Birth registration coverage according to the sex of the head of household: an analysis of national surveys from 93 low- and middle-income countries

Wendt, Andrea; Hellwig, Franciele; Saad, Ghada E; Faye, Cheikh; Boerma, Ties; Barros, Aluísio J. D.; Victora, César G.

doi:10.1186/s12889-022-14325-z

“…Finally, the study revealed that children born into female-headed households were less likely to be registered. Our result is in contrast to an earlier study, involving 93 countries in low-and middle-income countries that found the sex of household heads as not being consistently associated with the birth registration of children ( 22 ). We posit that the observed association could be due to several reasons.…”

Section: Discussioncontrasting

confidence: 99%

Determinants of birth registration in sub-Saharan Africa: evidence from demographic and health surveys

Aboagye

¹

,

Okyere

²

,

Seidu

³

et al. 2023

Front. Public Health

2

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BackgroundBirth registration is a crucial aspect of ensuring that children have access to their rights and benefits, including health care, education, and citizenship. In sub-Saharan Africa (SSA), birth registration rates remain low, with millions of children going unregistered each year. Understanding the predictors of birth registration among children in this sub-region is important for developing targeted interventions to improve registration rates. The study examines the predictors of birth registration among children in SSA.MethodsWe performed a cross-sectional analysis of secondary data pooled from the Demographic and Health Survey of 17 countries conducted from 2015 to 2021. A weighted sample of 162,500 children was included in the final analysis. We summarized the proportion of birth registration among children in SSA using a forest plot. We utilized a multilevel binary logistic regression analysis to examine the predictors of birth registration. The results were presented using adjusted odds ratios (aOR) with 95% confidence intervals (CIs).ResultsWe found that 48.32% [48.15–48.49] of births in SSA were registered. The lowest and highest prevalence of birth registration were found in Ethiopia (2.70 [2.38–3.02]) and Sierra Leone (92.93 [92.36–93.50]), respectively. Increasing child’s age was found to be significantly associated with a higher likelihood of birth registrations, with those aged 4 years [aOR = 1.55; CI = 1.49, 1.62] having the highest odds of birth registration compared to those aged below 1 year. Children born to mothers with primary [aOR = 1.17; CI = 1.11, 1.24], secondary [aOR = 1.44; CI = 1.34, 1.54], and higher education [aOR = 1.71; CI = 1.48, 1.99] were more likely to be registered than those born to mothers who had no formal education. Also, children born in health facilities were more likely to be registered [aOR = 1.60; CI = 1.48, 1.74] than those born at home. The odds of birth registration were significantly higher among children whose mothers received assistance during delivery [aOR = 1.88; CI = 1.72, 2.04], those in the richest wealth index [aOR = 3.91; CI = 3.54, 4.33], and those in rural areas [aOR = 1.92; CI = 1.76, 2.10].ConclusionThere is low childbirth registration coverage in SSA. The predictors of this phenomenon are the child’s age, maternal level of education, wealth index, place of residence, sub-region, maternal age, place of delivery, assistance during delivery, marital status, and sex of household head. Interventions and policies developed to improve childbirth registration coverage in SSA should prioritize mothers with no formal education, those who deliver at home, those with low socioeconomic status, those living in female headed household, and adolescent mothers.

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“…In many LMIC settings, men are considered the primary household earners and decision-makers [ 34 , 74 , 75 ]. Actively involving male partners and providing them with sufficient information can increase awareness of pregnancy-related threats and provision of financial or psychological support, which would consequently result in increased healthcare service uptake among pregnant women.…”

Section: Discussionmentioning

confidence: 99%

Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews

Mzembe,

Chikwapulo,

Kamninga

et al. 2023

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Background Maternal mortality in low- and middle-income countries (LMIC) has reduced considerably over the past three decades, but it remains high. Effective interventions are available, but their uptake and coverage remain low. We reviewed and synthesised evidence from systematic reviews on interventions to increase healthcare services utilisation to reduce maternal mortality in LMICs. Methods We searched Medline PubMed and Cochrane Library databases for systematic reviews published between January 2014 and December 2021, investigating interventions to increase healthcare services uptake among pregnant women in LMICs. We used the AMSTAR tool (A Measurement Tool to Assess Systematic Reviews) to assess the methodological quality of the included reviews. We extracted data on the interventions and their effects and grouped them into broad groups based on the outcomes reported in each systematic review. Results We retrieved 4,022 articles. After removing duplicates and screening, we included 14 systematic reviews. Male-partner interventions were effective in increasing skilled birth attendance (SBA) postnatal visits and maternal antiretroviral (ART) uptake for HIV-positive pregnant women. However, there was no evidence of their effectiveness on increased early ANC initiation or adequate ANC visits. Mobile health interventions were effective in increasing adequate ANC visits, SBA, facility-based service utilisation, early ANC initiation, and adherence to nutritional supplements. Incentive-based interventions, particularly financial incentives, were effective in increasing the number of ANC visits but not postnatal visits. Facility-based interventions were effective in increasing postnatal visits, maternal ART initiation and uptake, immunisation uptake and follow-up ANC visits. None of the reviews assessed their impact on SBA or adequate ANC visits. Community-based interventions were effective in increasing SBA, ANC service utilisation, ART initiation and uptake, and nutritional supplements and immunisation uptake. Conclusion Our findings show that the different interventions effectively improved different outcomes on the maternal healthcare continuum. Implementing these interventions in combination has the potential to enhance healthcare service uptake further.

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“…In many LMIC settings, men are considered the primary household earners and decision-makers [34,74,75]. Actively involving male partners and providing them with su cient information can increase awareness of pregnancy-related threats and provision of nancial or psychological support, which would consequently result in increased healthcare service uptake among pregnant women.…”

Section: Male Partner Involvementmentioning

confidence: 99%

Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews

Mzembe¹,

Chikwapulo²,

Kamninga

³

et al. 2023

Preprint

0

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Background Maternal mortality in low- and middle-income countries (LMIC) has reduced considerably over the past three decades, but it remains high. Effective interventions are available, but uptake and coverage remain low. We reviewed and synthesised evidence from systematic reviews on interventions to increase healthcare services utilisation to reduce maternal mortality among pregnant women in LMICs. Methods and findings We searched PubMed Medline and Cochrane Library databases for systematic reviews published between January 2014 and December 2021, investigating interventions to increase healthcare services uptake among pregnant women in LMICs. We used the AMSTAR tool (A Measurement Tool to Assess Systematic Reviews) to assess the methodological quality of the included reviews. We extracted data on the interventions and their effects and grouped them into broad groups based on the outcomes reported in each systematic review. We retrieved 4,022 articles. After removing duplicates, and performing title, abstract and full-text screening, we included 14 systematic reviews. The methodology quality of the included systematic reviews was from moderate to high. Male partner involvement interventions Interventions involving male partners were effective in increasing institutional delivery (one review, six studies); skilled attendance at delivery (one review, five studies); postnatal visits (one review, four studies); and maternal antiretroviral (ART) uptake for HIV-positive pregnant women (one review, three studies). However, there was no evidence of their effectiveness on increased early ANC initiation (less than 12 weeks gestation) or adequate ANC visits (at least four visits) (one review, four studies). Mobile health interventions Mobile health interventions were effective in increasing adequate ANC visits (three reviews, six studies), skilled attendance at delivery (two reviews with four studies), facility-based service utilisation (one review with three studies), early ANC initiation (one review with one study), and adherence to nutritional supplements (one review with five studies). Interventions involving giving incentives Only one systematic review reported interventions involving financial incentives and showed that incentives were effective in increasing the number of ANC visits but were ineffective in increasing postnatal visits. Health systems: facility-based interventions Facility-based health systems interventions were effective in increasing postnatal visits (one review with fourteen studies), maternal ART initiation and uptake (four interventions in one review with nine studies), immunisation uptake and follow-up ANC visits (one study each in one review). None of the reviews assessed the effect of facility-based interventions on increased facility delivery, adequate ANC visits or skilled attendance at delivery. Health systems: community-based interventions Community-based health-systems interventions were effective in increasing skilled attendance at delivery (one review with two interventions), ANC service utilisation (one review with two interventions), institutional delivery (one review with sixteen studies), ART initiation and uptake (two interventions in one review), and nutritional supplements and immunisation uptake (one review, seven and ten studies respectively). Conclusion Different interventions effectively improved healthcare service utilisation on the maternal healthcare continuum. Implementing these interventions in combination has the potential to enhance healthcare service uptake further.

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Birth registration coverage according to the sex of the head of household: an analysis of national surveys from 93 low- and middle-income countries

Cited by 8 publications

References 31 publications

Determinants of birth registration in sub-Saharan Africa: evidence from demographic and health surveys

Determinants of birth registration in sub-Saharan Africa: evidence from demographic and health surveys

Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews

Interventions to enhance healthcare utilisation among pregnant women to reduce maternal mortality in low- and middle-income countries: a review of systematic reviews

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