Maternal and newborn healthcare practices: assessment of the uptake of lifesaving services in Hoima District, Uganda

Babughirana, Geoffrey; Gerards, Sanne M. P. L.; Mokori, Alex; Nangosha, Elisha; Kremers, Stef; Gubbels, Jessica S.

doi:10.1186/s12884-020-03385-x

Cited by 26 publications

(11 citation statements)

References 17 publications

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“…Uganda’s perinatal mortality has stagnated at 40 per 1,000 pregnancies over the last decade [ 8 , 9 ]. Over the same period, the utilization of maternal healthcare services has generally improved, but maternal mortality rate has remained unacceptably high at 336 maternal deaths per 100,000 live births [ 9 , 10 ]. It is estimated that 80% of maternal deaths and 66% of neonatal deaths in the world could be averted by ensuring that women have access to quality and effective maternal healthcare services especially during childbirth and in the first week of life [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Continuum of care for maternal health in Uganda: A national cross-sectional study

Sserwanja¹,

Mukunya

Nabachenje

et al. 2022

PLoS ONE

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Introduction A continuum of maternal care approach can reduce gaps and missed opportunities experienced by women and newborns. We determined the level of coverage and factors associated with the continuum of maternal care in Uganda. Methods We used weighted data from the Uganda Demographic and Health Survey (UDHS) 2016. We included 10,152 women aged 15 to 49 years, who had had a live birth within five years preceding the survey. Stratified two-stage cluster sampling design was used to select participants. Continuum of maternal care was considered when a woman had at least four antenatal care (ANC) visits, had delivered in a health facility and they had at least one postnatal check-up within six weeks. We conducted multivariable logistic regression analysis to determine factors associated with completion of the continuum of maternal care using SPSS version 25. Results The level of coverage of complete continuum of maternal care was 10.7% (1,091) (95% CI: 10.0–11.2). About 59.9% (6,080) (95% CI: 59.0–60.8) had four or more antenatal visits while 76.6% (7,780) (95% CI: 75.8–77.5) delivered in a health facility and 22.5% (2,280) (95% CI: 21.5–23.2) attended at least one postnatal care visit within six weeks. The following factors were associated with continuum of maternal care; initiating ANC in the first trimester (AOR 1.49, 95% CI: 1.23–1.79), having secondary level of education (AOR 1.60, 95% CI: 1.15–2.22) and tertiary level of education (AOR 2.08 95% CI: 1.38–3.13) compared to no formal education, being resident in Central Uganda (AOR 1.44, 95% CI:1.11–1.89), Northern Uganda (AOR 1.35, 95% CI: 1.06–1.71) and Western Uganda (AOR 0.61, 95% CI: 0.45–0.82) compared to Eastern Uganda, and exposure to newspapers and magazines. Conclusion The level of coverage of the complete continuum of maternal care was low and varied across regions. It was associated with easily modifiable factors such as early initiation of ANC, exposure to mass media and level of education. Interventions to improve utilisation of the continuum of maternal care should leverage mass media to promote services, especially among the least educated and the residents of Western Uganda.

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Section: Introductionmentioning

confidence: 99%

Continuum of care for maternal health in Uganda: A national cross-sectional study

Sserwanja¹,

Mukunya

Nabachenje

et al. 2022

PLoS ONE

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“…Some studies have found a positive relationship between maternal education and utilization of MHC [ 7 – 9 ]. However, for the case of Uganda, most existing studies are unable to explain whether the link between education and maternal health is attributable to other correlated factors such as economic growth and household income among others.…”

Section: Introduction and Contextmentioning

confidence: 99%

Female education and maternal health care utilization: evidence from Uganda

2022

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Background Maternal health care is among the key indicators of population health and economic development. Therefore, the study attempted to explore female education and maternal healthcare utilization in Uganda. The study identified the causal effect of introduction of free education by exploiting the age as an instrument at the second stage model (BMC Health Serv Res. 2015. 10.1186/s12913-015-0943-8; Matern Child Health J. 2009;14:988–98). This instrument provided an exogenous source of variation in the years of schooling and allowed to implement a regression discontinuity design which accounted for heterogeneity in the cohort overtime. Methods The study used the Ordinary Least Squares (OLS) to help predict years of schooling that were used in the second stage model in the Two Stage Least Squares (2SLS). The study further used the Regression Discontinuity Design (RDD) model with a running variable of birth years to observe its effect on education. To control for heterogeneity in regions in the second stage model, a fixed effects model was used. Results Female education indeed had a positive impact on maternal health care utilization. It was further found out that age also influences maternal health care utilization. Conclusions Therefore, as an effort to improve professional maternal health care utilisation, there is need to focus on education beyond primary level. Uganda Government should also ensure that there is an improvement in community infrastructure and security across all regions and locations.

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“…Ensuring that mothers and newborns receive timely, high-quality care during these critical periods is essential. At baseline, attending four or more ANC was 55.1% [ 4 ]; therefore, this means almost half of the mothers miss goal oriented services such as screening for, preventing, and treating HIV, anemia, malaria, urinary tract infections, pre-eclampsia/eclampsia, preterm delivery, and other complications that can be life-threatening to both mother and baby [ 5 ]. Supporting women to deliver under the supervision of a skilled birth attendant and having the necessary supplies is key to preventing leading causes of maternal and newborn deaths [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…The home visits are implemented for pregnant mothers, and after birth, the children are followed up and registered. VHTs also monitor the use of certain services, for instance whether mothers come for antenatal care at the health facility and whether they have had an HIV test [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Can the Timed and Targeted Counseling Model Improve the Quality of Maternal and Newborn Health Care? A Process Analysis in the Rural Hoima District in Uganda

Babughirana

Gerards

Mokori³

et al. 2021

IJERPH

Self Cite

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Each year, more than half a million women die worldwide from causes related to pregnancy and childbirth, and nearly 4 million newborns die within 28 days of birth. In Uganda, 15 women die every single day from pregnancy and childbirth-related causes, 94 babies are stillborn, and 81 newborn babies die. Cost-effective solutions for the continuum of care can be achieved through Village Health Teams to improve home care practices and health care-seeking behavior. This study aims at examining the implementation of the timed and targeted counseling (ttC) model, as well as improving maternal and newborn health care practices. We conducted a quantitative longitudinal study on pregnant mothers who were recruited on suspicion of the pregnancy and followed-up until six weeks post-delivery. The household register was the primary data source, which was collected through a secondary review of the ttC registers. All outcome and process variables were analyzed using descriptive statistics. The study enrolled 616 households from 64 villages across seven sub-counties in Hoima district with a 98.5% successful follow-up rate. Over the course of the implementation period of ttC, there was an increase of 29.6% in timely 1st antenatal care, 28.7% in essential newborn care, 25.5% in exclusive breastfeeding, and 17.5% in quality of antenatal care. All these improvements were statistically significant. The findings from this study show that the application of the ttC model through Village Health Teams has great potential to improve the quality of antenatal and newborn care and the health-seeking practices of pregnant and breastfeeding mothers in rural communities.

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Maternal and newborn healthcare practices: assessment of the uptake of lifesaving services in Hoima District, Uganda

Cited by 26 publications

References 17 publications

Continuum of care for maternal health in Uganda: A national cross-sectional study

Continuum of care for maternal health in Uganda: A national cross-sectional study

Female education and maternal health care utilization: evidence from Uganda

Can the Timed and Targeted Counseling Model Improve the Quality of Maternal and Newborn Health Care? A Process Analysis in the Rural Hoima District in Uganda

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