Demand Side Factors Associated With Quality Antenatal Care Services: A Case Study of Lusaka District, Zambia

Katemba, Brave M.; Bwembya, Phoebe; Hamoonga, Twaambo Euphemia; Chola, Mumbi; Jacobs, Choolwe

doi:10.3389/fpubh.2018.00285

Cited by 17 publications

(33 citation statements)

References 13 publications

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“…These findings were corroborated by a study that showed how spouses or partners can influence women to participate in ANC [ 28 ], producing better results by ensuring that women attend their ANC consultations and receive quality services. Yet, these results also contrast with those reported by other authors [ 29 ].…”

Section: Discussioncontrasting

confidence: 99%

Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil

Morón-Duarte

Varela

Bertoldi

et al. 2021

BMC Health Serv Res

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Background Inadequate antenatal care (ANC) has been associated with adverse pregnancy outcomes. ANC quality is considered a key component of the right to health and a route to equity and dignity for women and their children. Although ANC coverage is relatively high in Brazil, there are revealed some health disparities when coverage is examined by socio-demographic determinants. In this study we evaluated ANC quality and its socio-demographic determinants using data from the 2015 Pelotas birth cohort, Rio Grande do Sul, Brazil. Methods This study is part of the 2015 Pelotas population-based birth cohort (n = 3923 pregnant women) conducted in southern Brazil. ANC quality was assessed through 19 content and service utilization indicators recommended by the Brazilian Ministry of Health. Descriptive analyses and associations of each of the ANC indicators and independent variables were performed using the chi-square and linear trend test. ANC indicators were analyzed individually and aggregated as a score. Associations between ANC score quality and socio-demographic variables were assessed with ordinal regressions. Mediation analysis with G-computation was performed to estimate direct and indirect effect of mother’s level of education on ANC quality mediated by the number of consultations and timing of ANC initiation. Base and post confounders were included. Results The results showed that except for breast examination, height measurement, tetanus toxoid vaccination and ANC starting at the first trimester, all ANC indicators showed more than 80% coverage during ANC visits. In the adjusted analysis, inadequate quality ANC was associated with lower maternal education level, not having a partner, being multiparous, being attended by a private provider and by the same professional in all consultations. In the mediation analyses, 6.8% of the association between ANC quality and mother’s education was mediated by the trimester in which ANC started, while 12.8% was mediated by the number of ANC visits. Conclusions ANC quality is associated with pregnant women’s socio-demographic characteristics. Significant efforts are needed to improve the quality of facility-based maternity care.

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Section: Discussioncontrasting

confidence: 99%

Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil

Morón-Duarte

Varela

Bertoldi

et al. 2021

BMC Health Serv Res

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“…Our study revealed that the proportion of adequately received ANC contents was 28%. This result is in line with a study conducted in LMICs ranging from 10 to 50% in Jordan, Nigeria, Nepal, Colombia, and Haiti 49 and studies in Bangladesh (22%), 20 Zambia (29%), 16 but lower than studies done in Ghana (48%), 23 Myanmar (58%), 41 Zambia (47.1%), 50 and higher than studies in Nigeria (7%), 22 twenty countries in sub-Saharan Africa (5%). 51 The slow progress towards maternal and newborn survival due to ineffective care may be attributable to the gaps between globally recommended coverage indicators measuring contacts rather than the actual content.…”

Section: Discussionsupporting

confidence: 91%

“…In the same way, previous studies showed that as education increases, number of received ANC content also increases. 9 , 22 , 42 , 50 , 51 , 55 Relatively affordable and accessible health information for educated women compared to those who never attended schools may explain the associations. 56 Furthermore, education fosters maternal healthcare awareness, appropriate need-based services utilization, 17 , 20 , 57 household maternal decision-making ability, 57 autonomy on their health, 58 new values and attitudes that favor modern health care.…”

Section: Discussionmentioning

confidence: 99%

Extent of Received Antenatal Care Components in Ethiopia: A Community-Based Panel Study

Shiferaw¹,

Mengistie²,

Gobena³

et al. 2021

IJWH

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This study aimed to identify the extent of antenatal care content received and associated factors among Ethiopian women. Methods: A nationally representative Performance Monitoring for Action 2020 Ethiopian data were used. A multistage cluster sampling design was used to select 2855 pregnant or recently postpartum women nested within 217 enumeration areas. Female resident enumerators collected the data using a semi-structured questionnaire. Researchers dichotomized the number of ANC content received greater than or equal to 75 percentiles as adequate. Otherwise, it was considered inadequate. A multilevel Poisson regression was fitted. The result was reported using an incidence rate ratio with a 95% confidence interval and a p-value less than 0.05 was considered for statistical significance. Results: The study revealed more than a quarter of pregnant women received adequate ANC content (27.8%; 95% CI: 23.8%, 32.2%). Multivariable analysis revealed urban residence (IRR = 1.09, 95% CI: 1.01, 1.21), attending secondary and above formal education (IRR = 1.08, 95% CI: 1.01, 1.16), maternal age 20-24 years (IRR = 1.10, 95% CI: 1.02, 1.19), and partner's encouragement to attend clinic for antenatal care (IRR = 1.14, 95% CI: 1.05, 1.24) was significantly associated with receiving higher numbers of antenatal care content. Conclusion:The proportion of women who received adequate antenatal care content in Ethiopia was low. Despite Ethiopia's effort to improve maternal health services utilization, disparities among regions and between rural and urban exist. This study highlights the importance of ensuring high received antenatal care content, which is crucial for reducing pregnancy-related morbidity and mortality. This implies prompt intersectoral collaboration to promote female education, target older aged women, and rural resident women, encourage partner involvements during the antenatal care process, minimize regional variation, and strengthen the implementation of received ANC content policies and programs with the active participation of the stakeholders are priority issues.

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“… 44 , 47 The quality of ANC services does not depend solely on the timing and number of ANC visits, and the physical examination but also on the type and quantity of interventions, such as maternal height, urine examination, examining the total blood count, measurement of blood pressure, general physical examination, iron supplementation, administration of folic acid tablets, voluntary counselling and testing for HIV, prevention of maternal transmission of HIV to the infant, administering antimalarial drugs, providing isoniazid prophylaxis against tuberculosis and other interventions. 48 , 49 Our study confirms the findings in other studies that showed that ANC interventions though important, were not mentioned as causes of pregnant women’s dissatisfaction with ANC services.…”

Section: Discussionsupporting

confidence: 89%

Late registration for antenatal care by pregnant women with previous history of caesarean section

Ramotsababa

Setlhare

2021

African Journal of Primary Health Care & Family Medicine

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Background: Despite good access to antenatal care (ANC) services for most women, and regular training of healthcare workers in obstetrics and gynaecology, many pregnant women with a previous history of caesarean section (C/S) still presented late for ANC services at Letsholathebe II Memorial Hospital (LIIMH) in Maun, Botswana. This may increase morbidity and mortality in women with previous C/S delivery and neonates. Knowing why women with previous C/S present late for ANC may help in the formulation of interventions that decrease morbidity and mortality amongst these women and neonates.Aim: The aim of this study was to explore the reasons why pregnant women with a previous history of C/S registered late for ANC, at LIIMH.Setting: This study was performed at LIIMH, a district hospital situated in Maun, Botswana.Methods: This was a descriptive qualitative study. Consenting pregnant women with previous C/S who presented at LIIMH after the 20 weeks of pregnancy were interviewed until data saturation. The data was analysed for themes.Results: The reasons for late registration at LIIMH include lack of information, misconception on the appropriate booking time and venue, dissatisfaction with the quality of ANC clinic services, use of alternative ANC providers, delayed referral, and pregnancy experience.Conclusion: Lack of knowledge of ANC delivery venue, using alternative ANC providers, and dissatisfaction with ANC clinic services, contributed to late registration. Pregnant women with previous history of C/S should be informed about ANC, delivery plans, and the assistance of alternative ANC providers should be explored.

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Demand Side Factors Associated With Quality Antenatal Care Services: A Case Study of Lusaka District, Zambia

Cited by 17 publications

References 13 publications

Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil

Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil

Extent of Received Antenatal Care Components in Ethiopia: A Community-Based Panel Study

Late registration for antenatal care by pregnant women with previous history of caesarean section

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