Antenatal care booked rural residence women have home delivery during the era of COVID-19 pandemic in Gidan District, Ethiopia
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ABSTRACT:
SUBMITTER: Asmamaw D
PROVIDER: S-EPMC10697573 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:IntroductionAntenatal care (ANC), health facility birth and postnatal care services are proved to reduce maternal and newborn morbidity and mortality. In Ethiopia, even though antenatal care coverage is good, still home birth is high. This study aimed to assess the prevalence and determinants of home birth among women who were booked for ANC in public hospitals in Wolaita zone, southern Ethiopia.MethodsA cohort study was conducted from February to May 2017 among 554 third trimester pregnant mothers who visited public hospitals of Wolaita Zone, southern Ethiopia for ANC service. All women were interviewed twice: the first interview was done face-to-face in the health facility in which they were having ANC follow up to gather information about basic socio-demographic and obstetric characteristics; the second interview was done via telephone after they gave birth to get information about the place of birth. Epi-Data version 3.1 was used for data entry and the Statistical Package for the Social Sciences (SPSS) version 22 was used for data analysis.ResultsA total of 68 (13.5%; 95% Confidence Interval (CI): 10.5%-16.6%) women who were booked for ANC gave birth at home. Being uneducated (AOR = 2.46, 95% CI: [1.10-5.10]), starting ANC visit late (>16weeks) (AOR = 2.27, 95% CI: [1.14-4.50]), time taken to reach at health facility for ANC service (>30minutes) (AOR = 8.94, 95% CI: [4.50-17.72]), waiting time of greater than 30 minutes for ANC in health facilities (AOR = 1.18, 95% CI: [1.06-2.30]) and lack of knowledge about danger signs of pregnancy (AOR = 4.18, 95%CI: [1.80-9.70]) were significantly associated with home birth.ConclusionsHome birth among ANC booked women is low compared to other studies. Yet, giving attention to women with no education and those coming from far areas while providing advice on birth preparedness and pregnancy danger signs may be useful to further reduce the rate of home birth. Advising mothers to start ANC early and trying to reduce ANC waiting time could also be of importance.
| S-EPMC6128615 | biostudies-literature
Project description:BackgroundThe uptake of maternal healthcare services remains suboptimal in Ethiopia. Significant proportions of antenatal care attendees give birth at home in the context of HIV. However, in Ethiopia, evidence is scarce on the predictors of dropout from maternity continuum of care among HIV-positive mothers. Therefore, this study aimed to supply valuable information on risk factors regarding dropout of HIV-positive mothers for institutional delivery services in northwest Ethiopia.MethodsA multicenter case-control study was conducted at governmental health facilities in Gondar City from May one to June 30/2018. A total of 222 HIV-positive women were included in the study. Data were collected using structured questionnaires and checklists through face-to-face interview and chart review; entered into EPI INFO version seven, and then exported to SPSS version 25. Both descriptive and analytical procedures were performed. Binary logistic regression analysis was undertaken. A significant association was declared based on the adjusted odds ratio (AOR) with its 95% CI and p-value of ≤ 0.05.ResultsThis study illustrates that maternal age of ≥ 35 years (AOR = 2.37; 95%CI: 1.13,5.13), unmarried marital relation (AOR = 3.28; 95%CI: 1.51, 7.13), unemployed spousal occupation (AOR = 3.91; 95%CI: 1.54, 9.91), family monthly income of ≤ 36 US dollar (AOR = 4.87; 95%CI: 2.08, 11.42) and no obstetric complication in the index pregnancy (AOR = 13.89; 95%CI: 2.73, 27.71) were positively associated with dropout from institutional delivery among HIV positive antenatal care booked mothers.ConclusionIn this study, the risk factors of dropout from institutional delivery in the context of HIV-positive women were connected to social determinants of health such as advanced maternal age, unmarried marital status, unemployed husband occupation, and low family income. Therefore, interacting with the health system by focusing on these women in lower socio-economic strata and unmarried HIV-positive ANC attendees, and increasing access to information on obstetric complications during the antenatal care visit would retain clients in the continuum of maternity services.
| S-EPMC8876812 | biostudies-literature
Project description:BackgroundThe Sustainable Development Goal Three has prioritised reducing maternal, under-5 and neonatal mortalities as core global health policy objectives. The place, where expectant mothers choose to deliver their babies has a direct effect on maternal health outcomes. In sub-Saharan Africa, existing literature has shown that some women attend antenatal care during pregnancy but choose to deliver their babies at home. Using the Andersen and Newman Behavioural Model, this study explored the institutional and socio-cultural factors motivating women to deliver at home after attending antenatal care.MethodsA qualitative, exploratory, cross-sectional design was deployed. Data were collected from a purposive sample of 23 women, who attended antenatal care during pregnancy but delivered their babies at home, 10 health workers and 17 other community-level stakeholders. The data were collected through semi-structured interviews, which were audio-recorded, transcribed and thematically analysed.ResultsIn line with the Andersen and Newman Model, the study discovered that traditional and religious belief systems about marital fidelity and the role of the gods in childbirth, myths about consequences of facility-based delivery, illiteracy, and weak women's autonomy in healthcare decision-making, predisposed women to home delivery. Home delivery was also enabled by inadequate midwives at health facilities, the unfriendly attitude of health workers, hidden charges for facility-based delivery, and long distances to healthcare facilities. The fear of caesarean section, also created the need for women who attended antenatal care to deliver at home.ConclusionThe study has established that socio-cultural and institutional level factors influenced women's decisions to deliver at home. We recommend a general improvement in the service delivery capacity of health facilities, and the implementation of collaborative educational and women empowerment programmes by stakeholders, to strengthen women's autonomy and reshape existing traditional and religious beliefs facilitating home delivery.
| S-EPMC8675692 | biostudies-literature
Project description:BackgroundDespite the current sustainable development goal period (i.e. SDG 3), the prevention of maternal and neonatal mortality is not satisfactory in Ethiopia. Keeping women knowledgeable about antenatal care and maintaining a positive attitude towards its uptake, particularly in the marginalized rural community is crucial. However, evidence regarding the knowledge and attitude of women towards antenatal care uptake is scarce. Therefore, this study aimed to assess factors affecting comprehensive knowledge of antenatal care and attitude towards its uptake among women delivered at home in rural Sehala Seyemit district, northern Ethiopia.MethodsA community-based cross-sectional study was conducted from September 1st to October 15th, 2020. A multi-stage sampling technique was used to select 653 women. The data were collected using a semi-structured interview guide. Data were entered into EPI INFO 7.1.2 and analyzed by SPSS version 25. Both bivariable and multivariable logistic regression analyses were undertaken to identify factors associated with women's knowledge of antenatal care and attitude towards its uptake. The level of significant association in the multivariable analysis was determined based on a p-value of < 0.05.ResultsWomen's knowledge of antenatal care and positive attitude towards its uptake was 56.5% and 75.2%, respectively. Older age (AOR = 7.2; 95% CI: 3.43, 15.1), media exposure (AOR = 3.69; 95% CI: 2.41, 5.65), history of abortion (AOR = 11.6; 95% CI: 3.3, 14.6), time to reach health facility (AOR = 4.58; 95% CI: 3.05, 6.88), and history of obstetric danger signs (AOR = 7.3; 95% CI: 3.92, 13.64) were factors significantly associated with knowledge of antenatal care. Furthermore, higher decision-making power (AOR = 8.3; 95% CI: 4.8, 13.83), adequate knowledge of antenatal care (AOR = 2.2; 95% CI: 1.26, 3.71), delivery attended by health extension workers (AOR = 2.3; 95% CI: 1.1, 5.1), and media exposure (AOR = 2.27; 95% CI: 1.30, 3.97) were predictors of a favorable attitude towards antenatal care utilization.ConclusionAlthough the majority of women in the present study had a favorable attitude towards antenatal care uptake, their knowledge level was inadequate. Strengthening access to transportation, mass media, involvement in household decision-making, and encouraging women to deliver at a health facility by a skilled provider may increase women's knowledge and attitude towards antenatal care uptake, thereby improving maternal healthcare service uptake.
| S-EPMC9555639 | biostudies-literature
Project description:Remote areas are often characterized by lower welfare outcomes due to economic disadvantages and higher transaction costs for trade. But their poorer situation may also be linked to worse public service delivery. Relying on large household surveys in rural Ethiopia, we explore this by assessing the association of two measures of remoteness - (1) the distance of service centers to district capitals and (2) the distance of households to service centers (the last mile) - with public service delivery in agriculture and health sectors. In the agriculture sector, we document statistically significant and economically meaningful associations between exposure to agriculture extension and the two measures of remoteness. For health extension, only the last mile matters. These differences between the two sectors could be due to the fact that more remote villages tend to have fewer agriculture extension workers who also put in fewer hours than their peers in more connected areas. This does not apply in the health sector. These findings provide valuable inputs for policymakers aiming to improve inclusiveness in poor rural areas.
| S-EPMC7511693 | biostudies-literature
Project description:BackgroundAttending antenatal care (ANC) early contribute to better birth outcomes. Studies have shown that many pregnant women in Sub-Saharan Africa do not initiate ANC early (i.e. in the first trimester). This study determined the gestational age of pregnancy at first ANC attendance. It also explored factors that influence initiation of ANC.MethodsThis cross-sectional study, conducted in Ghana, used mixed methods to collect data from women aged 15-45 years who delivered 6 months prior to the study. Crosstabs, chi-square test and logistic regression were used to analyse quantitative data. Also, 33 participants were engaged in focus group discussions (FGDs). Thematic content analysis was used to develop themes from the data.ResultsOf the 431 participants, 8.9, 8, 25.4, 45.3 and 10.7% started ANC in the first, second, third, fourth and fifth months of pregnancy respectively. Formal education, employment and number of living children were predictors of initiating ANC early; by 12 weeks of gestation. Women who attained primary, junior high, secondary education and above had 5.6, 57.5 and 163.2 higher odds respectively of initiating ANC in the first trimester compared to women with no education (p ≤ 0.05). Women with two, three and four to nine living children were 4.1, 3 and 3.5 times respectively more likely to access ANC early compared to primigravidae women. However, women with five or more children and primigravidae women are more likely to initiate ANC late; after 12 weeks gestation. The FGD data also show that most of the participants initiated ANC late. Two themes: visible signs of pregnancy and or sickness influence ANC attendance in the first trimester. The themes that explain late initiation of ANC are: healthy, do not value the benefits of early ANC attendance, desire to avoid embarrassment associated with the pregnancy, unplanned pregnancy, indirect cost of accessing ANC and traditional rites and practices.ConclusionContextual factors influence ANC initiation. Investment in female education, intensification of health promotion activities by health workers, non-governmental organisations, community and religious leaders to sensitise communities on the benefits of initiating ANC at the onset of pregnancy is needed to improve first trimester attendance.
| S-EPMC6693094 | biostudies-literature
Project description:BackgroundInstitutional delivery is one of the key interventions to reduce maternal death. It ensures safe birth, reduces both actual and potential complications, and decreases maternal and newborn death. However, a significant proportion of deliveries in developing countries like Ethiopia are home deliveries and are not attended by skilled birth attendants. We investigated the prevalence and determinants of home delivery in three districts in Sidama administration, Southern Ethiopia.MethodsBetween 15-29 October 2018, a cross sectional survey of 507 women who gave birth within the past 12 months was conducted using multi-stage sampling. Sociodemographic and childbirth related data were collected using structured, interviewer administered tools. Univariate and backward stepwise multivariate logistic regression models were run to assess independent predictors of home delivery.ResultsThe response rate was 97.6% (495). In the past year, 22.8% (113), 95% confidence interval (CI) (19%, 27%) gave birth at home. Rural residence, adjusted odds ratio (aOR) = 13.68 (95%CI:4.29-43.68); no maternal education, aOR = 20.73(95%CI:6.56-65.54) or completed only elementary school, aOR = 7.62(95% CI: 2.58-22.51); unknown expected date of delivery, aOR = 1.81(95% CI: 1.03-3.18); being employed women (those working for wage and self-employed), aOR = 2.79 (95%CI:1.41-5.52) and not planning place of delivery, aOR = 26.27, (95%CI: 2.59-266.89) were independently associated with place of delivery.ConclusionThe prevalence of institutional delivery in the study area has improved from the 2016 Ethiopian Demography Health Survey report of 26%. Uneducated, rural and employed women were more likely to deliver at home. Strategies should be designed to expand access to and utilization of institutional delivery services among the risky groups.
| S-EPMC8351986 | biostudies-literature
Project description:BackgroundApproximately 80% of people in Ethiopia live in rural areas, where poor access to maternity services, accounts for the majority of maternal and perinatal deaths. Maternity waiting homes are residential facilities for women who come from remote areas to stay and wait before giving birth at health facilities, particularly in hospitals and health centers. It is a new initiative and one of the strategies that increase skilled care utilization at birth. However, there is no evidence on the status of maternity waiting home utilization in the study area. Therefore, this study aimed to generate evidence on the status of maternity waiting home utilization and its associated factors.MethodsA community-based cross-sectional household survey was conducted from June 5-30, 2022. The sample size was calculated using the single population proportion formula, which resulted in 354 participants. The study population included mothers who gave birth within 12 months before the survey were selected by using a systematic sampling method. The data were coded, edited, cleaned, and entered into Epi Data version 3.1. The data were subsequently exported to SPSS version 25 for analysis. Descriptive, bivariable, and multivariable binary logistic regression analyses were performed. The results are presented in the text, figures, and tables. Finally, variables with a p value < 0.05 in the multivariable analysis were reported as significantly associated with the independent variables and outcome variable.ResultsThe magnitude of maternity waiting home utilization was 36.4% (95% CI = 31.4, 41.8). Being knowledgeable about the presence of maternity waiting home (AOR = 3.9; 95% CI: 1.0-15.2), being able to afford transportation (AOR = 2.4; 95% CI: 1.01-5.9), being home delivery (AOR = 0.007; 95% CI: 0.002-0.031) and being acess to transportation services (AOR = 3.0; 95% CI: 1.2-7.5) were significantly associated with maternity waiting home utilization.ConclusionThe magnitude of maternity waiting home utilization in the study area was found to be low. Access to and affordability of transportation services, being knowledgeable and being home delivery were associated factors for the use of maternity waiting homes. Therefore, increasing maternal knowledge, economically empowering women and respecting care while waiting at maternity homes are important for improving the utilization of maternity waiting homes.
| S-EPMC11468051 | biostudies-literature
Project description:Despite the increasing global concern of improving food security, the determinants of food insecurity at household level in the rural areas have been poorly known. Therefore, the aim of this study was to analyze determinants of food insecurity at household level. A total of 383 households were selected using multistage sampling techniques. The logistic regression model was used to analyze the data. The result revealed that odds of illiterate households were 2.376 times more likely than educated households to experience food insecurity in the rural areas (ref. (Coef. = 0.865, OR = 2.376, P = 0.006)). Households with landholdings of more than half hectare were less likely to experience food insecurity. (ref. (Coef. = 1.982, OR = 7.260, P = 0.000)). Odds of households who engaged in off-farm activities were 0.204 times less likely to experience food insecurity. (ref. (Coef. = -1.588, OR = 0.204, P = 0.000)). Households who adopt farm technologies were less likely to experience food insecurity than those who do not adopt farm technology (ref. (Coef. = -1.086, OR = 0.337, P = 0.001)). Odds of higher-aged household heads were 6.141 times more likely to experience food insecurity than younger-aged household heads (ref. (Coef. = 1.815, OR = 6.141, P = 0.000)). Larger household sizes were less likely to experience food insecurity (ref. (Coef. = -2.423, OR = 0.089, P = 0.000)). In conclusion, understanding determinants of food insecurity at household level is essential to achieve food security in rural areas. Results suggest implementation of the effective developmental programs are needed to reduce food insecurity in rural areas.
| S-EPMC9849972 | biostudies-literature
Project description:ObjectivesUptake of maternal health services remains suboptimal in Ethiopia. Significant proportions of antenatal care attendees give birth at home. This study was conducted to identify the predictors of non-institutional delivery among women who received antenatal care in the Southern Nations Nationalities and Peoples Region, Ethiopia.DesignA community-based cross-sectional survey was conducted among women who delivered in the year preceding the survey and who had at least one antenatal visit. Multistage cluster sampling was deployed to select 2390 women from all administrative zones of the region. A mixed-effects multivariable logistic regression analysis was performed to assess the predictors of non-institutional delivery; adjusted ORs (AOR) with 95% CIs are reported.ResultsThe proportion of non-institutional deliveries among participants was 62.2% (95% CI 60.2% to 64.2%). Previous experience of short and simple labour (46.9%) and uncomplicated home birth (42.9%), night-time labour (29.7%), absence of pregnancy-related problem (18.8%) and perceived providers poor reception of women (17.8%) were the main reasons to have non-institutional delivery. Attending secondary school and above (AOR=0.51; 95% CI 0.30 to 0.85), being a government employee (AOR=0.27; 95% CI 0.10 to 0.78) and woman's autonomy in healthcare utilisation decision making (AOR=0.51; 95% CI 0.33 to 0.79) were among the independent predictors negatively associated with non-institutional delivery. On the other hand, unplanned pregnancy (AOR=1.67; 95% CI 1.16 to 2.42), not experiencing any health problem during pregnancy (AOR=8.1; 95% CI 3.12 to 24.62), not perceiving the risks associated with home delivery (AOR=6.64; 95% CI 4.35 to 10.14) were the independent predictors positively associated with non-institutional delivery.ConclusionsThere is a missed opportunity among women attending antenatal care in southern Ethiopia. Further health system innovations that help to bridge the gap between antenatal care attendance and institutional delivery are highly recommended.
| S-EPMC6527994 | biostudies-literature