Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi: a retrospective study

Mchenga, Martina; Burger, Ronelle; Fintel, Dieter von

doi:10.1186/s12913-019-4130-1

Cited by 43 publications

(59 citation statements)

References 31 publications

(51 reference statements)

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“…These circumstances may have yielded limited nutrition awareness and thus unlikely for the women to remember or retain the information [ 36 ]. Other studies from sub-Saharan Africa also postulate that the poor quality of ANC is a result of low skills among health workers responsible for the nutrition education [ 11 , 37 ]. Apparently, health workers often do not utilise the standard guidelines, leading to variations in content and approaches [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Enhancing nutrition knowledge and dietary diversity among rural pregnant women in Malawi: a randomized controlled trial

Katenga-Kaunda

Kamudoni

Holmboe‐Ottesen

et al. 2021

BMC Pregnancy Childbirth

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Background In many sub-Saharan African countries, such as Malawi, antenatal care (ANC) services do not deliver sufficient nutrition awareness to improve adequate dietary intake in pregnancy. We therefore compared the effects of supplementary nutrition education and dietary counselling with routine ANC service on nutrition knowledge and dietary intakes among Malawian pregnant women. Methods We used data from a two-armed cluster randomised controlled trial (RCT) of which the intervention group received supplementary nutrition education, dietary counselling and routine ANC services whereas the controls received only routine ANC services. The RCT was conducted in 10 control and 10 intervention villages in Mangochi, Southern Malawi and included pregnant women between their 9th and 16th gestational weeks. We examined the changes in nutrition knowledge and dietary diversity from enrolment (baseline) to study end-point of the RCT (two weeks before expected delivery). We used three linear multilevel regression models with random effects at village level (cluster) to examine the associations between indicators of nutrition knowledge and diet consumption adjusted for selected explanatory variables. Results Among 257 pregnant women enrolled to the RCT, 195 (76%) were available for the current study. The supplementary nutrition education and counselling led to significant improvements in nutrition knowledge, dietary diversity and nutrition behaviour in the intervention group compared with controls. Most women from both study groups had a moderate consumption of diversified foods at study end-point. A significant positive association between nutrition knowledge and consumption of a diversified diet was only observed in the intervention group. Conclusions Nutrition knowledge and dietary diversity improved in both study groups, but higher in the intervention group. Increased nutrition knowledge was associated with improved dietary diversity only in the intervention women, who also improved their nutrition perceptions and behaviour. Antenatal nutrition education needs strengthening to improve dietary intakes in pregnancy in this low resource-setting. Trial registration Clinical trials.gov ID: NCT03136393 (registered on 02/05/2017).

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Section: Discussionmentioning

confidence: 99%

Enhancing nutrition knowledge and dietary diversity among rural pregnant women in Malawi: a randomized controlled trial

Katenga-Kaunda

Kamudoni

Holmboe‐Ottesen

et al. 2021

BMC Pregnancy Childbirth

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“…Numerous factors influence the uptake of optimal ANC contacts. Empirical studies have shown that maternal age [4], educational level [8], planned pregnancies [9], and timing of first ANC visit [10] are factors associated with adequate ANC visits. In addition, exposure to mass media, family income, and accessibility of the obstetric service are also associated with increased utilization of antenatal care [9,11,12].…”

Section: Introductionmentioning

confidence: 99%

Women’s enlightenment and early antenatal care initiation are determining factors for the use of eight or more antenatal visits in Benin: further analysis of the Demographic and Health Survey

Ekholuenetale

Nzoputam

Barrow

et al. 2020

J. Egypt. Public. Health. Assoc.

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Background: Within the continuum of reproductive health care, antenatal care (ANC) provides a platform for vital health care functions, such as disease prevention, health promotion, screening, and diagnosis. It has been widely confirmed that by implementing appropriate evidence-based practices, ANC can save lives. Previous studies investigated the utilization of ANC based on the four visits model. The new guidelines set by the World Health Organization 2016 recommended increasing contacts with health providers from four to eight contacts. The present study aims to determine the frequency, determinants, and socioeconomic inequalities of ANC utilization based on the eight or more contacts in Benin. This will provide information for policy makers to improve ANC utilization. Methods: We used a population-based cross-sectional data from Benin Demographic and Health Survey (BDHS)-2017-2018. The outcome variable considered for this study was coverage of ≥ 8 ANC contacts. About 1094 women of reproductive age who became pregnant after the new guideline of ≥ 8 ANC contacts was endorsed were included in this study. The determinants for ≥ 8 ANC contacts were measured using multivariable logistic regression. Concentration (Conc.) Index and Lorenz curves were used to estimate the socioeconomic inequalities of ≥ 8 ANC contacts. The level of significance was set at P < 0.05. Results: The coverage of ≥ 8 ANC contacts was 8.0%; 95%CI 6.5%, 9.7%. The results of timing of antenatal care initiation showed that women who had late booking (after 1st trimester) had 97% reduction in ≥ 8 ANC contacts compared with women who initiated ANC contacts within the first trimester (adjusted odds ratio (AOR) = 0.03; 95% CI 0.00, 0.21). In addition, women with medium or high enlightenment were 4.55 and 5.49 as more likely to have ≥ 8 ANC contacts, compared with women having low enlightenment (AOR = 4.55; 95% CI 1.41, 14.69 and AOR = 5.49; 95% CI 1.77, 17.00, respectively). Conc. Index for the household wealth-related factor was 0.33; p < 0.001 for urban women and 0.37; p < 0.001 for the total sample. Similarly, Conc. Index for maternal education was 0.18; p = 0.006 for urban women and 0.21; p < 0.001 for the total sample.

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“…A range of government, non-profit and private providers are involved in family planning and other reproductive health services; however, only government institutions provide the services without any charge. 4 However, existing resources are not enough for the reproductive healthcare needs of the population; only 65% of these facilities provide prenatal services and there are only 0.2 doctors and 3.4 nurses and midwives 10,000 people in the country. 4 The effect of inadequate healthcare infrastructure gets aggregated by low health literacy, lack of awareness, cultural beliefs and perceived need for pregnancy care.…”

Section: Introductionmentioning

confidence: 99%

“… 4 However, existing resources are not enough for the reproductive healthcare needs of the population; only 65% of these facilities provide prenatal services and there are only 0.2 doctors and 3.4 nurses and midwives 10,000 people in the country. 4 The effect of inadequate healthcare infrastructure gets aggregated by low health literacy, lack of awareness, cultural beliefs and perceived need for pregnancy care. 5 Even when service is available, one’s perception of pregnancy and healthcare needs can act as a barrier to availing the existing services.…”

Section: Introductionmentioning

confidence: 99%

Association Between Mass Media Use and Maternal Healthcare Service Utilisation in Malawi

Wang¹,

Etowa²,

Bishwajit³

et al. 2021

JMDH

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Introduction: Using data from Malawi Demographic and Health Survey (2015-16), in the present study, we aimed to assess the role of exposure to family planning information through various mass media on the utilization of maternal healthcare services. Methods: The sample population included 13,217 women aged 15-49 years with a history of at least one childbirth. Outcome measures included essential maternal healthcare services such as early and adequate use of antenatal care, skilled delivery service. Multivariate logistic regression models were used to find the association between maternal healthcare services and exposure to family planning messages by controlling for sociodemographic characteristics. Results: Women who reported receiving family planning message through internet [odds ratio=1.48, 95% CI=1.15, 1.91], radio [odds ratio=1.15, 95% CI=1.05, 1.26], TV [odds ratio=1.53, 95% CI=1.32, 1.76] and mobile phone [odds ratio=1.23, 95% CI=1.02, 1.48] had higher odds of having timely ANC care. For using adequate number of ANC, the associations were significant for TV [odds ratio=1.41, 1.23, 1.62] and mobile phone [odds ratio=1.20, 95% CI=1.01, 1.43] only. For the use of facility delivery, a strong association was observed for poster [odds ratio=1.43, 95% CI=1.12, 1.82] and TV [odds ratio=2.99, 95% CI=1.78, 5.03]. The odds of using all three services varied noticeably between urban and rural areas, eg, receiving family planning messages through internet increased the odds of antenatal care and facility delivery services in the urban areas only, whereas that from poster was associated only for facility delivery and only in the rural areas. Conclusion:The findings indicate a positive association on media communication regarding family planning on the uptake of maternal healthcare services.

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Examining the impact of WHO’s Focused Antenatal Care policy on early access, underutilisation and quality of antenatal care services in Malawi: a retrospective study

Cited by 43 publications

References 31 publications

Enhancing nutrition knowledge and dietary diversity among rural pregnant women in Malawi: a randomized controlled trial

Enhancing nutrition knowledge and dietary diversity among rural pregnant women in Malawi: a randomized controlled trial

Women’s enlightenment and early antenatal care initiation are determining factors for the use of eight or more antenatal visits in Benin: further analysis of the Demographic and Health Survey

Association Between Mass Media Use and Maternal Healthcare Service Utilisation in Malawi

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