cross-referenced with the frequency and variability of terms across time. Literature from Pubmed (MEDLINE), Google Scholar, PLOS One, and Cochrane database were reviewed. Results: Evidence-based preventative therapy options for iron deficiency anaemia in pregnancy include prophylactic iron supplementation, food fortification with iron and folate, and health education. There is a wealth of research on the effects of these therapies on the occurrence of anaemia during pregnancy. However, these prospects are endangered by several variables, such as inadequate health facilities, low maternal health literacy, low utilisation of maternal health care in developing countries, a dearth of resources for health education, and lack of a government policy that prevents anaemia during pregnancy. Conclusion: If the highlighted challenges are appropriately addressed through the provision of health education material, the effectiveness of anaemia prevention in pregnancy could be sustained.

Maternal and child health care access to skilled delivery services among Ghanaian rural mothers

IntroductionMost new-born babies are born at home in rural communities which is not new phenomenon due to lack of access to primary healthcare services and trained skilled health attendants, exposing mothers and children to a high risk of labour complications. The purpose of this study was to better understand factors influence rural women's access to primary health care and skilled delivery services as well as their reasons for using or not using maternal health care and skilled delivery services.MethodsThe study employed a social survey design with a quantitative approach to data analysis. Cluster Sampling was used, possibly based on rural communities, to efficiently collect data from different geographic locations. Simple random sampling individuals from each cluster ensures that all eligible individuals have an equal chance of being included in the study. This enhances the representativity of the sample. A total of 366 mothers were selected from four rural communities in the North East Region of Ghana. The choice of sample size considered factors like the study's objectives, available resources, and the desired level of statistical power. Data was primarily gathered through the administration of a questionnaire to the respondents. Factors considered for achieving representativity include, geographic representation, accessibility, healthcare infrastructure and healthcare professionals’ attitudes.FindingsThe study found that distance to health centres limits women's access to skilled delivery services. Lack of primary health facilities in the rural communities hamper maternal and child care services delivery. The attitude of health care professionals determines a mother’s utilisation of maternal health care and skilled delivery services.ConclusionThe study contributes to the limited research on maternal health services and their impact on mother and child health in the study area. This study is one of the first to investigate into maternal health care as a key predictor of mother and child health in the study area. The study's theoretical lens was the Andersen and Newman Health Behavioural Model theory, which supports the explanation of distance, lack of primary health centres, attitudes and lack of skilled personnel to the non-utilisation of maternal and health services in rural communities. The study recommended that primary healthcare facilities and trained health professionals should be a priority of government in rural communities to promote maternal and child healthcare.

Utilizing maternal healthcare services: are female-headed households faring poorly?

BackgroundUtilization of maternal healthcare services has a direct bearing on maternal mortality but is contingent on a wide range of socioeconomic factors, including the sex of the household head. This paper studies the role of the sex of the household head in the utilization of maternal healthcare services in India using data from the National Family Health Survey-V (2019–2021).MethodsThe outcome variable of this study is maternal healthcare service utilization. To that end, we consider three types of maternal healthcare services: antenatal care, skilled birth assistance, and postnatal care to measure the utilization of maternal healthcare service utilization. The explanatory variable is the sex of the household head and we control for specific characteristics at the individual level, household-head level, household level and spouse level. We then incorporate a bivariate logistic regression on the variables of interest.Results24.25% of women from male-headed households have complete utilization of maternal healthcare services while this proportion for women from female-headed households stands at 22.39%. The results from the bivariate logistic regression confirm the significant impact that the sex of the household head has on the utilization of maternal healthcare services in India. It is observed that women from female-headed households in India are 19% (AOR, 0.81; 95% CI: 0.63,1.03) less likely to utilize these services than those from male-headed households. Moreover with higher levels of education, there is a 25% (AOR, 1.25; 95% CI: 1.08,1.44) greater likelihood of utilizing maternal healthcare services. Residence in urban areas, improved wealth quintiles and access to healthcare facilities significantly increases the chances of maternal healthcare utilization. The interaction term between the sex of the household head and the wealth quintile the household belongs to, (AOR, 1.39; 95% CI: 1.02, 1.89) shows that the utilization of maternal healthcare services improves when the wealth quintile of the household improves.ConclusionThe results throw light on the fact that the added expenditure on maternal healthcare services exacerbates the existing financial burden for the economically vulnerable female-headed households. This necessitates the concentration of research and policy attention to alleviate these households from the sexual and reproductive health distresses.Trial RegistrationNot Applicable.JEL ClassificationD10, I12, J16.

Continuum of care in maternal and child health in Indonesia.

This paper aims to empirically analyze the socioeconomic and demographic correlates of maternal and child health (MCH) care utilization in Indonesia using the continuum of care (CoC) concept. The concept of CoC has emerged as an important guiding principle in reproductive, maternal, newborn, and child health. Indonesia's maternal mortality rate, neonatal mortality, and under-five mortality rates are among the highest in the Southeast Asian region. Using pooled data from four successive waves of the nationally representative Indonesian Demographic and Health Survey (IDHS) conducted in the years 2002, 2007, 2012, and 2017, we use multivariate regression models to analyze care across four components of the continuum: antenatal care (ANC), institutional delivery, postnatal care for children, and full immunization (IM). CoC at each stage of MCH care has improved continuously over the period 2002-2017 in Indonesia. Despite this, just less than one out of two children receive all four components of the CoC. The overall coverage of CoC from its second stage (four or more ANC visits) to the final stage (full child IM) is driven by the dropouts at the ANC visit stage, followed by the loss of postnatal checkups and child IM. We find that the probability of a child receiving CoC at each of the four stages is significantly associated with maternal age and education, the household's socioeconomic and demographic characteristics, and economic status. Complete CoC with improved, affordable, and accessible MCH care services has the potential to accelerate the progress of Sustainable Development Goal 3 by reducing maternal and childhood mortality risks. Our findings show that in Indonesia, the CoC continuously declines as women proceed from ANC to other MCH services, with a sharp decline observed after four ANC visits. Our study has identified key socioeconomic characteristics of women and children that increase their probability of failing to access care.

Socioeconomic Determinants of Maternal and Child Healthcare Utilization and Infant Survival: A Case Study of Kijumo Village, Uganda

This study examines the socioeconomic determinants of maternal and child healthcare utilization and its impact on infant survival in Kijumo Village, Uganda. Through a survey of 70 mothers, data was collected on demographic characteristics, healthcare service utilization, and infant survival. Regression analyses were conducted to explore the relationship between socioeconomic factors, healthcare utilization, and infant survival. Results indicate a significant association between maternal education, household wealth, and infant survival. Moreover, healthcare service utilization was influenced by factors such as distance to healthcare centers and economic constraints. The findings underscore the need for targeted interventions to improve healthcare access and utilization in underserved communities like Kijumo Village. Keywords: Maternal and child healthcare, healthcare utilization, socioeconomic determinants and infant survival.

Understanding the barriers to integrating maternal and mental health at primary health care in Vietnam.

The prevalence of common perinatal mental disorders in Vietnam ranges from 16.9% to 39.9%, and substantial treatment gaps have been identified at all levels. This paper explores constraints to the integration of maternal and mental health services at the primary healthcare level and the implications for the health system's responsiveness to the needs and expectations of pregnant women with mental health conditions in Vietnam. As part of the RESPONSE project, a three-phased realist evaluation study, we present Phase One findings which employed systematic and scoping literature reviews, and qualitative data collection (focus groups and interviews) with key health system actors, in Bac Giang province, Vietnam, to understand the barriers to maternal mental healthcare provision, utilisation, and integration strategies. A four-level framing of the barriers to integrating perinatal mental health services in Vietnam was used in reporting findings, which comprised individual, socio-cultural, organisational, and structural levels. At the socio-cultural and structural levels, these barriers included: cultural beliefs about the holistic notion of physical and mental health, stigma towards mental health, biomedical approach to healthcare services, absence of comprehensive mental health policy, and a lack of mental health workforce. At the organisational level, there was absence of clinical guidelines on the integration of mental health in routine antenatal visits, a shortage of staff, and poor health facilities. Finally, at the provider level, a lack of knowledge and training on mental health was identified. The integration of mental health into routine antenatal visits at the primary care level has the potential help to reduce stigma towards mental health and improve health system responsiveness by providing services closer to the local level, offering prompt attention, better choice of services, and better communication while ensuring privacy and confidentiality of services. This can improve the demand for mental health services and help reduce the delay of care-seeking.

Male partners involvement in their wives’ antenatal care and its associated factors in southern Ethiopia. A community-based cross-sectional study

BackgroundInvolvement of male partners in antenatal care (ANC) is an effective approach to improve maternal and child health outcomes. It also enhances maternal healthcare utilization as males prevails decision-making regarding healthcare utilization in most developing countries including Ethiopia. Despite the acknowledged importance of male partners involvement, there is no research data in the study area. Therefore, the purpose of this study is to assess the status of male partners’ involvement in antenatal care and associated factors in Chencha town, which is found in southern region of Ethiopia. MethodsThe study adopted a community-based cross-sectional design from April 1–30, 2022, among 560 male partners in Chencha Town. To collect data, we use a structured, pretested and interviewer-administered questionnaire. The study participants were selected using a simple random sampling method. Analysis of data was performed using the statistical package for social sciences (SPSS) version 25. Descriptive statistics including mean, frequency, and percentage were used to summarize pertinent characteristics of study participants. Both bivariable and multivariable logistic regression analyses were carried out to detect the association between the independent and outcome variables. The statistical significance was set at P < 0.05 in the final model. ResultThe study found that 57% (95% CI: 53%–61%) of male partners were involved in antenatal care. Age 20 to 29 (AOR = 2.60, 95%CI:1.26, 5.37), more than secondary educational level (AOR = 2.04, 95%CI:1.08, 3.88), being government workers (AOR = 2.03, 95%CI:1.12, 3.67), exposure to information on male involvement during antenatal care (AOR = 4.37, 95%CI: 2.77, 6.91), and males’ knowledge about pregnancy danger sign (AOR = 2.55, 95%CI: 1.62, 4.02) were factors positively associated with male partner involvement in antenatal care. ConclusionThe prevalence of male partner involvement in antenatal care was relatively high, but it still needs to be improved to reach acceptable level. The involvement thrives among those aged 20–29 years, who have been exposed to information on male involvement in antenatal care, have higher education levels, government employees, and are aware of pregnancy danger signs. These factors can be used to target interventions that aim to increase male involvement in antenatal care, which helps to improve the health of both mothers and children.

Barriers in utilization of ante natal care services among Lodha populations: A study from Eastern India

ABSTRACT There are various factors that may operate at the individual, household, or community level and control the supply of public health service facilities. These factors acted as barriers of non-acceptance of skilled antenatal care service (ANC). This study made an attempt to examine the interdependent relationship of supply/contextual side and demand side variables which are responsible for non-utilization of ANC among indigenous population. This cross-sectional study was conducted on 248 married Lodha (Particularly Vulnerable Tribal Groups) women of West Bengal, Eastern India. Participants were aged between 15 and 44 years, had pregnancy during the last five years prior to the time of the fieldwork. Supply/contextual side and demand side barrier of ANC care were collected. Hierarchical Cluster analysis was done to find out the interdependent relationship among the barriers of non-utilization of skilled ANC. Two hierarchical clusters (HC), one for supply/contextual side and other for demand side barriers, were formed. Dendogram resulted from hierarchical clusters revealed several individual and household characteristics as demand side barriers forming one cluster. Another cluster was formed by factors that controlled health service facilities. We conclude from this study that the utilization of maternal health care is still a challenge in India.

Maternal health care utilization following the implementation of the free maternal health care policy in Ghana: analysis of Ghana demographic and health surveys 2008–2014

BackgroundIn July 2008, Ghana introduced a ‘free’ maternal health care policy (FMHCP) through the national health insurance scheme (NHIS) to provide comprehensive antenatal, delivery and post-natal care services to pregnant women. In this study, we evaluated the ‘free’ policy impact on antenatal care uptake and facility-level delivery utilization since the policy inception.MethodsThe study used two rounds of repeated cross-sectional data from the Ghana Demographic and Health Survey (GDHS, 2008–2014) and constructed exposure variable of the FMHCP using mothers’ national health insurance status as a proxy variable and another group of mothers who did not subscribe to the policy. We then generated the propensity scores of the two groups, ex-post, and matched them to determine the impact of the ‘free’ maternal health care policy as an intervention on antenatal care uptake and facility-level delivery utilization, using probit and logit models.ResultsAntenatal care uptake and facility-level delivery utilization increased by 8 and 13 percentage points difference, observed coefficients; 0.08; CI: 95% [0.06–0.10]; p < 0.001 and 0.13; CI: 95% [0.11–0.15], p < 0.001, respectively. Pregnant women were 1.97 times more likely to make four plus [a WHO recommended number of visits at the time] antenatal care visits and 1.87 times more likely to give birth in a health care facility of any level in Ghana between 2008 and 2104; aOR = 1.97; CI: 95% [1.61–2.4]; p < 0.001 and aOR = 1.87; CI: 95% [1.57–2.23]; p < 0.001, respectively.ConclusionsAntenatal care uptake and facility-level delivery utilization improved significantly in Ghana indicating a positive impact of the FMHCP on maternal health care utilization in Ghana since its implementation.

Socioeconomic inequalities in utilizing maternal health care in five South Asian countries: A decomposition analysis.

High maternal mortality rates still today remain a significant public health concern in South Asian countries. The majority of maternal deaths occur during pregnancy, and these deaths may typically be avoided by ensuring that women have access to reliable maternity care such as antenatal care (ANC) and facility delivery. The objectives of this research were to assess socioeconomic disparities in the utilization of health care services by mothers and to determine the factors influencing this utilization among women aged 15 to 49 in five South Asian countries. For this study, nationally representative data from the Demographic and Health Survey (DHS) were analyzed. This research included a total of 262,531 women between the ages of 15 and 49. To determine the likely causes of maternal health care utilization, simple bivariate statistics and binary logistic regression were applied, and decomposition analysis and the concentration curve were used to quantify disparity (Lorenz curve). ANC and institutional delivery were both prevalent in 59.27% and 86.52% of cases, respectively. Among the five nations, Maldives has the greatest ANC (96.83%) and institutional delivery (99.39%), while Bangladesh has the lowest ANC (47.01%) and institutional delivery (49.81%). Women's and husbands' education, household wealth status, BMI, and urban residents are the most important factors influencing maternal health service utilization, whereas higher education level, affluent wealth quintiles, and place of residence are the major contributors to socioeconomic inequalities in access to maternal health care that favor the wealthy. Maternal health care services must be utilized properly in order to promote optimal health and prevent maternal mortality. Several socioeconomic and sociodemographic variables of the individual population, as well as policy issues, all have an impact on maternal mortality. This research recommends for concerted action to enhance how successfully women use maternity care services.

Factors Associated With Influenza Vaccination During Pregnancy: A Real-World Evidence-Based Study.

Pregnant women are at increased risk of influenza-related complications. However, the rate of influenza vaccination among pregnant women in Taiwan is low. By analyzing real-world data in this study, we investigated the factors associated with influenza vaccination during pregnancy in Taiwan. This study was a cross-sectional study. We collected real-world data from 2 databases in Taiwan: the Birth Certificate Database and the National Health Insurance Research Database. The study population was pregnant between October 2014 and December 2016 in Taiwan. The multivariate logistic regression was performed to identify factors associated with influenza vaccination, including maternal sociodemographics, trimester, comorbidities, and health-care utilization. The vaccination rate of among pregnant women was 8.2%. Factors significantly associated with a high likelihood of influenza vaccination were age between 30 and 34 years (odds ratio [OR]: 1.14; 95% confidence interval [CI]: 1.10-1.19), second trimester (OR: 1.80; 95% CI: 1.75-1.85), income equal to or exceeding NT$ 38 201 (OR: 1.92; 95% CI: 1.86-1.99), hypertension (OR: 1.16; 95% CI: 1.05-1.29), cardiovascular disease (OR: 1.29; 95% CI: 1.17-1.42), autoimmune disease (OR: 1.47; 95% CI: 1.38-1.58), and chronic pulmonary disease (OR: 1.24; 95% CI: 1.18-1.31). A low level of urbanization, at least 1 hospitalization in the previous year, and the presence of pregnancy complications (eg, gestational diabetes, preeclampsia, and placenta previa) were associated with a lower likelihood rate of influenza vaccination. The influenza vaccination rate among pregnant women in Taiwan was low. Age, gestational age, income level, urbanization level, hypertension, cardiovascular disease, autoimmune disease, chronic pulmonary disease, and pregnancy complications may be associated with influenza vaccination among pregnant women.

Influence of socio-demographic factors on the use of maternal health care among Muslim women in urban slums of Mumbai, India

Background: Low and middle-income countries such as India face significant challenges in improving maternal health and reducing maternal mortality rate. To combat this problem, it is essential to utilize maternal health-care services. Objective: This study aims to assess the utilization of maternal health-care services (Antenatal care [ANC] and skilled attendance at birth) and the determining factors of maternal health-care utilization. Materials and Methods: This study is cross-sectional. The study is carried out in an urban slum in Mumbai, India. The respondents were selected using a multistage sampling procedure, and 300 Muslim women who delivered in the past 2 years in the reproductive age group (15–49 years) were selected. The data were collected using a structured interview schedule. Data were analyzed using logistic regression analysis. Results: The study shows that maternal health-care utilization among respondents was unsatisfactory. Only 43.8% of the respondents utilized full ANC service and 27.3% still delivered at home with unskilled birth attendance (traditional Dai). A medical emergency, high cost, and lack of quality of services were the most common reasons to deliver at home. Respondents’ age at marriage, education (respondents and partners), monthly income, number of children, and type of family are the most important determining factors for the utilization of maternal health-care services. Conclusion: Better utilization of maternal health-care services can be achieved by improving the overall socioeconomic status of Muslim women. To improve maternal healthcare, special attention is required to be paid to the education of women and spouses. Furthermore, policies may address the women’s subordinate position in socioeconomic parameters. Similarly, close monitoring is required by the government through different agencies on the utilization of maternal health-care services.

Socio-Economic Differentials of Antenatal Health Care Utilisation in Ekiti State, Nigeria.

This study examined how socio-economic factors influence the pattern of antenatal care (ANC) utilization. Specifically, the patterns of ANC was analysed while statistical association between socio-economic factors and ANC utilisation was analysed using chi-square analysis. Andersen Behavioural Theoretical Model guided the research process. This is a cross-sectional survey with the use of structured interviews for data collection among nursing mothers aged 15-49 years with at least a child aged one year. Multi-stage random sampling was used to identify and contact the 444 household respondents across six local government areas of the State, that is, two local government areas from each of the three senatorial districts. A pretest was conducted to assure of the reliability of the instruments while pilot test was conducted for validity. The Statistical Package for the Social Sciences version 22.0 was used for data analysis. Findings show that nursing mothers have adequate knowledge of ANC and child health services. 87% of the mothers utilized modern ANC while about 13% utilized the traditional or spiritual healing homes. Over 80% have at least two ANC contacts and there was average of five contacts starting in the first trimester. Age, income, religion, ethnic status are significant explants of utilization of ANC while employment status, level of educational, marital status are not. The most significant factor is the positive relationship of Income to patronage of modern ANC service and the need to improve access of non-Yoruba ethnic group women to ANC and other maternal and child health care services. Availability Family support and improved economic status are booster factors to ANC utilisation and promotion of maternal and child health care utilisation.

Exploring Antenatal Health Care Service Utilization in Nepal: A Comprehensive Analysis

The utilization of maternal health care is one of the important factors in reducing the incidence of maternal mortality. Studies in Nepal and in developing countries shows that various demographic, socio-economic and economic factors are associated with ANC service utilization. The main objective of this study is to identify and examine socio-demographic and economic factors affecting antenatal healthcare service utilization in Nepal. This study used data from the Nepal Demographic and Health Survey 2016 and analyzed the data using logistic regression analysis. This research analyzes ANC (antenatal care) concerning dependent variables: age, birth order, religion, ethnicity, educational attainment, province, residence, and wealth indices. Maternal health has been receiving increased attention in the global health, development, and human rights agenda, representing a priority area for accelerating progress on the SDGs and sustaining the gains of the MDGs. Bivariate analysis was conducted for all variables, and some of them were statistically significant at the 5 percent significance level (since p &lt; 0.05). The dichotomous use of modern maternal healthcare utilization, namely whether a woman utilized maternal health care or not, employed dichotomous logistic regression to determine which factors best explain and predict the outcome of maternal health care utilization during pregnancy. A positive estimated value indicates that the odds favor the event and the event is likely to occur, while a negative value indicates that the event is not likely to occur. ANC visits of women decrease with birth order. Based on empirical results, the major factors for ANC services were income, awareness, access to health care services, and birth order attended. The level of awareness among women about the utilization of maternal healthcare in the study area was low. Maternal healthcare service utilization differed across various components of maternity. It would be better to increase awareness about the utilization of modern maternal healthcare for mothers and improve access to healthcare services in their villages to minimize transportation costs and waiting times from the government's side, thus increasing the utilization of maternal health care services in Nepal.

Utilization of maternal health care services in a rural community of Nepal

Introduction: Nepal has made progress in declining maternal mortality; but not up to the target. One of the important aspects in this regard is to know about the base line maternal health care utilization among women and to develop intervention accordingly. This study aims to identify the utilization of maternal health care services among women of rural municipality of Nepal. Method: A cross sectional analytical study with purposive sampling among 323 married women having at least one child less than five years old was conducted in Bagnaskali rural municipality of Palpa district using face to face interview technique with self-developed structured interview schedule. Descriptive statistics frequency, percentage, mean and standard deviations were used and association between descriptive variables and utilization was done using Chi square and Fisher Exact test as applicable using Statistical Package for Social Sciences (SPSS) version 16. Result: The study showed 21.05% of respondents had completely utilized maternal health care services (four Antenatal Care (ANC) checkups, institutional delivery and three Postnatal Care (PNC) checkups), 78.94% of the respondents had partially utilized services. There was no significant difference in health care utilization between maternal age, education of both mothers and husbands, occupation, types of families and distance to nearest health facility as seen by Chi Square and Fisher Exact Test. Conclusion: Almost all the respondents had ANC checkup and institutional delivery. More than half of the respondents had PNC checkup and the demographic variables had no association with utilization of maternal health care services.

Determinants of maternal health care utilization at urban slums in Northeast India: a cross-sectional study

Background: Factors affecting maternal health care utilization determine maternal mortality rate (MMR). Therefore this study has been carried out to out to assess the level and determinants of maternal health care service utilization in an urban slum of north-east India. Methods: A cross-sectional study design was used. The study area comprised of four municipal wards with well-defined geographical boundaries. All married women in the age group 18-45 years who were either pregnant and/ or had at least one child under 3 years of age on the day of survey residing in that area for a minimum of one year were the study population. Data collection was done by house-to-house visit. Descriptive analysis and chi-square test was used for data analysis. Results: Adequate utilization of IFA and TT was 86.3% and 84.4%, respectively. Adequate utilization of maternal health care was found to be 79.8% and 20.2% respectively. Age, educational status, income of the participants and birth order of the relevant child was found to be significantly associated with the maternal health care utilization. Conclusions: The study concludes that maternal health care utilization was found adequate among 79.8% of study participants, out of which antenatal care, intranatal care and postnatal care utilization rate was found in 85.4%, 89.8% and 82.5% respectively. Age, education, income of the women and birth order of their children were significantly associated with maternal health care utilization.

Digital media and maternal healthcare among young women in Kenya: Use, patterns, and perspectives

This study aimed to examine the relationship between digital media use and maternal health care utilization among young pregnant mothers in Kenya. Using a mixed methods approach combining questionnaires and focus group discussions (FGDs), data were collected from pregnant women and new mothers aged 19–35 years in Nairobi. Using Microsoft Excel Data Analysis ToolPak Ver. 2016, primary data were statistically analyzed, while FGD data were subjected to thematic analysis and narrative interpretation. Findings revealed that 88% of participants preferred internet searches for information, 92% used different digital media during pregnancy, 56% used pregnancy apps, and 9% abstained from digital media for maternal health information. The study concludes that, in addition to the continued importance of traditional sources of information, digital media have a significant impact on the use of maternal health services. It recommends that health care providers actively usedigital media, especially apps, as educational tools to disseminate reliable information to young pregnant women and new mothers in Kenya. It also recommends that planners and policymakers incorporate digital media into maternal health interventions to increase their effectiveness.