Maternal Health Facilities Research Articles

Analyzing the Risk Factors of Early Neonatal Deaths in Kupang District, Rural Eastern Indonesia

The neonatal mortality rate in East Nusa Tenggara (NTT) remains high, with 80% of neonatal deaths occurring in the early period. This study aims to analyze the risk factors contributing to early neonatal death in Kupang District. A retrospective case-control study was conducted, involving 31 cases of early neonatal death and 69 controls from medical records from January 2023 to June 2024. Multinomial logistic regression analysis was used to identify the influence of maternal health, birth, neonatal factors, and healthcare facility readiness. The results showed that birth weight, frequency of antenatal visits, and the completeness of medical equipment were significant predictors of early neonatal death. More frequent antenatal visits were found to reduce the risk of death by 24%, while low birth weight increased the risk by 30%. In conclusion, interventions focusing on preventing low birth weight, ensuring compliance with minimum antenatal visits, and improving the readiness of basic healthcare facilities could reduce early neonatal death in this region.

Physical activity level among pregnant women attending maternal healthcare services in rural Karnataka; findings of a cross-sectional study

Background Regular exercise during pregnancy improves fetal and mother outcomes unless contraindicated. Despite being generally safe and beneficial, non-participation in prenatal activity is relatively common among most of the Asian countries due to multiple reasons. In India, findings related to maternal physical activity and its determinant are scant. Objective The objective of this study is to assess the physical activity level and associated factors among pregnant women attending maternal healthcare services in Dakshina Kannada District in India. Method A multi-center community-based cross-sectional study was conducted recruiting 424 pregnant women attending the maternal healthcare facilities at four taluks of Dakshina Kannada district in Karnataka state, India. A structured questionnaire that collected information on socio-demographic, and maternal characteristics was used and the Pregnancy Physical Activity Questionnaire tool was used to determine the physical activity during pregnancy. Logistic regression model was used to determine the predictor variables. Results The prevalence of physical inactivity was 40.33%. Physical activity is favorable among pregnant women aged between 25 to 29 years, residing in an urban locality, diploma or graduation and being housewife. Determinants of physical inactivity during pregnancy were sedentary occupation (AOR 7.22, 95% CI 2.2, 23.4), low family income (AOR 3.16, 95% CI 1.414, 7.054), having one child (AOR 5.4, 95% CI 1.3, 22.2), during 2nd trimester (AOR 2.513, 95% CI 1.5, 4.23) and self-reported lack of time (AOR 2.884, 95% CI 1.410, 5.901). Conclusion and recommendation A moderate proportion of pregnant women reported physical inactivity during pregnancy in the Dakshina Kannada district, Karnataka. Physical inactivity was associated with sedentary employment, low income, number of children, trimester, and time constraints. Measures should be undertaken to promote the importance of recommended levels of physical activity, enhance access, and support system targeting pregnant women.

Spatial patterns of maternal and neonatal continuum of care use and its correlations with women’s empowerment

BackgroundThe continuum of care (CoC) in maternal health refers to the continuity of individual reproductive health care across the antenatal, intrapartum, and postnatal periods. The CoC is an indicator of the quality of maternal and newborn health outcomes and women’s empowerment is crucial to improving maternal and neonatal health service access and utilisation.ObjectiveTo examine the spatial patterns of continuum of care use for maternal and neonatal health services and its correlation with women’s empowerment.MethodsWe analysed data from the Ethiopian Demographic and Health Surveys (EDHS) of 2011 and 2016. All women aged 15–49 who had live births in the preceding five years of the DHS surveys were included in the analysis. We measured the continuum of care using the modified co-coverage index (CoCI), which consisted of six indicators. Women’s empowerment was assessed using a validated survey-based Women’s Empowerment (SWPER) index. We used the Getis-Ord-Gi* spatial analysis tool to portray locations with clusters of CoC service use and spatial correlations between CoC use and women empowerment.ResultsNone of the newborn-mother pairs in the 2011 survey received the entire continuum of care and only 2.5% of newborn-mother pairs received the full range of continuum of care services in the 2016 survey. In 2016, 6.9% of mother-newborn pairs received the basic CoC services (four or more antenatal care [ANC] visits, skilled birth attendance [SBA], and postnatal care [PNC]), and no mother-newborn pair received all three services at the same time in 2011. The Amhara, Afar, and Somali regional states had the least CoC service use in both surveys. There was a positive spatial correlation between CoC use and women’s empowerment domains.ConclusionOur analysis showed that the use of four or more ANC visits, SBS, newborn PNC, Bacillus Calmette-Guérin (BCG) vaccine uptake, and tetanus toxoid protection at birth were low in Ethiopia. Women empowerment domains were found to have a positive spatial correlation with CoC services use. To improve and preserve continuity of care, it is critical to leverage every maternal health facility encounter to encourage sustained service usage at each step of the continuum. Government policies should prioritise women’s empowerment and raise public awareness of maternity services.

Utilization of maternal health facilities and rural women’s well-being: towards the attainment of sustainable development goals

BackgroundThe sustenance of any household is tied to the well-being of the mother's health before, during, and after pregnancy. Maternal health care has continued a downward slope, increasing maternal mortality in rural communities in Nigeria. Presently, few empirical findings connect maternal healthcare facilities' use to mothers' well-being in Nigeria. Using maternal health facilities and the well-being of rural women is crucial in achieving the United Nations’ Sustainable Development Goals 1, 2, and 3 (No poverty, zero hunger, good health, and well-being).ObjectiveThe objective of the study was to examine the level of maternal healthcare utilization and its effect on mothers’ well-being status among mothers in rural Nigeria.MethodsIn this study, secondary data extracted from the Nigeria’s 2018 National Demographic Health Survey was used. Data was analyzed with Multiple correspondence analysis, Fuzzy set analysis, and Extended ordered logit model.ResultsWomen in rural Nigeria were moderate users of maternal health care services and had moderate well-being indices (0.54 ± 0.2, 0.424 ± 0.2, respectively). Mothers' moderate well-being status was increased by using maternal health care facilities, having a larger household, and having mothers who worked exclusively in agriculture.ConclusionWe concluded that mothers in rural Nigeria use maternal healthcare facilities moderately, and their well-being level was improved using maternal healthcare facilities. Therefore, Nigeria’s Ministry of Health should raise awareness about the vitality of mothers using health care services before, during, and after pregnancy. In order to promote greater female participation in full-scale agricultural production, it is imperative for the Nigerian government to allocate substantial resources in the form of subsidies and incentives. The Nigerian government should source these resources from various channels, including expanded development cooperation. Additionally, policymakers should focus on designing developmental programmes specifically tailored for rural households and the health sector.

Patient actor training improves preexposure prophylaxis delivery for adolescent girls and young women in Kenya: a cluster randomized trial.

To evaluate effectiveness of a standardized patient actor (SP) training intervention to improve quality of preexposure prophylaxis (PrEP) services for adolescent girls and young women (AGYW) in Kenya. Cluster randomized trial and mystery shopper evaluation. Twelve of 24 maternal child health and family planning facilities were randomized to SP training. Providers at intervention facilities participated in 2-day training in adolescent health, PrEP guidelines, values clarification, and communication skills, followed by role-playing and de-briefing with trained actors. Control facilities received standard national training. The primary outcome was quality of care, assessed by unannounced SPs (USPs) or "mystery shoppers" blinded to intervention arm. Quality was measured in two domains: guideline adherence and communication skills. Intent to treat analysis compared postintervention quality scores by randomization arm, clustering on facility, and adjusting for baseline scores and USP. Overall, 232 providers consented to USP visits, and 94 providers completed the training. Following training, USPs posed as AGYW seeking PrEP in 142 encounters (5-6 encounters per site). The mean quality score was 73.6% at intervention sites and 58.4% at control sites [adjusted mean difference = 15.3, 95% confidence interval (CI): 9.4-21.1, P < 0.001]. Mean guideline adherence scores were 57.2% at intervention sites and 36.2% at control sites (adjusted mean difference = 21.0, 95% CI: 12.5-29.4, P < 0.001). Mean communication scores were 90.0% at intervention sites and 80.5% at control sites (adjusted mean difference = 9.5, 95% CI: 5.5-13.6, P < 0.001). SP training significantly improved quality of PrEP care for AGYW in Kenya. Incorporating SP training and unannounced SP evaluation could improve PrEP uptake among AGYW.

Midwives' lived experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini: a qualitative study.

Midwives encounter various difficulties while aiming to achieve excellence in providing maternity care to women with mobility disabilities. The study aimed to explore and describe midwives' experiences of caring for women with mobility disabilities during pregnancy, labour and puerperium in Eswatini. A qualitative, exploratory, descriptive, contextual research design with a phenomenological approach was followed. Twelve midwives working in maternal health facilities in the Hhohho and Manzini regions in Eswatini were interviewed. Purposive sampling was used to select midwives to participate in the research. In-depth phenomenological interviews were conducted, and Giorgi's descriptive phenomenological method was used for data analysis. Three themes emerged from the data analysis: midwives experienced physical and emotional strain in providing maternity care to women with mobility disabilities, they experienced frustration due to the lack of equipment to meet the needs of women with mobility disabilities, and they faced challenges in providing support and holistic care to women with mobility disabilities during pregnancy, labour and puerperium. Midwives experienced challenges caring for women with mobility disabilities during pregnancy, labour and the puerperium in Eswatini. There is a need to develop and empower midwives with the knowledge and skill to implement guidelines and enact protocols. Moreover, equipment and infrastructure are required to facilitate support and holistic maternity care for women with mobility disabilities.

An Overview of Maternity healthcare Monitoring in Developing Nations

A healthcare monitoring arrangement is essential for frequently monitoring a patient's health status. Specifically, maternal healthcare systems for tracking are utilized to evaluate the clinical status and monitor any abnormal condition changes during all three trimesters. This paper's objective is to conduct an extensive literature review and acknowledge earlier initiatives and studies conducted previously in maternal health care monitoring. This review focuses on accumulating information from earlier work and presents a general overview of previous studies concerning maternal health care monitoring (MHCM). The paper focuses on the maternal healthcare systems in developing countries accessed by pregnant women during the antenatal period. Furthermore, this paper highlights the challenges in the maternal health sector that include inadequate work conditions for health workers, home-based birth practices, long distances to healthcare facilities, and long waiting times in health facilities. The paper indicates the potential opportunities to strengthen maternal healthcare services and allow effective access to maternal healthcare facilities by pregnant women.

Impact of Insecurity on Access to Maternal Health Services by Women of Reproductive Age in Selected Rural Communities in Zamfara State, Nigeria

Nigeria, Africa’s largest economy is of late, enmeshed in monumental security challenges, to the extent that no section of the country is insulated from the activities of criminal elements. The most prominent of Nigeria's security hiccups is the Boko-Haram sect in the northeastern region of the country. Besides the Boko-Haram menace, the northwestern zone, particularly Zamfara State, has been under persistent bandit attacks with 16,086 persons abducted between 2015 and 2022. Similarly, 9,490 were killed while 1,385,625 persons were displaced within the period under review. This paper examined the impact of insecurity on access to maternal health services by women of reproductive age in selected local government areas of Zamfara State, Nigeria. Questionnaire and Key Informant Interview were the primary data collection instruments while the Subcultural theory served as the theoretical framework. A total of 382 respondents were used for the study while 30 key informants were interviewed. The study found out that respondents travel 10 to 15km kilometres and 2 to 3 hours to arrive at the nearest maternal health facility leading to a remarkable decline in the rate of utilisation of health services. It was also discovered that insecurity has led to massive relocation of medical personnel, destruction of rural health facilities, decline in hospital patronage and dearth of essential drugs. The paper recommends the adoption of kinetic and non-kinetics strategies to stem insecurity; reconstruction of destroyed medical infrastructures; and location of health care centres within accessible distance to encourage patronage and rehabilitation of persons displaced by bandits in the State.

Development and internal validation of a clinical prediction model for spontaneous abortion risk in early pregnancy

ObjectiveThis study aimed to develop and internally validate a prediction model for estimating the risk of spontaneous abortion in early pregnancy. MethodsThis prospective cohort study included 9,895 pregnant women who received prenatal care at a maternal health facility in China from January 2021 to December 2022. Data on demographics, medical history, lifestyle factors, and mental health were collected. A multivariable logistic regression analysis was performed to develop the prediction model with spontaneous abortion as the outcome. The model was internally validated using bootstrapping techniques, and its discrimination and calibration were assessed. ResultsThe spontaneous abortion rate was 5.95% (589/9,895) 1. The final prediction model included nine variables: maternal age, history of embryonic arrest, thyroid dysfunction, polycystic ovary syndrome, assisted reproduction, exposure to pollution, recent home renovation, depression score, and stress score 1. The model showed good discrimination with a C-statistic of 0.88 (95% CI 0.87‒0.90) 1, and its calibration was adequate based on the Hosmer-Lemeshow test (p = 0.27). ConclusionsThe prediction model demonstrated good performance in estimating spontaneous abortion risk in early pregnancy based on demographic, clinical, and psychosocial factors. Further external validation is recommended before clinical application.

Maternal HealthCare Using IoT-Based Integrated Medical Device: Bangladesh Perspective

Purpose: The main purpose of this study is to develop a low-cost integrated medical device. This device will help investigate the risk levels of maternal patients as well will reduce the cost involved in medical diagnosis for poor countries like Bangladesh, where maternal healthcare is a great concern.&#x0D; Methodology: We proposed and developed an integrated medical device that includes all possible sensors to collect raw data from maternal patients. As soon as the data is collected it will be sent to the cloud for processing. In the cloud, there are a set of algorithms (software) for processing raw data received from the device. After processing and analyzing our system will automatically identify the risk levels of those patients. The software is developed in open source code so that in the future it can be updated by researchers.&#x0D; Results: We developed the system and practically collected raw data from patients and uploaded those data to our cloud system. In the cloud, it was processed and the resultant data were presented in the form of graphs. From these graphs, the risk levels were identified.&#x0D; Limitations: The proposed system is developed for maternal patients only. This system needs to be authorized by the health regulatory authority. To make it cost-effective some expensive sensors were not used.&#x0D; Contribution: The main contribution of this study is to minimize the cost involved in maternal healthcare in poor countries like Bangladesh. This, in turn, controls the death of mother and child by improving maternal healthcare facilities.

Provision of emergency obstetric care: Midwives' knowledge and involvement in rural health facilities of Cross River State, Nigeria

BACKGROUND: Maternal Mortality (MM) in Nigeria is greatest in rural regions where access to emergency obstetric care (EmOC) services is hampered by a number of circumstances. Delay in obtaining prompt and proper care in obstetric emergency situations is a significant factor in poor mother outcomes. It is based on this premise that the researchers examined midwives' knowledge and involvement regarding provision of emergency obstetric care in rural health facilities of Cross River State. MATERIALS AND METHODS: The study adopted a cross-sectional descriptive design; a total population study of all ninety-four midwives who worked in maternal health care facilities in rural areas of CRS was utilised. Cross River state is a state in the South-South geopolitical zone of Nigeria, named after the Cross River, which passes through the state, located in the Niger Delta and occupies 20,156 square kilometers A self-developed and validated questionnaire was used for data collection. The instrument was pre-tested for reliability and result showed the reliability index ranging from 0.70 to 0.82. Quantitative data collected was analysed using Pearson product moment correlation test at 0.05 level of significance. RESULTS: The research findings revealed midwives' level of knowledge on emergency obstetric care in rural health facilities of CRS was significantly high, majority of the participants had provided some aspects of essential emergency obstetric care. The result of hypotheses revealed a significant relationship between knowledge and provision of EmOC amongst the midwives (P &lt; .05). CONCLUSION: Based on this, it was recommended that appropriate strategies such as on the job training\ supportive supervision, refresher training and mentorship should also be ensured to enhance midwives' capacity in emergency obstetric care. Finally, there is need for Community involvement/enlightenment, motivating traditional birth attendants and integrating them into maternal health care system.

Prevalence of HIV/AIDS as a Health Indicator on Productivity in Nigeria

This paper analyzed empirically the impact of public health expenditure on productivity in Nigeria. The study employs econometric techniques to verify the time series properties and the relationship among HIV/AIDS prevalence rate, life expectancy rate and productivity in Nigeria. The findings revealed that maternal mortality rate and HIV/AIDS prevalence rate have a negative significant impact on productivity in the long run. Again, the life expectancy rate was found to have a positive significant effect on productivity. In the short run, the multiple regression results showed that public health expenditure has a positive insignificant impact on productivity in Nigeria. Also, the findings revealed that the maternal mortality rate has a negative insignificant effect on productivity in the short run. The study consequently proposes that more research be conducted to determine the root reason of the negative link between public health spending and productivity in Nigeria. To boost Nigerian productivity, the government should enhance public health spending and strengthen maternity healthcare facilities.

Prevailing Government Maternal Health Care System and Challenges Faced by Health Professionals: A Case study in Tehsil Jampur

This research aims to investigate maternal healthcare facilities and the challenges faced by the health professionals in tehsil Jampur. The present study utilized a qualitative approach and collected data from 23 participants through purposive sampling. The population of Tehsil Jampur in the Punjab province of Pakistan predominantly resides in rural areas. The data was collected via in-depth interviews and analyzed using a straightforward thematic analysis methodology. Services provided at primary healthcare units endeavor to met service-provision standards by arranging, LHVs, LHWs, LHS, CMWs, transportation, nutrition etc. but it requires to highlighting the importance of addressing staff absenteeism, inadequate infrastructure, and inconsistent working hours to improve health outcomes. It also reveals that due to multiple deficiencies, the assessment of service quality at facility centers is of utmost importance. The challenges encompass insufficient medicine accessibility, restricted service hours, inconvenient transportation to remote medical facilities, male exclusion as partaker of health program, traditional practices including reliance on TBAs and a scarcity of female healthcare providers influenced by cultural norms pertaining to gender dynamics. The health sector’s governance is adversely affected by the frequent fluctuations in government and its system. The health department experiences instability due to the varying strategies, programs, and staff appointments introduced by successive prime ministers.

Perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia: a qualitative explorative study

BackgroundGlobally, hormonal contraceptives have proved to be effective in the prevention of unwanted pregnancies. However, despite evidence of the many benefits associated with the use of hormonal contraceptives, concerns related to their safety and side effects have been reported. We conducted a study to explore the perspectives on the side effects of hormonal contraceptives among women of reproductive age in Kitwe district of Zambia.MethodsAn explorative qualitative study was done among 32 women of reproductive age (18–45 years). Participants were selected conveniently as they accessed family planning services at a designated reproductive, maternal, and child health facility. Data collection was done through in-depth interviews (IDIs). Recruitment of participants and data collection continued until the saturation point was reached. The interviews were recorded, translated, and transcribed verbatim. Data were imported into NVivo.x64 for coding and node generation after which categories and themes were developed manually.ResultsOverall, participants demonstrated a considerable amount of knowledge of family planning, recounting the economic and health benefits as well as demerits of family planning use. The main reasons for discontinuing and switching hormonal contraceptive methods were the desire to get pregnant and the fear of unpleasant side effects, including excessive bleeding or prolonged menstruation, headache, dizziness, lower abdominal/back pain, and weight gain. Most importantly, participants cited concerns about the delay in the resumption of fertility after the termination of contraception and how the side effects disrupted their daily activities at home.ConclusionThere is a need for family planning providers to offer family planning services that address the side effects of hormonal contraceptives during counselling and how women can manage them. Family planning services should adopt a patient-centred approach that takes into consideration the concerns regarding side effects and how this affects the quality of life among women. Also, there is a need to extend family planning services to include scheduled follow-ups and clinical management of contraceptive side effects among women.

The role of maternal serum alpha-fetoprotein in preterm birth: A literature review

Preterm birth is one of the most important global issues. Mortality and morbidity among children under 5 years, including neonates, is affected by preterm birth. A good maternal care, health workers, and health facilities play an important role in the outcome of pregnancy, including preterm birth. An early screening test for pregnancy is crucial to find any abnormality thus preterm birth can be predicted and the following treatment may be applied without delay. One of potential biomarker for the screening test is alpha-fetoprotein (AFP) that can be found in maternal serum. Web-based literature search was carried out using several keywords. This literature review aims to collect data and articles to conclude the correlation of the potential biomarkers in diagnostic of preterm birth.

Strengthening Nutrition Interventions during Antenatal Care Improved Maternal Dietary Diversity and Child Feeding Practices in Urban Bangladesh: Results of a Quasi-Experimental Evaluation Study

BackgroundBangladesh is urbanizing rapidly, facing challenges of malnutrition, low coverage and poor quality of urban nutrition services. ObjectivesWe assessed the effect of integrating maternal, infant, and young child nutrition interventions, delivered at urban Maternal Neonatal and Child Health facilities, on maternal dietary diversity, iron and folic acid (IFA) and calcium consumption, and child feeding practices. MethodsWe used a quasi-experimental design with a nonrandom assignment of 20 health care facilities in Dhaka to intensive and standard service arms. We conducted facility-based observations and community-based surveys at baseline (2020) and endline (2022) (n = 2455 observations and surveys with 1678 pregnant women [PW] or recently delivered women [RDW] at endline). We derived difference-in-difference (DID) estimates, adjusted for characteristics that differed at baseline or endline, and accounted for clustering. ResultsExposure to antenatal care (ANC) was similar in both arms: two-thirds of RDW received ANC during the first trimester and three-fourths received ≥4 ANC checkups. Compared to the standard arm, a higher proportion of PW in the intensive arm received counseling on dietary diversity (DID: 45 percentage points [pp]), and a higher proportion of RDW received IFA (25 pp) and calcium supplementation (19 pp), showed adequate weight gain (44 pp), and recorded appropriate child feeding (27 pp). Improvements were greater in the intensive than the standard arm for the number of food groups consumed (DID: 1.1 food groups) and minimum dietary diversity (23 pp); no effect was observed for IFA and calcium consumption during pregnancy. However, effects were observed for early initiation of (20 pp) and exclusive breastfeeding (45 pp), introduction of solid or semisolid foods (28 pp), and egg and/or flesh food consumption (33 pp) among children. Minimum dietary diversity and acceptable diet remained low in both arms. ConclusionsIntensifying nutrition in government-aligned health care services delivered by experienced nongovernmental organization-run facilities is a feasible model to address the urban health gap, nutrition services coverage, and improve practices.The trial was registered at clinicaltrials.gov as NCT03882268.

The factors influencing the quality of ANC in public maternal and child health facilities in Mogadishu province, Somalia.

The factors influencing the quality of ANC in public maternal and child health facilities in Mogadishu province, Somalia.

Trends and risk factors of stillbirth among women of reproductive age in Pakistan: A multivariate decomposition analysis.

Every year, 2 million babies are stillborn in the world. Globally, there has been a decline in the stillbirth rate of 2%. Despite advancements in prenatal care and the implementation of new medical technologies, the incidence of early stillbirths remains unchanged. A slight decrease in the rate of late-term stillbirth has been observed. Pakistan ranked third in South Asia for having the highest stillbirth rate. Compared to its neighbors and other developing nations, Pakistan has shown a lack of progress in reducing maternal and neonatal fatalities. Therefore, the purpose of this study is to use a multivariate decomposition analysis to examine the trends and factors that have contributed to the change in the stillbirth rate over time. To conduct this study, we used a secondary data analysis approach and analyzed data from the Pakistan Demographic and Health Survey (PDHS) of 2012-2013 and 2017-2018). For the analysis, a total sample of 15,068 births in 2017-2018 and 13,558 births in the PDHS from 2012 to 2013 were taken into account. Using the MVDCMP function within STATA version 15 statistical software, a logit-based multivariate decomposition model was fitted to determine the variables that influence the change in stillbirth. The current study used two cross-sectional surveys to identify important risk factors for stillbirths. Over the past 5 years, Pakistan's stillbirth rate has risen from 3.98 to 5.75%. According to the total multivariate decomposition analysis, the change in coefficient (change in the effect of attributes) accounted for 81.17% of the overall change in the proportion of stillbirths. In contrast, the change in endowment was not statistically significant. Changes in maternal education, individual and community-level wealth status, and mode of delivery all significantly impacted the rate of stillbirths over time. Stillbirths increased in Pakistan from 2012 to 2017. Stillbirths are observed more frequently for women residing in Punjab, Sindh, and rural areas. A major concern that is directly related to the prevalence of stillbirths in Pakistan is the lack of accessible, affordable, and high-quality maternal healthcare facilities. Older, overweight, and uneducated women are more likely to have stillbirths than women who deliver vaginally. High parity and short birth intervals also accelerated the rate of stillbirths. An effective remedy to control stillbirths is the provision of accessible and affordable healthcare services. Awareness campaigns for the health education of pregnant women should focus on raising awareness to support better pregnancy outcomes for poor women living in communities with higher education levels. The risk of stillbirth can be reduced by offering free diagnostics for early detection of birth complications in low-resource settings and referring these cases to knowledgeable gynecologists for safe delivery.

Prevalence and socioeconomic determinants of awareness and visitation of community clinic among ever married women: evidence from Bangladesh Demographic and Health Survey, 2017–2018

ObjectivesBangladesh has made remarkable progress in improving the population’s health, but maternal health and healthcare facilities are still in a vulnerable situation. This study aims to investigate the prevalence and...

The Effect of a Facility Level Intervention on Disrespect and Abuse during Childbirth: A Controlled Before and After Comparison of Two District Hospital in Abuja, Nigeria

Disrespect and abuse of women by health care workers during pregnancy and childbirth is very common especially in developing countries like Nigeria. This is a deterrent to the utilization of available maternal health-care facilities with resultant high maternal morbidity and mortality. Hence there is a need for interventional strategies to reduce the prevalence. This study examines the effectiveness of an educational intervention on the prevalence of disrespect and abuse in two district hospitals in Nigeria. It employed a quasi-experimental design as a control before and after with a comparison to measure the effect of a single intervention on the prevalence of disrespect and abuse experienced by women during childbirth, using two health facilities. A total of three hundred and seventy four (374) women experiencing childbirth, one hundred and eighty seven from each health facility were randomly selected as research participants for a baseline study while the same total number of women were selected after a 3 days training on respectful maternity care targeted at health workers in only one of the hospitals. The overall prevalence of disrespect and abuse among the women at baseline was 92.33%. The results from the logistic regression analysis conducted at post intervention and the z-score comparison of proportion test indicates a significant reduction in the overall prevalence of disrespect and abuse at the intervention site, from 88.2% to 46% with no significant change in the overall prevalence of disrespect and abuse at the control site. It was concluded that there is a significant relationship between educational intervention and prevalence of disrespect and abuse hence recommendations were made for relevant stakeholders to implement strategies that will improve respectful maternity care.