Multilevel analysis of quality of antenatal care and associated factors among pregnant women in Ethiopia: a community based cross-sectional study

Negash, Wubshet Debebe; Fetene, Samrawit Mihret; Shewarega, Ever Siyoum; Fentie, Elsa Awoke; Asmamaw, Desale Bihonegn; Teklu, Rediet Eristu; Aragaw, Fantu Mamo; Belay, Daniel Gashaneh; Alemu, Tewodros Getaneh; Eshetu, Habitu Birhan

doi:10.1136/bmjopen-2022-063426

Cited by 27 publications

(24 citation statements)

References 58 publications

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“…Model III was the best-fitted model since it had the lowest deviance. Variables having a p-value less than 0.2 in bivariable analysis were used for multivariable analysis [ 49 – 51 ]. Finally, in the multivariable analysis, adjusted odds ratios with 95% confidence intervals and a p-value of less than 0.05 were used to identify factors of SBI.…”

Section: Methodsmentioning

confidence: 99%

Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel analysis of recent Demographic and Health Surveys

Belachew

Asmamaw

Negash

2023

BMC Pregnancy Childbirth

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Background In developing countries, short birth interval is one of the major public health issues. It is one of the leading cause’s adverse birth outcomes in the worldwide. Despite the fact that ending maternal and perinatal morbidity and mortality is one of the Sustainable Development Goals (SDG), the burden of the problem continues to be a huge concern in developing countries, including high fertility countries. Thus, this study aimed to determine the short birth interval and its predictors in ten high fertile sub-Saharan African countries. Methods Data for this study was obtained from the most recent Demographic and Health Surveys (DHS). A total of weighted sample of 303,979 women of childbearing age group (15– 49) who had at least two alive consecutive children was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the associated factors of short birth interval. As a final step, the Adjusted Odds Ratio (AOR) was used with a confidence interval of 95% in determining statistical significance. Results Overall prevalence of short birth interval in high fertile sub Saharan Africa was 58.74% (52.32%, 65.17%).The factors significantly associated with the short birth interval were women's educational status; primary education (AOR = 0.88; 95% CI: 0.86,0 .91), secondary and higher (AOR = 0.10; 95% CI: 0.09, 0.11), working (AOR = 0.91; 95% CI: 0.88, 0 .93), classified as rich wealth index level (AOR = 0.90; 95% CI: 0.88, 0.93),having six and above ideal number of children (AOR = 2.25; 95% CI: 2.22, 2.30), preferred waiting time two years and above to give birth (AOR = 0.83; 95% CI: 0.76, 0.89), contraceptive non users (AOR = 3.01; 95% CI: 2.93, 3.07), community level education (AOR = 1.97; 95% CI: 1.54, 2.08), rural residency (AOR = 2.17; 95% CI: 2.13, 2.22), and country Chad (AOR = 1.37; 95% CI: 1.22, 1.54). Conclusion The prevalence of short birth interval in the top ten high fertile sub Saharan African countries is still optimally high. Therefore, the government of each country should work on the access to family planning and education in rural parts of the countries.

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Section: Methodsmentioning

confidence: 99%

Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel analysis of recent Demographic and Health Surveys

Belachew

Asmamaw

Negash

2023

BMC Pregnancy Childbirth

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“…Whereas studies in other African countries like South Africa [13], Tanzania [48], and Nigeria [11] revealed that the prompt attention domain was poorly performed. Te concern for these domains might be due to factors such as overcrowding, understafng, delays in reception, inaccessibility to recommended medicines, provider attitudes, and poor healthcare management that could probably contribute to low responsiveness [11,49].…”

Section: Responsiveness Performancementioning

confidence: 99%

Does Health System Responsiveness Differ between Insured and Uninsured Outpatients in Primary Health Care Facilities in Asagirt District, Ethiopia? A Cross-Sectional Study

Negash

Atnafu

Asmamaw

et al. 2022

Advances in Public Health

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Background. An effective designation of health facilities improves the facility’s ability to respond to patients’ legitimate expectations. Limited evidence exists regarding the association between health system responsiveness and financial fairness in Sub-Saharan Africa, particularly in Ethiopia. The purpose of the study was, therefore to evaluate the health system responsiveness among insured and uninsured outpatients in primary healthcare facilities and determine the association between health insurance and health system responsiveness among outpatients. Methods. A facility-based cross-sectional study was conducted between March 30 and April 30,2021. The study sampled 423 participants using a systematic random sampling technique, and the data was collected with structured and pretested questionnaires administered by interviewers. Responsiveness was measured using the short version of the World Health Organization’s multicountry responsiveness survey, which has seven dimensions including autonomy, communication, confidentiality, attention, dignity, choice, and amenities. Using quantile regression, a specific association between health insurance and the health system responsiveness index was examined, adjusting for sociodemographic, quality, and satisfaction-related factors. Results. Of a total of 417 outpatients, 70.74% had health insurance. There was no statistical difference in health system responsiveness among insured and uninsured outpatients. Possession of health insurance was not associated with responsiveness (−0.67; 95%CI: −1.59, 0.25). There was a statistically significant negative relationship between age and responsiveness (−1.33; 95% CI: −2.47, −0.19) among 30–39 year olds and (−1.66; 95% CI: −3.02, −0.32) among 40–49 year olds. However, there was a positive statistical association between responsiveness with urban residence (+1.33; 95%CI: 0.37, 2.29), perceived quality of healthcare (+2.96; 95%CI: 1.95, 4.05), and patient satisfaction (3; 95%CI: 1.94, 4.07). Conclusions. There was no difference in the responsiveness of the health system between insured and uninsured outpatients. All domains need further improvement, particularly those more closely related to patients’ concerns, such as waiting time to get service and choices of healthcare providers. Furthermore, health facility administrators and the government should enhance responsive healthcare services in parallel with quality improvement and patient satisfaction, based on feedback from service users for better performance.

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“…The new approach to ANC emphasizes the quality of care rather than quantity [4]. However, Evidences suggested that, not more than one third of the pregnant women receive a good quality ANC service [5][6][7]. Studies have shown that there are many missed opportunities for care, both because of the client-and health system-related factors.…”

Section: Introductionmentioning

confidence: 99%

Quality of antenatal care in selected public health facilities of West Ethiopia

Nemomsa

Wirtu

Getachew

et al. 2022

Contracept Reprod Med

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Background Ante natal care (ANC) is a key entry point for a pregnant woman to receive abroad range of promotion and preventive health services. Quality of ANC has paramount role to ensure better maternal and neonatal outcome. Objective To assess the quality of antenatal care services at public health facilities of western Ethiopia. Methods Facility-based cross-sectional study was conducted from May 30th to June 30th, 2016. All public health facilities in the Kellem Wollega Zone of West Ethiopia were audited, 316 medical records were reviewed, and 316 pregnant women were interviewed. The data was entered using EPI Data version 3.1 and analyzed using SPSS version 20.0. Descriptive statistics, binary, and multiple logistic regressions were conducted. Variables with a P-value of <0.05 were considered as statistically significant associated factors. Results A total of 316 pregnant women were enrolled in the study. All facilities were categorized as “good” by the possession of necessary equipment, 3/4 by basic amenities and 87.34% by general and gynecologic examination. The information was provided for 222(86.21%), which is categorized as poor. About 252 (79.7%) of the women were satisfied with ANC. A urine sample taken during ANC visit [(AOR= 3.36 (95 % CI= 1.70, 6.61)], and counseling on nutrition during pregnancy [(AOR= 2.27 (95 % CI=1.16, 4.45)] were predictors of client satisfaction on ANC. Conclusions In this study quality of ANC was labeled good for structural aspects and poor for process aspects of quality. In terms of outcome aspects, the majority of pregnant women were satisfied with the ANC they received. A urine sample taken during the ANC visits and being counseled on nutrition during pregnancy were predictors for client satisfaction on ANC. Concerned bodies need to improve laboratory tests and information provision.

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Multilevel analysis of quality of antenatal care and associated factors among pregnant women in Ethiopia: a community based cross-sectional study

Cited by 27 publications

References 58 publications

Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel analysis of recent Demographic and Health Surveys

Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel analysis of recent Demographic and Health Surveys

Does Health System Responsiveness Differ between Insured and Uninsured Outpatients in Primary Health Care Facilities in Asagirt District, Ethiopia? A Cross-Sectional Study

Quality of antenatal care in selected public health facilities of West Ethiopia

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