Socio-economic and cultural factors associated with the utilization of maternal healthcare services in Togo: a cross-sectional study

Kota, Komlan; Chomienne, Marie-Hélène; Geneau, Robert; Yaya, Sanni

doi:10.1186/s12978-023-01644-6

Cited by 4 publications

(1 citation statement)

References 57 publications

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“…Women who made fewer than four ANC visits were more likely to initiate ANC later than those with four ANC visits or more. Similar findings were reported in other studies [41,54,55]. Women with fewer than four ANC visits may have experienced challenges to access maternal health services or had negative healthcare-seeking behaviour in terms of modern healthcare services.…”

Section: Discussionsupporting

confidence: 88%

Factors Associated with Late Antenatal Initiation among Women in Malawi

Palamuleni

2024

IJERPH

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Background Early initiation of antenatal care (ANC) is critical in identifying and mitigating adverse pregnancy-related complications. However, globally, a high percentage of women initiate ANC only at a late stage of their pregnancy. In view of this, the main objective of the study is to establish the prevalence and factors associated with late ANC initiation among women in Malawi. Methods The study was based on the 2015–16 Malawi Demographic and Health Survey (MDHS). The study population consisted of 13,251 women of reproductive age who had given birth during the five years preceding the survey. The data was analyzed using the chi-square test and multivariate logistic regression. Results The prevalence of late ANC initiation in Malawi was 75.6%. The logistic regression modelling revealed increased odds of late ANC initiation attendance among women residing in the Northern Region (AOR: 1.172; 95% CI: 1.021–1.345) and the Central Region (AOR: 1.178; 95% CI: 1.074–1.291), women residing in urban areas (AOR: 1.273; 95% CI: 1.108–1.463), women with no education (AOR: 1.814; 95% CI: 1.13–1.47) or with primary education (AOR: 1.697; 95% CI: 1.13–1.47), women with less than four ANC visits (AOR: 4.155; 95% CI: 4.002–4.814), unmarried women (AOR: 1.478; 95% CI: 1.111–1.985) and those whose last birth was not by caesarean section (AOR: 1.377; 95% CI: 1.179–1.607). Reduced odds of late ANC initiation among women were observed among women in the 20–24 age group (AOR: 0.634; 95% CI: 0.456–0.881), those in the 25–29 age group (AOR: 0.645; 95% CI: 0.476–0.874) and those aged 30–34 years (AOR: 0.634; 95% CI: 0.456–0.881). Conclusions The study found that ANC initiation in Malawi is often delayed, with most first visits occurring after the first trimester. Late ANC initiation is associated with region, place of residence, marital status, and the women’s age. These are significant factors to be considered when designing new or reviewing ANC policies and strategies aimed at increasing ANC utilization and encouraging early initiation of ANC. Earlier ANC initiation among Malawian women can contribute positively towards improving maternal and child health in Malawi. Therefore, government policies and interventions should target women with no or little education, those living in poor families and other modifiable risk factors, such as young unmarried women.

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Section: Discussionsupporting

confidence: 88%

Factors Associated with Late Antenatal Initiation among Women in Malawi

Palamuleni

2024

IJERPH

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Geographic disparities and determinants of full utilization of the continuum of maternal and newborn healthcare services in rural India

Tripathi,

Chakrabarty,

Singh

et al. 2024

BMC Public Health

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Background To further reduce maternal and neonatal mortality, it is essential for mothers and newborns to fully utilize all essential services within the continuum of maternal and newborn care. However, research on maternal and child health services in India has not sufficiently examined geographical disparities in the full utilization of these services and the factors influencing the full utilization, particularly in rural areas. This study aims to address this critical gap. Methods Utilizing data from 130,312 mothers collected in the National Family Health Survey-5 (2019–21), this study employed spatial analysis to uncover geographical disparities in the full utilization of the continuum of maternal and newborn healthcare services in rural India. Additionally, binary logistic regression was used to identify the factors associated with this utilization. Results In rural India, 54.3% mothers recieved four or more antenatal care visits, 88.6% received skilled birth attendance, and 75.5% of mothers and 79.8% of newborns received postnatal care within 48 hours of birth. However, only 43.5% mothers-newborn dyads in rural India utilized all four services of the continuum of maternal and newborn healthcare. There were significant geographical disparities in the full utilization of the continuum of maternal and newborn healthcare services. Hotspots were primarily identified in districts of southern states, western Maharashtra, and central Odisha, while cold spots were evident in the northeastern states of Arunachal Pradesh, Meghalaya, Assam, and Nagaland, as well as in the Empowered Action Group states of Bihar, Uttar Pradesh, and Jharkhand. Key determinants influencing the full utilization of the continuum of care in rural India included maternal education, household wealth, parity, health insurance coverage, and exposure to mass media. Specifically, the odds of fully utilizing the continuum of care were significantly lower among women without formal education (adjusted odds ratio = 0.60, 95% CI = 0.56–0.65), those from the poorest wealth quintile (0.65, 0.61–0.69), and mothers with six or more children (0.42, 0.37–0.47), compared to mothers with higher education, those in the richest wealth quintile, and mothers with a single child, respectively. Additionally, mothers from the southern region were more than twice as likely (2.11, 1.99–2.20) to fully utilize the continuum of healthcare services compared to mothers from the northern region. Conclusion The significant geographical disparities in the full utilization of maternal and newborn healthcare services in rural India highlight the necessity for tailored, region-specific interventions. Future programs should focus on addressing the barriers to care by prioritizing vulnerable groups, including those who are poor, uninsured, less educated, adolescents, and women with high parity. Supplementary Information The online version contains s...

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Exploring Machine Learning Algorithms for Predicting Early Antenatal Care Initiation at First Trimester among Reproductive Women in Nigeria

Sani,

Ahmed,

Oluyomi

2024

Preprint

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Background Early antenatal care (ANC) initiation during the first trimester is crucial for maternal and child health outcomes. However, in Nigeria, early ANC uptake remains low due to socioeconomic and cultural barriers. Traditional statistical models used to predict ANC initiation often fail to capture the complex nonlinear interactions between predictors. This study applies machine learning (ML) algorithms to predict early ANC initiation using data from Nigeria’s 2018 Demographic and Health Survey (NDHS). Methods This cross-sectional study utilized NDHS 2018 data and six ML algorithms: Logistic Regression (LR), Support Vector Machine (SVM), K-Nearest Neighbors (KNN), Decision Tree, Random Forest (RF), and XGBoost. The synthetic minority oversampling technique (SMOTE) was used to address data imbalance. The models were evaluated using metrics, such as accuracy, precision, recall, and AUROC values. Feature importance was assessed using the permutation importance and Gini impurity methods. Results The Random Forest model demonstrated the best performance, achieving the highest accuracy (77%), precision (75%), recall (80%), and AUROC value of 0.77. This model effectively identified key predictors of early ANC, including education level, wealth index, and place of delivery, with educated and wealthier women being more likely to seek early care. Feature importance analysis revealed significant sociodemographic and geographic disparities, highlighting the critical role of economic resources and healthcare accessibility in influencing ANC behavior. Conclusion ML models, particularly Random Forest, provide an effective approach for predicting early ANC initiation, offering comprehensive insights beyond traditional methods. These findings underscore the need for targeted interventions focusing on education, economic empowerment, and healthcare access to enhance early ANC uptake among Nigerian women.

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Socio-economic and cultural factors associated with the utilization of maternal healthcare services in Togo: a cross-sectional study

Cited by 4 publications

References 57 publications

Factors Associated with Late Antenatal Initiation among Women in Malawi

Factors Associated with Late Antenatal Initiation among Women in Malawi

Geographic disparities and determinants of full utilization of the continuum of maternal and newborn healthcare services in rural India

Exploring Machine Learning Algorithms for Predicting Early Antenatal Care Initiation at First Trimester among Reproductive Women in Nigeria

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