Awareness of obstetric warning signs in Ecuador: a cross-sectional study

Bustamante, Gabriela; Mantilla, Barbara; Cabrera-Barona, Pablo; Barragan, Elena; Sória, Sidartha; Quizhpe, Edy; Aguilar, Angie; Trujillo, Marangellie; Wang, E.; Grunauer, Michelle

doi:10.1016/j.puhe.2019.04.013

Cited by 11 publications

(9 citation statements)

References 12 publications

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“…To improve intercultural health care, the MoH incorporated guidelines for traditional practices in all governmental health care services in 2008 [33]; however, several national studies have demonstrated inconsistent levels of integration of traditional practices during pregnancy and childbirth [34,35]. Similarly, several barriers have been observed in access to health services amongst indigenous women [36], and research has shown that this same group tend to be less aware of obstetric warning signs, as well as the use of health services, than mestizas in the country [37].…”

Section: Skilled Birth Attendancementioning

confidence: 99%

Socioeconomic inequalities in women’s access to health care: has Ecuadorian health reform been successful?

Quizhpe

Sebastián

Terán

et al. 2020

Int J Equity Health

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Background Over the last 12 years, Ecuador has implemented comprehensive health sector reform to ensure equitable access to health care services according to need. While there have been important achievements in terms of health care coverage, the effects of these reforms on socioeconomic inequalities in health care have not been analysed. The present study assesses whether the health care reforms implemented in the decade between 2007 and 2017 have contributed to reducing the socioeconomic inequalities in women’s health care access. Methods The present study was based on two waves (2006 and 2014) of the Living Standards Measurement Survey conducted in Ecuador. Data from women of reproductive age (15 to 49 years) were analysed to evaluate health care coverage across three indicators: skilled birth attendance, cervical cancer screening, and the use of modern contraceptives. Absolute risk differences were calculated between the heath care indicators and the socioeconomic variables using binomial regression analysis for each time period. The Slope Index of Inequality (SII) was also calculated for each socioeconomic variable and period. A multiplicative interaction term between the socioeconomic variables and period was included to assess the changes in socioeconomic inequalities in health care over time. Results Access to health care increased in the three studied outcomes during the health sector reform. Significant reductions in inequality in skilled birth attendance were observed in all socioeconomic variables except in the occupational class. Cervical cancer screening inequalities increased according to education and occupation, but decreased by wealth. Only a poorer education was observed for modern contraceptive use. Conclusions While most socioeconomic inequalities in skilled birth attendance decreased during the reform period, this was not the case for inequalities in cervical cancer screening or the use of modern contraceptives. Further studies are needed to address the social determinants of these health inequalities.

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Section: Skilled Birth Attendancementioning

confidence: 99%

Socioeconomic inequalities in women’s access to health care: has Ecuadorian health reform been successful?

Quizhpe

Sebastián

Terán

et al. 2020

Int J Equity Health

View full text Add to dashboard Cite

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“…Women from low-income, rural and indigenous communities have limited access to healthcare services [81] and are at high risk of experiencing pregnancy complications [18,78,116,151]. For example, severe cases of hypertensive disorders have shown high rates of poor perinatal outcomes, an increase of caesarean sections and admissions to the intensive care unit [116,151].…”

Section: Background 21 Maternal Health and Pregnancy Complications In Ecuadormentioning

confidence: 99%

“…The maternal mortality rate has only decreased from 74 in 2005 to 64 per 1000000 live births in 2015 [153] and it is particularly high among indigenous women reaching over 100 per 1000000 live births in some provinces [105]. Major risk factors include maternal age, lack of awareness of warning signs and family support, and ethnic discrimination [18,45,112,151].…”

Section: Background 21 Maternal Health and Pregnancy Complications In Ecuadormentioning

confidence: 99%

Indigenous Women Managing Pregnancy Complications in Rural Ecuador

Verdezoto

Carpio-Arias²,

Carpio-Arias

et al. 2020

Proceedings of the 11th Nordic Conference on Human-Computer Interaction: Shaping Experiences, Shaping Society

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Previous research has explored the potential use of digital health to support maternal health in the Global South highlighting the importance of understanding the socio-cultural context to inform system design. However, the experiences of indigenous women managing pregnancy complications in Latin America remain underexplored in HCI. We present a qualitative study with 25 indigenous pregnant women in an Ecuadorian rural community looking at their experiences during complications, their antenatal care visits and their access and use of technologies. Our findings highlight key barriers that hinder the use of antenatal care services and influence women's experiences managing complications. Based on the findings, we present opportunities for digital health centered on indigenous women to enhance antenatal care in rural Ecuador.

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“…To improve intercultural health care, the MoH incorporated guidelines for traditional practices in all governmental health care services in 2008 [33], however, several national studies have demonstrated inconsistent levels of integration of traditional practices during pregnancy and childbirth [34,35]. Similarly, several barriers have been observed to indigenous women accessing health services [36], and research has shown that indigenous women tend to be less aware of obstetric warning signs, as well as the use of health services, than mestizas in the country [37].…”

Section: Skilled Birth Attendancementioning

confidence: 99%

Socioeconomic inequalities in women's access to health care: has Ecuadorian health reform succeeded?

Quizhpe

Sebastián

Terán

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Over the last twelve years, Ecuador has implemented a comprehensive health sector reform to ensure equitable access to health care services according to health needs. While there have been important achievements in terms of health care coverage, the effects of these reforms on socioeconomic inequalities in health care have not been analysed. This study assessed whether the health care reform implemented in the 2007 - 2017 decade contributed to reducing the socioeconomic inequalities in women´s health care access.Methods: This study was based on two waves of the Living Standards Measurement Survey conducted in Ecuador in 2006 and 2014. Data from women of reproductive age (15 to 49 years) was analysed to evaluate health care coverage in three indicators: skilled birth attendance, cervical cancer screening and the use of modern contraceptives. Absolute risk differences were calculated between the heath care indicators and the socioeconomic variables using binomial regression analysis for each time period. The Slope Index of Inequality (SII) was also calculated for each socioeconomic variable and period. A multiplicative interaction term between the socioeconomic variables and period was included to assess the changes in socioeconomic inequalities in health care over time.Results: Access to health care increased in the three studied outcomes during the health sector reform. Significant inequality reductions in skilled birth attendance were observed in all socioeconomic variables except in the occupational class. Cervical cancer screening inequalities increased according to education and occupation, but decreased by wealth. Only a decrease by education was observed for modern contraceptive use. Conclusions: While most socioeconomic inequalities in skilled birth attendance decreased during the reform, this was not the case for inequalities in cervical cancer screening or the use of modern contraceptives. Further work is needed to address the social determinants of these health inequalities.

show abstract

Awareness of obstetric warning signs in Ecuador: a cross-sectional study

Cited by 11 publications

References 12 publications

Socioeconomic inequalities in women’s access to health care: has Ecuadorian health reform been successful?

Socioeconomic inequalities in women’s access to health care: has Ecuadorian health reform been successful?

Indigenous Women Managing Pregnancy Complications in Rural Ecuador

Socioeconomic inequalities in women's access to health care: has Ecuadorian health reform succeeded?

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