Determinants of continued maternal care seeking during pregnancy, birth and postnatal and associated neonatal survival outcomes in Kenya and Uganda : analysis of cross-sectional, demographic and health surveys data
Arunda, Malachi Ochieng LU ; Agardh, Anette LU
and Asamoah, Benedict Oppong
LU
(2021)
In BMJ Open
11(12).
p.1-16
- Abstract
OBJECTIVES: To examine how maternal and sociodemographic factors determine continued care-seeking behaviour from pregnancy to postnatal period in Kenya and Uganda and to determine associated neonatal survival outcomes.
DESIGN: A population-based analysis of cross-sectional data using multinomial and binary logistic regressions.
SETTING: Countrywide, Kenya and Uganda.
PARTICIPANTS: Most recent live births of 24 502 mothers within 1-59 months prior to the 2014-2016 Demographic and Health Surveys.
OUTCOMES: Care-seeking continuum and neonatal mortality.
RESULTS: Overall, 57% of the mothers had four or more antenatal care (ANC) contacts, of which 73% and 41% had facility births and postnatal care (PNC),... (More)
OBJECTIVES: To examine how maternal and sociodemographic factors determine continued care-seeking behaviour from pregnancy to postnatal period in Kenya and Uganda and to determine associated neonatal survival outcomes.
DESIGN: A population-based analysis of cross-sectional data using multinomial and binary logistic regressions.
SETTING: Countrywide, Kenya and Uganda.
PARTICIPANTS: Most recent live births of 24 502 mothers within 1-59 months prior to the 2014-2016 Demographic and Health Surveys.
OUTCOMES: Care-seeking continuum and neonatal mortality.
RESULTS: Overall, 57% of the mothers had four or more antenatal care (ANC) contacts, of which 73% and 41% had facility births and postnatal care (PNC), respectively. Maternal/paternal education versus no education was associated with continued care seeking in majority of care-seeking classes; relative risk ratios (RRRs) ranged from 2.1 to 8.0 (95% CI 1.1 to 16.3). Similarly, exposure to mass media was generally associated with continued care seekin; RRRs ranged from 1.8 to 3.2 (95% CI 1.2 to 5.4). Care-seeking tendency reduced if a husband made major maternal care-seeking decisions. Transportation problems and living in rural versus urban were largely associated with lower continued care use; RRR ranged from 0.4 to 0.7 (95% CI 0.3 to 0.9). The two lowest care-seeking categories with no ANC and no PNC indicated the highest odds for neonatal mortality (adjusted OR 4.2, 95% CI 1.6 to 10.9). 23% neonatal deaths were attributable to inadequate maternal care attendance.
CONCLUSION: Strategies such as mobile health specifically for promoting continued maternal care use up to postnatal could be integrated in the existing structures. Another strategy would be to develop and employ a brief standard questionnaire to determine a mother's continued care-seeking level during the first ANC visit and to use the information to close the care-seeking gaps. Strengthening the community health workers system to be an integral part of promoting continued care seeking could enhance care seeking as a stand-alone strategy or as a component of aforementioned suggested strategies.
(Less)
- author
- Arunda, Malachi Ochieng
LU
; Agardh, Anette
LU
and Asamoah, Benedict Oppong
LU
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- BMJ Open
- volume
- 11
- issue
- 12
- article number
- e054136
- pages
- 1 - 16
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:34903549
- scopus:85122123398
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2021-054136
- language
- English
- LU publication?
- yes
- additional info
- © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
- id
- e0bf8850-f1b9-4a98-a7cf-9a45fbd1985d
- date added to LUP
- 2022-02-03 14:25:55
- date last changed
- 2024-06-20 14:49:58
@article{e0bf8850-f1b9-4a98-a7cf-9a45fbd1985d,
abstract = {{<p>OBJECTIVES: To examine how maternal and sociodemographic factors determine continued care-seeking behaviour from pregnancy to postnatal period in Kenya and Uganda and to determine associated neonatal survival outcomes.</p><p>DESIGN: A population-based analysis of cross-sectional data using multinomial and binary logistic regressions.</p><p>SETTING: Countrywide, Kenya and Uganda.</p><p>PARTICIPANTS: Most recent live births of 24 502 mothers within 1-59 months prior to the 2014-2016 Demographic and Health Surveys.</p><p>OUTCOMES: Care-seeking continuum and neonatal mortality.</p><p>RESULTS: Overall, 57% of the mothers had four or more antenatal care (ANC) contacts, of which 73% and 41% had facility births and postnatal care (PNC), respectively. Maternal/paternal education versus no education was associated with continued care seeking in majority of care-seeking classes; relative risk ratios (RRRs) ranged from 2.1 to 8.0 (95% CI 1.1 to 16.3). Similarly, exposure to mass media was generally associated with continued care seekin; RRRs ranged from 1.8 to 3.2 (95% CI 1.2 to 5.4). Care-seeking tendency reduced if a husband made major maternal care-seeking decisions. Transportation problems and living in rural versus urban were largely associated with lower continued care use; RRR ranged from 0.4 to 0.7 (95% CI 0.3 to 0.9). The two lowest care-seeking categories with no ANC and no PNC indicated the highest odds for neonatal mortality (adjusted OR 4.2, 95% CI 1.6 to 10.9). 23% neonatal deaths were attributable to inadequate maternal care attendance.</p><p>CONCLUSION: Strategies such as mobile health specifically for promoting continued maternal care use up to postnatal could be integrated in the existing structures. Another strategy would be to develop and employ a brief standard questionnaire to determine a mother's continued care-seeking level during the first ANC visit and to use the information to close the care-seeking gaps. Strengthening the community health workers system to be an integral part of promoting continued care seeking could enhance care seeking as a stand-alone strategy or as a component of aforementioned suggested strategies.</p>}},
author = {{Arunda, Malachi Ochieng and Agardh, Anette and Asamoah, Benedict Oppong}},
issn = {{2044-6055}},
language = {{eng}},
number = {{12}},
pages = {{1--16}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Open}},
title = {{Determinants of continued maternal care seeking during pregnancy, birth and postnatal and associated neonatal survival outcomes in Kenya and Uganda : analysis of cross-sectional, demographic and health surveys data}},
url = {{http://dx.doi.org/10.1136/bmjopen-2021-054136}},
doi = {{10.1136/bmjopen-2021-054136}},
volume = {{11}},
year = {{2021}},
}