Number Of Antenatal Care Visits Research Articles

Health reforms, facility-based delivery, and newborn's health: evidence from Rwanda

Abstract Since 2006, Rwanda has experienced a substantial rise in the facility-based delivery (FBD) rate, attributed to various health initiatives. This paper investigates the impact of multiple health reforms on maternal service utilization and neonatal mortality rates. Employing a difference-in-differences framework utilizing geographical variation in the baseline FBD rate, our estimates indicate a 10–17 percentage point increase in FBD and a 0.15–0.18 times increase in the number of antenatal care visits. While our analysis indicates some evidence of a reduction in neonatal mortality rates, the findings are inconclusive. Nevertheless, our results suggest that the effect of the reforms on neonatal mortality rates was weakly intensified for those residing near district hospitals providing care for complicated pregnancies.

Why does the number of antenatal care visits in Ethiopia remain low?: A Bayesian multilevel approach.

Antenatal care (ANC) visit is a proxy for maternal and neonatal health. The ANC is a key indicator of access and utilization of health care for pregnant women. Recently, eight times ANC visits have been recommended during the pregnancy period. However, nearly 57% of women received less than four ANC visits in Ethiopia. Therefore, the objective of this study is to identify factors associated withthe number of ANC visits in Ethiopia. A community-based cross-sectional study design was conducted from March 21 to June 28/2019. Data were collected using interviewer-administered questionnaires from reproductive age groups. A stratified cluster sampling was used to select enumeration areas, households, and women from selected households. A Bayesian multilevel negative binomial model was applied for the analysis of this study. There is an intra-class correlation (ICC) = 23.42% and 25.51% for the null and final model, respectively. Data were analyzed using the STATA version 17.0. The adjusted incidence risk ratio (IRR) with 95% credible intervals (CrI) was used to declare the association. A total of 3915 pregnant women were included in this study. The mean(SD) age of the participants was 28.7 (.11) years. Nearly one-fourth (26.5%) of pregnant women did not have ANC visits, and 3% had eight-time ANC visits in Ethiopia. In the adjusted model, the age of the women 25-28 years (IRR:1.13; 95% CrI: 1.11, 1.16), 29-33 years (IRR: 1.15; 95% CrI: 1.15, 1.16), ≥34 years (IRR:1.14; 95% CrI: 1.12, 1.17), being a primary school (IRR: 1.22, 95% CrI: 1.21, 1.22), secondary school and above (IRR: 1.26, 95% CrI: 1.26, 1.26), delivered in health facility (IRR: 1.93; 95% CrI: 1.92, 1.93), delivered with cesarian section (IRR: 1.18; 95% CrI: 1.18, 1.19), multiple (twin) pregnancy (IRR: 1.11; 95% CrI: 1.10, 1.12), richest (IRR:1.23; 95% CrI: 1.23, 1.24), rich family (IRR: 1.34, 95% CrI: 1.30, 1.37), middle income (IRR: 1.29, 95% CrI: 1.28, 1.31), and poor family (IRR = 1.28, 95% CrI:1.28, 1.29) were shown to have significant association with higher number of ANC vists, while, households with total family size of ≥ 5 (IRR: 0.92; 95% CrI: 0.91, 0.92), and being a rural resident (IRR: 0.92, 95% CrI: 0.92, 0.94) were shown to have a significant association with the lower number of ANC visits. Overall, 26.5% of pregnant women do not have ANC visits during their pregnancy, and 3% of women have eight-time ANC visits. This result is much lower as compared to WHO's recommendation, which states that all pregnant women should have at least eight ANC visits. In this study, the ages of the women 25-28, 29-33, and ≥34 years, being a primary school, secondary school, and above, delivered in a health facility, delivered with caesarian section, multiple pregnancies, rich, middle and poor wealth index, were significantly associated with the higher number of ANC visits, while households with large family size and rural residence were significantly associated with a lower number of ANC visits in Ethiopia.

Do tuition-free lower secondary education policies matter for antenatal care among women in sub-saharan African countries?

Antenatal care (ANC) is critical to reducing maternal and infant mortality. However, sub-Saharan Africa (SSA) continues to have among the lowest levels of ANC receipt globally, with half of mothers not meeting the WHO minimum recommendation of at least four visits. Increasing ANC coverage will require not only directly reducing geographic and financial barriers to care but also addressing the social determinants of health that shape access. Among those with the greatest potential for impact is maternal education: past research has documented a relationship between higher educational attainment and antenatal healthcare access, as well as related outcomes like health literacy and autonomy in health decision-making. Yet little causal evidence exists about whether changing educational policies can improve ANC coverage. This study fills this research gap by investigating the impact of national-level policies that eliminate tuition fees for lower secondary education in SSA on the number of ANC visits. To estimate the effect of women's exposure to tuition-free education policies at the primary and lower secondary levels on their ANC visits, a difference-in-difference methodology was employed. This analysis leverages the variation in the timing of education policies across nine SSA countries. Exposure to tuition-free primary and lower secondary education is associated with improvements in the number of ANC visits, increasing the share of women meeting the WHO recommendation of at least four ANC visits by 6-14%. Moreover, the impact of both education policies combined is greater than that of tuition-free primary education alone. However, the effects vary across individual treatment countries, suggesting the need for further investigation into country-specific dynamics. The findings of this study have significant implications for policymakers and stakeholders seeking to improve ANC coverage. Removing the tuition barrier at the secondary level has shown to be a powerful strategy for advancing health outcomes and educational attainment. As governments across Africa consider eliminating tuition fees at the secondary level, this study provides valuable evidence about the impacts on reproductive health outcomes. While investing in free education requires initial investment, the long-term benefits for both human development and economic growth far outweigh the costs.

Determinant Factors of Antenatal Clinic on Female Sex Workers Attendance within Nairobi County, Kenya

Globally antenatal care (ANC) initiation is at 58.6% but varies in different continents. Sub-Sahara has the lowest level of ANC care where women attend at least four times during pregnancy. Recent survey in Nairobi County found out that majority of women attends only one antenatal visit during pregnancy. The aim of the study was to explore determinants of antenatal clinic attendance among female sex workers in Nairobi County. A quantitative cross-sectional descriptive study among FSWs (18-49years) was carried out. Simple random sampling and self-administered questionnaires were used for data collection. Data analysis was done using descriptive and inferential statistics. The results show that 132 (32.8%) FSWs were aged 30 to 34 years, 242 (60.0%) were not married. 346 (85.9%) had unplanned pregnancy. Late ANC initiation was due to 42.4% (171) attitude of HCWs, 67.6% (215) distance to the healthcare facility and 86.1% (347) longer waiting time. On inferential analysis, there was an association between occupation of respondent vs number of ANC attendance which was significant = 22.525, df 12, P = 0.032 at P < 0.05. Marital of respondent vs number of ANC attendance was significant =29.058, df 15, P=0.016 at P<0.05. The income level of respondents vs number of antenatal care visits was significant =17.557, df 6, P=0.007 at P<0.05. Thus, pregnant FSWs face discrimination during ANC visits. These research findings will form a basis for future studies as well as guide the Ministry of Health and other stakeholders to develop policies that will guide ANC services among FSWs. Outreach programs on ANC among FSWs should be implemented and there should ANC services that only target FSWs.

Predicting risk of preterm birth in singleton pregnancies using machine learning algorithms.

We aimed to develop, train, and validate machine learning models for predicting preterm birth (<37 weeks' gestation) in singleton pregnancies at different gestational intervals. Models were developed based on complete data from 22,603 singleton pregnancies from a prospective population-based cohort study that was conducted in 51 midwifery clinics and hospitals in Wenzhou City of China between 2014 and 2016. We applied Catboost, Random Forest, Stacked Model, Deep Neural Networks (DNN), and Support Vector Machine (SVM) algorithms, as well as logistic regression, to conduct feature selection and predictive modeling. Feature selection was implemented based on permutation-based feature importance lists derived from the machine learning models including all features, using a balanced training data set. To develop prediction models, the top 10%, 25%, and 50% most important predictive features were selected. Prediction models were developed with the training data set with 5-fold cross-validation for internal validation. Model performance was assessed using area under the receiver operating curve (AUC) values. The CatBoost-based prediction model after 26 weeks' gestation performed best with an AUC value of 0.70 (0.67, 0.73), accuracy of 0.81, sensitivity of 0.47, and specificity of 0.83. Number of antenatal care visits before 24 weeks' gestation, aspartate aminotransferase level at registration, symphysis fundal height, maternal weight, abdominal circumference, and blood pressure emerged as strong predictors after 26 completed weeks. The application of machine learning on pregnancy surveillance data is a promising approach to predict preterm birth and we identified several modifiable antenatal predictors.

Giving Birth While Facing Death: Cesarean Sections and Community Violence in Latin America

Armed conflict and organized crime are known to be linked to numerous negative maternal and neonatal health outcomes, such as stillbirth, low birth weight, and neonatal mortality. This study investigates how exposure to lethal community violence during pregnancy correlates with Cesarean births in Latin America, a region characterized by high rates of both C-sections and violence. The analysis combines micro-level survey data, covering 123,503 births, with subnational homicide statistics from Colombia, the Dominican Republic, Guatemala, and Mexico. Region-fixed effects linear probability models were used to eliminate geographically varying omitted factors that could potentially confound exposure to violence and health conditions. The findings suggest that the high rates of C-sections in Latin America can partially be attributed to the high levels of violence, due to an increase in both medically unnecessary and emergency procedures. The relationship between exposure to community violence and C-section delivery varied by country, women’s socio-demographic characteristics, and the number of antenatal care visits. Exposure to violence during all trimesters correlated with the uptake of C-sections, indicating that violence negatively affects maternal and child health throughout pregnancy. This study enriches our understanding of the social determinants of maternal and child health. The findings can serve to inform comprehensive interventions aimed at reducing excess C-section rates and improving the health of women and newborns in areas affected by violence.

Magnitude and determinants of adherence to iron-folic acid supplementation among Somaliland pregnant women in Ahmed-dhagah district: A facility based cross-sectional study

BackgroundIron deficiency is a major cause of anemia globally, especially in low-income countries, and pregnant women are at higher risk. Despite guidelines recommending IFA supplementation, adherence remains low. Therefore, the aim of this study is to assess the adherence to iron-folic acid (IFA) supplementation among pregnant women receiving antenatal care services in the Ahmed-Dhagah district, Hargeisa, Somaliland. MethodsA cross-sectional study was conducted at an institutional level from May to July 2022. A systematic sampling method was used to select 320 pregnant women. Data collection was performed using the Kobo Collect Android app, and the data were analyzed using SPSS. Descriptive statistics, bivariate analysis, and multivariable logistic regression analysis were employed to identify independent variables associated with adherence to IFA supplementation. Statistical significance was determined using a p-value <0.05. ResultsOnly 74 (24%) women adhered to ≥ 65% of the recommended IFA supplement doses, equivalent to more than four days a week. In the multivariate logistic regression model, the husband's educational status (AOR = 8.468, 95% CI: 3.436, 20.87), number of antenatal care visits (AOR = 3.385, 95% CI: 1.55, 7.39), and maternal knowledge about anemia (AOR = 3.534, 95% CI: 1.739, 7.194) were identified as factors significantly associated with good adherence to IFA supplementation. ConclusionThe pregnant women's adherence to IFA supplementation was very low compared to WHO guidelines. Factors like the husband's education, antenatal care visits, and maternal knowledge of anemia affected adherence. Common reasons for non-compliance included forgetfulness, drug side effects, and fear of side effects.

“The more the better?” Association between number of antenatal care visits and components of care received: analysis of the Burundi Demographic and Health Survey 2016/2017

Background The World Health Organization promotes antenatal care (ANC) as a package of health interventions women receive during pregnancy. This study examined the association between the number of ANC visits and the number of ANC components received in Burundi. Methods This cross-sectional study used data from the most recent Burundi Demographic and Health Survey (DHS) 2016/2017. The Burundi DHS is a household survey using a stratified two-stage sampling design. We included all women aged 15-49 years who had a live birth in the two years preceding the survey, and ANC for the pregnancy leading to the most recent live birth in this period was analysed. We analysed women’s self-report of receipt of eight routine ANC components. We used chi-square and ANOVA tests to examine the distribution of the number of ANC visits and the number of components received among ANC users, and linear regression to investigate the crude and adjusted association between the number of ANC visits and number of ANC components received. Results Nearly all women (99.4%, 95% confidence interval, CI=99.2-99.6) reported receiving some ANC; half (51.7%, 95% CI=49.8-53.6) reported receiving 4+ visits. The mean number of visits among ANC users was 4.44, and this was only marginally higher (4.63) among women who received 4+ ANC visits. Among ANC users, blood sample taken was the most commonly reported ANC component (88.3%); urine sample taken was the least received component (28.3%). Women’s report of blood pressure having been measured and iron tablets or syrup taken were not significantly associated with number of ANC visits (P&gt;0.05); the probability of receiving the other six components increased with higher number of ANC visits. The number of ANC visits was significantly associated with an increasing number of components received in both bivariate (regression coefficient= 0.23; 95% CI=0.18–0.28; P&lt;0.001) and multivariable (adjusted regression coefficient= 0.21; 95% CI=0.16–0.25; P&lt;0.001) models. Conclusions Coverage with routine ANC components is suboptimal in Burundi among women who receive the recommended four visits or more. While an increasing number of ANC visits was associated with an increased number of ANC components reported, rigorous mixed-methods research is needed to understand barriers and facilitators for improving the quality of care according to the national guidelines, and thus also contributing to achieving a high retention rate in the continuum of care.

Magnitude, disparity, and predictors of poor-quality antenatal care service: A systematic review and meta-analysis.

Antenatal care is directed toward ensuring healthy pregnancy outcomes. Quality antenatal care increases the likelihood of receiving an effective intervention to maintain maternal, fetal, and neonatal well-being, while poor quality is linked to poor pregnancy outcomes. However, owing to the complex nature of quality, researchers have followed several approaches to systematically measure it. The evidence from these variable approaches appears inconsistence and poses challenges to programmers and policymakers. Hence, it is imperative to obtain a pooled estimate of the quality of antenatal care. Therefore, considering the scarcity of evidence on the quality of antenatal care, this study aimed to review, synthesize, and bring pooled estimates of accessible evidence. This study aimed to estimate the pooled magnitude and predictors of quality of antenatal care services and compare regional disparity. We conducted a comprehensive systematic three-step approach search of published and unpublished sources from 2002 to 2022. The methodological quality of eligible studies was checked using Joanna Briggs Institute critical appraisal tool for cross-sectional studies. Meta-analysis was carried out using STATA version 16. Statistical heterogeneity was assessed using Cochran's Q test. In the presence of moderate heterogeneity (I2 more than 50%), sensitivity and subgroup analyses were conducted and presented in a forest plot. Effect size was reported using standardized mean difference and its 95% confidence interval. Funnel plots and Egger's regression test were used to measure publication bias at the 5% significance level. A trim-and-fill analysis was conducted to adjust for publication bias. Pooled estimates were computed using random-effects models and weighted using the inverse variance method in the presence of high heterogeneity among studies. A 95% CI and 5% significance level were considered to declare significance variables. The global pooled poor-quality antenatal care was 64.28% (95% CI: 59.58%-68.98%) (I2 = 99.97%, p = 0.001). The identified pooled predictors of good-quality antenatal care service were: number of antenatal care visits (fourth and above antenatal care visit) (Adjusted odds ratio (AOR) = 2.6, 95% CI: 1.37-3.84), family wealth index (AOR = 2.72, 95% CI: 1.89-3.55), maternal education attainment (AOR = 3.03, 95% CI: 2.24-3.82), residence (urban dwellers) (AOR = 4.06, 95% CI: 0.95-7.17), and confidentiality antenatal care (AOR = 2.23, 95% CI: -0.36 to -4.82). The study found regional and country-level disparities in the quality of antenatal care services for pregnant women, where poor-quality antenatal care services were provided for more than two-thirds to three-fourths of antenatal care attendants. Therefore, policymakers and health planners should put a great deal of emphasis on addressing the quality of antenatal care services.

Maternal health outcomes in the context of fragility: a retrospective study from Lebanon

Background and aimsThe Lebanese healthcare system faces multiple challenges including limited capacities, shortage of skilled professionals, and inadequate supplies, in addition to hosting a significant number of refugees. While subsidized services are available for pregnant women, representing the majority of the refugee population in Lebanon, suboptimal access to antenatal care (ANC) and increased maternal mortality rates are still observed, especially among socioeconomically disadvantaged populations. This study aimed to review the maternal health outcomes of disadvantaged Lebanese and refugee pregnant women seeking ANC services at primary healthcare centers (PHCs) in Lebanon.MethodsA retrospective chart review was conducted at twenty PHCs in Lebanon, including Ministry of Public Health (MOPH) and United Nations Relief and Works Agency for Palestine refugees (UNRWA) facilities. Data was collected from medical charts of pregnant women who visited the centers between August 2018 and August 2020. Statistical analysis was performed to explore outcomes such as the number of ANC visits, delivery type, and onset of delivery, using bivariate and multivariable logistic regression models.ResultsIn the study, 3977 medical charts were analyzed. A multivariate logistic regression analysis, revealed that suboptimal ANC visits were more common in the Beqaa region and among women with current abortion or C-section. Syrians had reduced odds of C-sections, and Beqaa, Mount Lebanon, and South Lebanon regions had reduced odds of abortion. Suboptimal ANC visits and history of C-section increased the odds of C-section and abortion in the current pregnancy. As for preterm onset, the study showed an increased likelihood for it to occur when being Palestinian, having current C-section delivery, experiencing previous preterm onset, and enduring complications at the time of delivery.ConclusionThis study suggests the need for low-cost interventions aiming at enhancing access to ANC services, especially among pregnant women in fragile settings.

Validation of maternal recall of number of antenatal care visits attended in rural Southern Nepal: a longitudinal cohort study

ObjectivesThis study aimed to examine the validity of maternal recall of total number of antenatal care (ANC) visits during pregnancy and factors associated with the accuracy of maternal recall.DesignThis was...

Intimate partner violence and antenatal care utilization predictors in Uganda: an analysis applying Andersen’s behavioral model of healthcare utilization

BackgroundOptimal utilization of antenatal care (ANC) services improves positive pregnancy experiences and birth outcomes. However, paucity of evidence exists on which factors should be targeted to increase ANC utilization among women experiencing intimate partner violence (IPV) in Uganda.ObjectiveTo determine the independent association between IPV exposure and ANC utilization as well as the predictors of ANC utilization informed by Andersen’s Behavioral Model of Healthcare Utilization.MethodsWe analyzed 2016 Uganda Demographic and Health Survey data that included a sample of 1,768 women with children aged 12 to 18 months and responded to both ANC utilization and IPV items. Our outcome was ANC utilization, a count variable assessed as the number of ANC visits in the last 12 months preceding the survey. The key independent variable was exposure to any IPV form defined as self-report of having experienced physical, sexual and/or emotional IPV. Covariates were grouped into predisposing (age, formal education, religion, problem paying treatment costs), enabling (women’s autonomy, mass media exposure), need (unintended pregnancy, parity, history of pregnancy termination), and healthcare system/environmental factors (rural/urban residence, spatial accessibility to health facility). Poisson regression models tested the independent association between IPV and ANC utilization, and the predictors of ANC utilization after controlling for potential confounders.ResultsMean number of ANC visits (ANC utilization) was 3.71 visits with standard deviation (SD) of ± 1.5 respectively. Overall, 60.8% of our sample reported experiencing any form of IPV. Any IPV exposure was associated with lower number of ANC visits (3.64, SD ± 1.41) when compared to women without IPV exposure (3.82, SD ± 1.64) at p = 0.013. In the adjusted models, any IPV exposure was negatively associated with ANC utilization when compared to women with no IPV exposure after controlling for enabling factors (Coef. -0.03; 95%CI -0.06,-0.01), and healthcare system/environmental factors (Coef. -0.06; 95%CI -0.11,-0.04). Predictors of ANC utilization were higher education (Coef. 0.27; 95%CI 0.15,0.39) compared with no education, high autonomy (Coef. 0.12; 95%CI 0.02,0.23) compared to low autonomy, and partial media exposure (Coef. 0.06; 95%CI 0.01,0.12) compared to low media exposure.ConclusionAddressing enabling and healthcare system/environmental factors may increase ANC utilization among Ugandan women experiencing IPV. Prevention and response interventions for IPV should include strategies to increase girls’ higher education completion rates, improve women’s financial autonomy, and mass media exposure to improve ANC utilization in similar populations in Uganda.

Low birth weight (LBW) classification with SMOTE (Synthetic Minority Over-sampling Technique) random forest

Low birth weight (LBW) is defined as a condition where the birth weight is less than 2500 grams. Infants born with LBW conditions are more susceptible to disease and have a higher risk of dying at an early age. LBW conditions that are prone to unbalanced data can be classified using the Synthetic Minority Oversampling Technique (SMOTE) random forest method. The analysis was processed on the 2017 Indonesian Demographic and Health Survey (IDHS) data to identify important variables in predicting the incidence of LBW. The results showed that the SMOTE random forest model provided an accuracy value of 79.84%, sensitivity of 30.99%, specificity of 83.6%, and AUC of 62%. Important variables in predicting the incidence of LBW were the number of antenatal care visits, wealth quantile, maternal age at delivery, iron supplementation, marital status, and twins’ birth.

Regional differences in the utilisation of antenatal care and skilled birth attendant services during the COVID-19 pandemic in Nigeria: an interrupted time series analysis

IntroductionThe COVID-19 pandemic has had a substantial negative impact on the utilisation of essential health services (EHS) globally, especially in resource-limited settings such as Nigeria. High maternal deaths associated with...

Level and correlates of disrespect and abuse among newborns in selected public hospitals of Addis Ababa, Ethiopia

BackgroundThe provision of respectful and dignified maternal and newborn care is an important component of the quality of childbirth care. Although a growing body of evidence was generated on disrespect and abuse (D&A) of women during childbirth in the past decade there is limited evidence on D&A experienced by newborns. Our study aimed to determine the level of and factors associated with D&A among newborns.MethodsWe conducted the study in three public hospitals in Addis Ababa. We directly observed childbirth care starting from the first stage of labor through two hours after the birth of 498 mother–baby dyads. We used frequencies and percentages to describe different forms of D&A among newborns. We used binary and multivariable logistic regression analysis to assess the association between the D&A among newborns and independent variables.ResultAll of the newborns 496/496 (100%) experienced at least one form of D&A. Physical abuse was experienced by 41.1% of newborns in the form of unnecessary airway suctioning (23.2%) or slapping or holding upside down (33.5%). Additionally, 42.3% weren’t dried immediately after birth, 9.1% weren’t placed on the mother’s abdomen skin-to-skin, 61.7% had their cord cut before 1 min of birth, 34.9% weren’t breastfed within an hour of birth, 24.2% didn’t receive vitamin K and 1.8% didn’t receive tetracycline. All newborns who developed complications (69/69) received treatments without the consent of parents/caregivers. Moreover, 93.6% of parents/caregivers didn’t receive explanations regarding newborn care while the lack of breastfeeding counseling and thermal support during the immediate post-partum period was 87.3%. The likelihood of D&A was higher among newborns who were preterm (AOR = 2.02; 95% CI: 1.11–3.69), female (AOR = 2.01; 95% CI: 1.37–2.95), delivered assisted by instrument (AOR = 2.19; 95%CI: 1.20–3.99), whose mothers reside in rural areas (AOR = 1.97; 95%CI: 1.22–3.20), born from unmarried mothers (AOR = 2.77; 95%CI (1.26–6.06) and whose mothers received fewer than four-time antenatal care (ANC) visits (AOR = 2.37; 95%CI: 1.42–3.96).ConclusionOur study found a high magnitude D&A among newborns. Gestational age at birth, sex of the newborn, maternal residence, maternal marital status, number of ANC visits, and mode of delivery were statistically significantly associated with D&A among newborns.

The Relationship Between Maternal Knowledge Level and the Number of Pregnancy Check-Up Visits at the Grogol Petamburan Community Health Center

Antenatal care is the health service carried out by health workers to the mother during her pregnancy antenatal service standard compliance. When examined more deeply that the process of maternal death has a long journey so that prevention can be done since the antenatal care through education related to maternal health. Therefore, knowledge of pregnant women about antenatal care is very important because it will help reduce maternal and infant mortality .The purpose of this research is to know the relation of knowledge of mother with antenatal care number of visit of the Puskesmas Kecamatan Grogol Petamburan Jakarta Barat. This research conducted by method of cross sectional, the selection of samples with a consecutive sampling with 52 sample respondents. Data collection is carried out by filling a questionnaire made by researchers and is completed by respondents. Collected data is analyzed by chisquare test with significance level (⍺) 0.05. Stastical analysis.showed significant relationship between knowledge of antenatal care and the number of antenatal care visits (p=0,001)

The association between mother-to-child HIV transmission knowledge and antenatal care utilisation in Cameroon.

While the health benefits of antenatal care (ANC) utilisation for mothers and their infants have been well documented, very few studies have explored the association between mother-to-child transmission (MTCT) knowledge of human immunodeficiency virus (HIV) and mothers' utilisation of ANC in HIV endemic regions such as Cameroon. To address this void in the literature, we use the 2018 Cameroon Demographic and Health Survey to examine the association between mother's knowledge of MTCT of HIV and the three strands of ANC utilisation (i.e., number of ANC visits, timing to first ANC visit, and place of delivery). We found that women with adequate MTCT knowledge were more likely to have four to seven ANC visits (relative risk ratio [RRR]=1.39, p<0.001) and more than eight ANC visits (RRR=1.43, p<0.05), compared to their counterparts with inadequate knowledge. Similarly, women with adequate MTCT knowledge were more likely to attend ANC within the first trimester (odds ratio [OR]=1.16, p<0.05) and to give birth in a health facility (OR=1.37, p<0.001) than their counterparts with inadequate MTCT of HIV knowledge. These results remained robust after controlling for theoretically relevant variables. Based on these findings, we discussed several implications for policymakers and recommendations for future research.

Predictors of neonatal mortality in Ghana: evidence from 2017 Ghana maternal health survey

BackgroundNeonatal mortality contributes about 47% of child mortality globally and over 50% of under-5 deaths in Ghana. There is limited population level analysis done in Ghana on predictors of neonatal mortality.ObjectivesThe objective of the study was to examine the predictors of neonatal mortality in Ghana.MethodThis study utilizes secondary data from the 2017 Ghana Maternal Health Survey (GMHS). The GMHS survey focuses on population and household characteristics, health, nutrition, and lifestyle with particular emphasis on topics that affect the lives of newborns and women, including mortality levels, fertility preferences and family planning methods. A total of 10,624 respondents were included in the study after data cleaning. Descriptive statistical techniques were used to describe important background characteristics of the women and Pearson’s Chi-squares (χ2) test used to assess association between the outcome (neonatal death) and independent variables. Multivariate logistic regression analysis was done to estimate odd ratios and potential confounders controlled. Confidence level was held at 95%, and a p < 0.05 was considered statistically significant. Data analysis was done using STATA 15.ResultsThe prevalence of neonatal mortality was 18 per 1000 live births. ANC attendance, sex of baby, and skin-to-skin contact immediately after birth were predictors of neonatal mortality. Women with at least one ANC visit were less likely to experience neonatal mortality as compared to women with no ANC visit prior to delivery (AOR = 0.11; CI = 0.02–0.56, p = 0.01). Girls were less likely (AOR = 0.68; CI = 0.47–0.98; p = 0.03) to die during the neonatal period as compared to boys. Neonates who were not put skin-to-skin contact immediately after birth were 2.6 times more likely to die within the neonatal period than those who were put skin-to-skin contact immediately after birth (AOR = 2.59; CI = 1.75–3.83, p = 0.00).ConclusionNeonatal mortality remains a public health concern in Ghana, with an estimated rate of 18 deaths per 1,000 live births. Maternal and neonatal factors such as the sex of the newborn, the number of antenatal care visits, and skin-to-skin contact between the newborn and mother immediately after birth are the predictors of neonatal mortality in Ghana.

Role of Family Characteristics in the Utilization of Antenatal Care Services

The major objective of this study was to point out the family characteristics which observed as the main hurdle in order to utilize the available health care services. Data was collected from 323 females which were not currently pregnant but gave birth to one or more children. Family characteristics were asked in order to examine the family participation in maternal care. In order to check the relationship between family characteristics and utilization of health care services binomial logistic regression analysis was used. Major findings of the study shows that family system, role of husband regarding qualification and income play a great role to predict the number of antenatal care visits. Results shows that husband’s age, education and income were also have strong association with the utilization of e health care services. In order to improve the critical situation of maternal and infant mortality education needs more attention.

Multilevel logistic regression analysis of factors associated with delivery care service utilization among childbearing women in Ethiopia.

Delivery service utilization is one of the key and proven interventions to reduce maternal death during childbearing. In Ethiopia, the utilization of health facilities for delivery service is still at a lower level. This study intends to model the determinant factors for the delivery care service utilization of childbearing mothers in Ethiopia using the 2016 Ethiopian demographic and health survey data. A cross-sectional study design was selected to assess factors associated with delivery care among mothers who had at least one child in the last 5 years before the survey aged 15-49 years in the data. Among these eligible mothers, 3,052 (27.7%) mothers had received delivery service care from health professionals. The results of multilevel logistic regression indicated that those at age 35-49 years (AOR = 0.7808, 95% CI: 0.5965-1.1132), an urban place of residence (AOR = 5.849 95% CI: 4.2755-8.0021), woman's higher level of education (AOR = 3.484, 95% CI: 2.0214-6.0038) and partner's higher educational level (AOR = 1.9335, 95% CI: 3,808-2.07352), household wealth index (AOR = 1.99, 95% CI: 1.724-2.3122), most every day exposed to mass media (AOR = 3.068, 95% CI: 1.456-6.4624), 2-4 birth order number (AOR = 0.604, 95% CI: 0.51845-1.4213), using contraceptive type (AOR = 1.4584, 95% CI: 1.2591-1.6249) and visiting more than 4 antenatal care visits (AOR = 7.574, 95% CI: 6.4824-8.84896) were more likely to give birth at a health facility compared to their counterparts. The woman's and partner's educational level, household wealth index, exposure to mass media and number of antenatal care visits had a positive association with delivery assistance whereas birth order had a negative association. The findings of this study were valuable implications to support strategies and interventions to address delivery care service in Ethiopia.