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      Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data

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          Abstract

          Background

          Globally, maternal health remains a major priority. Most of maternal deaths globally occur in sub-Saharan Africa, with most of these deaths linked to lack of access to antenatal care and skilled assistance during delivery. This study assessed the determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea.

          Methods

          Data for this study were obtained from the 2018 Guinea Demographic and Health Survey (GDHS). Data of 4,917 childbearing women were considered as our analytical sample. The outcome variables for the study were utilization of antenatal care and skilled birth attendance. Analysis was carried out using chi-square tests and multivariable logistic regression.

          Results

          The results showed that women aged 15-24 (AOR=1.29, CI=1.03-1.62), women who had secondary/higher level of education (AOR=1.70, CI=1.33-2.19), and those whose partners had secondary/higher level of education (AOR=1.46, CI=1.22-1.75), women in the richest wealth quintile (AOR=5.09, CI=3.70-7.00), those with planned pregnancies (AOR=1.50, CI=1.23-1.81), Muslim women (AOR=1.65, CI=1.38-2.12), those who take healthcare decisions alone (AOR=1.53, CI=1.24-1.89), and those who listened to radio less than once a week (AOR= 1.30, CI=1.10-1.53) had higher odds of antenatal care uptake. Also, women with secondary/higher level of education (AOR=1.83, CI=1.25-2.68), those whose partners had secondary/higher level of education (AOR=1.40, CI=1.11-1.76), those in the richest wealth quintile (AOR=10.79, CI=6.64-17.51), those with planned pregnancies (AOR=1.25, CI=1.03-1.52), Christian women (AOR=4.13, CI=3.17-5.39), those living in urban areas (AOR=3.00, CI=2.29-3.94), women with one birth (AOR= 1.58, CI=1.20-2.06), those who take healthcare decisions alone (AOR=1.87, CI=1.46-2.39), those who read newspaper at least once a week (AOR= 1.19, CI=1.01-1.40), those who watched television at least once week (AOR=1.69, CI=1.30-2.19), and those in female-headed households (AOR=1.52, CI=1.20-1.92) were more likely to utilize the services of skilled birth attendants.

          Conclusion

          The study proved that various socio-economic and contextual factors influence antenatal care and skilled birth attendance in Guinea. These findings suggest the need to design community-based interventions (e.g., miniature local ANC clinics, early screening services) that prioritize women’s education and vocational training, media accessibility, especially among the poor, and those residing in rural settings. Such interventions should not ignore the influence of other socio-cultural norms that hinder the utilization of antenatal care and skilled birth attendance services in Guinea.

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          Most cited references27

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          Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries

          Background Relative to the attention given to improving the quality of and access to maternal health services, the influence of women's socio-economic situation on maternal health care use has received scant attention. The objective of this paper is to examine the relationship between women's economic, educational and empowerment status, introduced as the 3Es, and maternal health service utilization in developing countries. Methods/Principal Findings The analysis uses data from the most recent Demographic and Health Surveys conducted in 31 countries for which data on all the 3Es are available. Separate logistic regression models are fitted for modern contraceptive use, antenatal care and skilled birth attendance in relation to the three covariates of interest: economic, education and empowerment status, additionally controlling for women's age and residence. We use meta-analysis techniques to combine and summarize results from multiple countries. The 3Es are significantly associated with utilization of maternal health services. The odds of having a skilled attendant at delivery for women in the poorest wealth quintile are 94% lower than that for women in the highest wealth quintile and almost 5 times higher for women with complete primary education relative to those less educated. The likelihood of using modern contraception and attending four or more antenatal care visits are 2.01 and 2.89 times, respectively, higher for women with complete primary education than for those less educated. Women with the highest empowerment score are between 1.31 and 1.82 times more likely than those with a null empowerment score to use modern contraception, attend four or more antenatal care visits and have a skilled attendant at birth. Conclusions/Significance Efforts to expand maternal health service utilization can be accelerated by parallel investments in programs aimed at poverty eradication (MDG 1), universal primary education (MDG 2), and women's empowerment (MDG 3).
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            Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: A cross-sectional analysis

            Background There has been an increasing availability and accessibility of modern health services in rural Bangladesh over the past decades. However, previous studies on the socioeconomic differentials in the utilization of these services were based on a limited number of factors, focusing either on preventive or on curative modern health services. These studies failed to collect data from remote rural areas of the different regions to examine the socioeconomic differentials in health-seeking behavior. Methods Data from 3,498 randomly selected currently married women from three strata of households within 128 purposively chosen remote villages in three divisions of Bangladesh were collected in 2006. This study used bivariate and multivariate logistic analyses to examine both curative and preventive health-seeking behaviors in seven areas of maternal and child health care: antenatal care, postnatal care, child delivery care, mother's receipt of Vitamin A postpartum, newborn baby care, care during recent child fever/cough episodes, and maternal coverageby tetanus toxoid (TT). Results A principal finding was that a household's relative poverty status, as reflected by wealth quintiles, was a major determinant in health-seeking behavior. Mothers in the highest wealth quintile were significantly more likely to use modern trained providers for antenatal care, birth attendance, post natal care and child health care than those in the poorest quintile (χ2, p < 0.01). The differentials were less pronounced for other factors examined, such as education, age, and the relative decision-making power of a woman, in both bivariate and multivariate analyses. Conclusion Within rural areas of Bangladesh, where overall poverty is greater and access to health care more difficult, wealth differentials in utilization remain pronounced. Those programs with high international visibility and dedicated funding (e.g., Immunization and Vitamin A delivery) have higher overall prevalence and a more equitable distribution of beneficiaries than the use of modern trained providers for basic essential health care services. Implications of these findings and recommendations are provided.
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              Overcoming barriers to health service access: influencing the demand side.

              T Ensor (2004)
              Evidence suggests that demand-side barriers may be as important as supply factors in deterring patients from obtaining treatment. Yet relatively little attention is given, either by policy makers or researchers, to ways of minimizing their effect. These barriers are likely to be more important for the poor and other vulnerable groups, where the costs of access, lack of information and cultural barriers impede them from benefiting from public spending. Demand barriers present in low- and middle-income countries and evidence on the effectiveness of interventions to overcome these obstacles are reviewed. Demand barriers are also shown to be important in richer countries, particularly among vulnerable groups. This suggests that while barriers are plentiful, there is a dearth of evidence on ways to reduce them. Where evidence does exist, the data and methodology for evaluating effectiveness and cost-effectiveness is insufficient. An increased focus on obtaining robust evidence on effective interventions could yield high returns. The likely nature of the interventions means that pragmatic policy routes that go beyond the traditional boundaries of the public health sector are required for implementing the findings.
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                Author and article information

                Contributors
                brightahinkorah@gmail.com
                abdul-aziz.seidu@stu.ucc.edu.gh
                ebengola@gmail.com
                collinsadu80@yahoo.com
                budueugene@gmail.com
                elvis.hagan@ucc.edu.gh
                Thomas.schack@uni-bielefeld.de
                sanni.yaya@uOttawa.ca
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                3 January 2021
                3 January 2021
                2021
                : 21
                : 2
                Affiliations
                [1 ]GRID grid.117476.2, ISNI 0000 0004 1936 7611, School of Public Health, Faculty of Health, , University of Technology Sydney, ; Ultimo, Australia
                [2 ]GRID grid.413081.f, ISNI 0000 0001 2322 8567, Department of Population and Health, , University of Cape Coast, ; Cape Coast, Ghana
                [3 ]GRID grid.413081.f, ISNI 0000 0001 2322 8567, Department of English, , University of Cape Coast, ; Cape Coast, Ghana
                [4 ]GRID grid.9829.a, ISNI 0000000109466120, Department of Health Promotion and Disability Studies, , Kwame Nkrumah University of Science and Technology, ; Kumasi, Ghana
                [5 ]GRID grid.413081.f, ISNI 0000 0001 2322 8567, Department of Health, Physical Education, and Recreation, , University of Cape Coast, ; Cape Coast, Ghana
                [6 ]GRID grid.7491.b, ISNI 0000 0001 0944 9128, Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sport Sciences, , Bielefeld University, ; Bielefeld, Germany
                [7 ]GRID grid.28046.38, ISNI 0000 0001 2182 2255, School of International Development and Global Studies, , University of Ottawa, ; Ottawa, Canada
                [8 ]GRID grid.4991.5, ISNI 0000 0004 1936 8948, The George Institute for Global Health, , The University of Oxford, ; Oxford, United Kingdom
                Article
                3489
                10.1186/s12884-020-03489-4
                7778812
                33390164
                911a3744-29db-4c19-b155-60155911df87
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 27 May 2020
                : 10 December 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Obstetrics & Gynecology
                antenatal care,skilled birth attendance,guinea,public health,global health
                Obstetrics & Gynecology
                antenatal care, skilled birth attendance, guinea, public health, global health

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