Interrelationships between early antenatal care, health facility delivery and early postnatal care among women in Uganda: a structural equation analysis

Background The government is obliged to guarantee equal access to antenatal care (ANC) between urban and rural areas. This study aimed to analyze urban-rural disparities in ≥4 ANC visits during pregnancy in the Philippines and Indonesia. Methods The study processed data from the 2017 PDHS and the 2017 IDHS. The analysis unit was women aged 15–49 years old who had given birth in the last 5 years. The weighted sample size was 7992 respondents in the Philippines and 14,568 respondents in Indonesia. Apart from ANC as the dependent variable, other variables analyzed were residence, age, husband/partner, education, parity, and wealth. Determination of urban-rural disparities using binary logistic regression. Results The results show that women in the urban Philippines are 0.932 times more likely than women in the rural Philippines to make ≥4 ANC visits. On the other side, women in urban Indonesia are more likely 1.255 times than women in rural Indonesia to make ≥4 ANC visits. Apart from the type of residence place (urban-rural), five other tested multivariate variables also proved significant contributions to ANC’s use in both countries, i.e., age, have a husband/partner, education, parity, and wealth status. Conclusions The study concluded that disparities exist between urban and rural areas utilizing ANC in the Philippines and Indonesia. Pregnant women in the rural Philippines have a better chance of making ≥4 ANC visits. Meanwhile, pregnant women in urban Indonesia have a better chance of making ≥4 ANC visits.

Section: Discussionmentioning

confidence: 99%

Urban-rural disparities of antenatal care in South East Asia: a case study in the Philippines and Indonesia

2021

“…Consent and authorization to make use of the data were acquired from ICF Macro International U.S.A, DHS Program. Based on our previous study (Atuhaire, Atuhaire, Wamala, & Nansubuga, 2020), 939 women from Eastern and 582 women from Western sub-regions were sampled. The selection was based on the two sub-regions having almost similar economic indicators but with different maternal healthcare utilization factors (UBOS, 2017).…”

Section: Methodsmentioning

confidence: 99%

“…Using available information, we created three outcome variables defined as; early antenatal care (EANC) (women who utilized first antenatal care within the three months of pregnancy), health facility delivery (HFD) (women who had institutional deliveries) and early postnatal care (women who received the first PNC within 2 days after giving birth). The predictor variables included maternal age, education, wealth, marital status if the pregnancy was wanted or not, media exposure, complications during pregnancy, available health workers in the community if the distance to a health facility was problematic or not, and costs of service (Atuhaire et al, 2020).…”

Section: Methodsmentioning

confidence: 99%

Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

Wamala

et al. 2021

JEBS

Self Cite

This study aimed at examining regional differentials in maternal healthcare services in Uganda. Using a sample of 1,521 women of reproductive ages (15-49) from Eastern and Western sub-regions of Uganda, and non-linear Oaxaca’ Blinder Multivariate Decomposition method, we assessed differentials in utilization of early antenatal care, health facility delivery and early postnatal care services among the women, henceforth, establishing main predictors of regional inequalities that will enable policymakers to make better evenly interventions and focused decisions. The study reveals that differentials in the utilization of maternal healthcare services are not only hindered by social and economic barriers, but also widespread disparities in the utilization of existing services. Significant differentials were attributed to both variation in women’s characteristics and effects of coefficients. Findings showed that the gap in early antenatal care would reduce on average by 31.6% and 34.7% of differences in availability of community health workers and media exposure respectively, were to disappear. Furthermore, the gap would increase on average by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth respectively. The gap in health facility delivery would reduce on average by 24.6% and 37.2% of differences in community health worker availability and media exposure were to disappear respectively and increase on average by 54.9% in the absence of variations in effects of maternal education. The gap in EPNC would reduce on average by 18.5% and 17.17% of differences in maternal education and community health worker availability were to disappear respectively and increase on average by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth respectively. Progress towards equitable maternal health care should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.

“…Based on our previous study (22), we selected a sample of 939 women of reproductive age from Eastern_Busoga and 582 women from Western_Bunyoro sub regions, who had delivered a (18).…”

Section: Data Sourcementioning

confidence: 99%

“…The predictor variables include maternal age (15-19, 20-24, 25-29, 30-34, 35-39, 40-44 and 45-49years), highest maternal education level (some primary, completed primary seven, some secondary, and completed secondary six), wealth (poor, middle and rich), marital status (unmarried and married), pregnancy wanted (yes and no), media exposure (exposure and non-exposure), complications (yes and no), available community workers (yes and no), distance to a health facility (big problem and not), costs (big problem and not) (22).…”

Section: Predictor Variablesmentioning

confidence: 99%

Regional differentials in early antenatal care, health facility delivery and early postnatal care among women in Uganda

Wamala

2021

Preprint

Self Cite

BackgroundMaternal health equality is an ultimate goal for a better world. Early maternal healthcare service utilization is hindered by numerous social and economical barriers, along with widespread inequalities in utilization of existing services. To better understand variations existing in Uganda, we assessed differences in early antenatal care, health facility delivery and early postnatal care among women in selected sub regions. The differences were decomposed into components attributed to variation in women's characteristics and the effects of coefficients.MethodsWe used a sample of 1,521 women of reproductive ages (15-49), who delivered a child five years prior to the 2016 Uganda Demographic and Health Survey. Non-linear Oaxaca’ Blinder Multivariate Decomposition method and STATA 13.0 software were used.ResultsSignificant differences in early ANC, health facility delivery and EPNC among women in Eastern and Western sub regions were attributed to both variation in women’s characteristics and effects of coefficients. Overall gap in early ANC (57.39%), health facility delivery (63.88%) and EPNC (59.06%) was attributed to differences in women's characteristics, whereas differences in effects of coefficients attributed 42.61% variations in early ANC, 36.12% in health facility delivery, and 40.94% in EPNC.Specifically, overall gap in early ANC would reduce if differences in availability of community health workers (31.6%) and media exposure (34.7%) were to disappear. Furthermore, the gap would increase by 68.8% and 12.6% in absence of the variation in effects of maternal education, and wealth differences respectively. Overall gap in health facility delivery would reduce if differences in community health worker availability (24.6%) and media exposure (37.2%) were to disappear, and increase by 54.9% in the absence of variations in effects of maternal education. The overall gap in EPNC would reduce if differences in maternal education (18.5%) and community health worker availability (17.17%) were to disappear and increase by 52.8% and 8.4% in the absence of the variation in effects of maternal education and wealth quintile respectively.ConclusionProgress towards equitable maternal health should focus more on strategies that guarantee even distribution of community health workers, broad dissemination of maternal healthcare information and girl child education completion in Uganda.