Why do rural women in the most remote and poorest areas of Zambia predominantly attend only one antenatal care visit with a skilled provider? A qualitative inquiry

Jacobs, Choolwe; Michelo, Charles; Moshabela, Mosa

doi:10.1186/s12913-018-3212-9

Cited by 19 publications

(20 citation statements)

References 34 publications

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“…We also found a higher likelihood of timely ANC attendance among pregnant women of the richest wealth index compared to those of the poorest wealth index. The poorest women tend to suffer several challenges with respect to being able to afford health care as well as being capable of making decisions concerning their reproductive health and health promotive behaviors [ 41 ]. Hence, making them less likely to seek timely ANC attendance.…”

Section: Discussionmentioning

confidence: 99%

Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

Aboagye

Okyere

Seidu

et al. 2022

BMC Health Serv Res

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Introduction Out-of-pocket payments for healthcare remain a significant health financing challenge in sub-Saharan Africa (SSA), preventing women from using maternal health services. There is a paucity of empirical literature on the influence of health insurance coverage on the timeliness of antenatal care (ANC) attendance in low- and middle-income countries. In this study, we examined the association between health insurance coverage and timely ANC attendance among pregnant women in SSA. Methods Secondary data from Demographic and Health Surveys conducted between 2015 and 2020 in sixteen (16) sub-Saharan African countries with 113,918 women aged 15-49 years were included in the analysis. The outcome variable was the timing of antenatal care (ANC). A multilevel binary logistic regression analysis was carried out to determine the association between health insurance coverage and timely ANC. Results The overall coverage of health insurance and timely antenatal attendance among pregnant women in SSA were 4.4% and 39.0% respectively. At the country level, the highest coverage of health insurance was found in Burundi (24.3%) and the lowest was in Benin (0.9%). For timely ANC attendance, the highest prevalence was in Liberia (72.4%) and the lowest was in Nigeria (24.2%). The results in the model showed that women who were covered by health insurance were more likely to have timely ANC attendance compared to those who were not covered by health insurance (aOR = 1.21, 95% CI = 1.11-1.31). Conclusion Our findings show that that being covered under health insurance is associated with higher likelihood of seeking timely ANC attendance. To accelerate progress towards achievement of the Sustainable Development Goal targets by the year 2030, we recommend that governments and health insurance authorities across the sub-Saharan African countries actively implement health insurance policies as well as roll out health educational programmes that facilitate and ensure increased coverage of health insurance.

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Section: Discussionmentioning

confidence: 99%

Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

Aboagye

Okyere

Seidu

et al. 2022

BMC Health Serv Res

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“…Research question/hypothesis/objectives clearly stated 98 (96) Description of the target population present 98 (96) Participant recruitment or sampling methodology described 100 (98) Methods section present 97 (95) Data analysis described 84 (82) Results presented 102 (100)…”

Section: Reporting Quality Indicator (N = 102)mentioning

confidence: 99%

Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature

et al. 2020

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The estimated 50 million nomadic pastoralists in Africa are among the most "hard-to-reach" populations for health-service delivery. While data are limited, some studies have identified these communities as potential disease reservoirs relevant to neglected tropical disease programs, particularly those slated for elimination and eradication. Although previous literature has emphasized the role of these populations' mobility, the full range of factors influencing health service utilization has not been examined systematically. We systematically reviewed empirical literature on health services uptake among African nomadic pastoralists from seven online journal databases. Papers meeting inclusion criteria were reviewed using STROBE-and PRISMA-derived guidelines. Study characteristics were summarized quantitatively, and 10 key themes were identified through inductive qualitative coding. One-hundred two papers published between 1974-2019 presenting data from 16 African countries met our inclusion criteria. Among the indicators of study-reporting quality, limitations (37%) and data analysis were most frequently omitted (18%). We identified supply-and demandside influences on health services uptake that related to geographic access (79%); service quality (90%); disease-specific knowledge and awareness of health services (59%); patient costs (35%); contextual tailoring of interventions (75%); social structure and gender (50%); subjects' beliefs, behaviors, and attitudes (43%); political will (14%); social, political, and armed conflict (30%); and community agency (10%). A range of context-specific factors beyond distance to facilities or population mobility affects health service uptake. Approaches tailored to the nomadic pastoralist lifeway, e.g., that integrated human and veterinary health service delivery (a.k.a., "One Health") and initiatives that engaged communities in program design to address social structures were especially promising. Better causal PLOS NEGLECTED TROPICAL DISEASES

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“…The utilization of ANC services by rural area women during pregnancy is constrained by different problems [ 4 ]. A cross-sectional study from Nigeria showed that the national average of ANC utilization rate is 61%, of which 81% of them had ≥4 visits [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors affecting the utilization of antenatal care in rural areas of Southwestern Ethiopia

Belay

Astatkie

Abebaw

et al. 2022

BMC Pregnancy Childbirth

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Background Antenatal care (ANC) is a health care intervention intended to ensure the safety of pregnancy. According to the World Health Organization, at least four ANC visits are recommended for a healthy pregnancy. However, whether this recommended number of visits was followed or not in the rural areas of Southwestern Ethiopia is not known. Therefore, the study aimed to investigate the prevalence of, and the associated factors of ANC utilization by pregnant women in the rural areas of Southwestern Ethiopia. Methods A community-based cross-sectional study design was used in three rural zones. The data were collected from n = 978 women through a structured questionnaire with face-to-face interview. The collected data were analyzed using descriptive statistics and a multiple binary logistic regression model. Results The results showed that 56% of women made the recommended minimum number of ANC visits and the remaining 44% of them underutilized the ANC service. The multiple binary logistic regression model identified zone, marital status of the woman, educational level of the husband, occupation of the husband, knowledge of danger signs of pregnancy, birth interval, source of information, timely visits, and transportation problem to be statistically significant factors affecting the prevalence of ANC visit utilization of women. Bench Maji zone had smaller odds ratio of ANC visit prevalence as compared to Kaffa zone. Women who lived in the rural area of Sheko zone are 2.67 times less likely to utilize ANC visit than those who lived in the rural area of Kaffa zone keeping other variables constant. Conclusion The study results highlight the need to increase the number of ANC visits, and the importance of using an appropriate model to determine the important socio-demographic factors that ANC service providers shall focus on to improve the health of the unborn baby and the mother during pregnancy.

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Why do rural women in the most remote and poorest areas of Zambia predominantly attend only one antenatal care visit with a skilled provider? A qualitative inquiry

Cited by 19 publications

References 34 publications

Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

Health services uptake among nomadic pastoralist populations in Africa: A systematic review of the literature

Prevalence and factors affecting the utilization of antenatal care in rural areas of Southwestern Ethiopia

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