Cargando…

Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti

Proximity of households to comprehensive obstetric care is a key determinant for preventing maternal mortality due to obstetric emergencies. The relationship between proximity to comprehensive care and facility delivery is further complicated by the use of varied methods in measuring facility obstet...

Descripción completa

Detalles Bibliográficos
Autores principales: Amadi-Mgbenka, Chioma T., Borrell, Luisa N., Jones, Heidi E., Maroko, Andrew, Bolumar, Francisco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021570/
https://www.ncbi.nlm.nih.gov/pubmed/36962282
http://dx.doi.org/10.1371/journal.pgph.0000184
_version_ 1784908524163170304
author Amadi-Mgbenka, Chioma T.
Borrell, Luisa N.
Jones, Heidi E.
Maroko, Andrew
Bolumar, Francisco
author_facet Amadi-Mgbenka, Chioma T.
Borrell, Luisa N.
Jones, Heidi E.
Maroko, Andrew
Bolumar, Francisco
author_sort Amadi-Mgbenka, Chioma T.
collection PubMed
description Proximity of households to comprehensive obstetric care is a key determinant for preventing maternal mortality due to obstetric emergencies. The relationship between proximity to comprehensive care and facility delivery is further complicated by the use of varied methods in measuring facility obstetric capacity–which may misrepresent the real scenario of obstetric care availability in a service environment. We investigated the joint effects of proximity and two emergency obstetric care assessment (EmOC) methods on women’s place of delivery in Malawi and Haiti. Household level and health facility data were obtained from the 2013–2018 Demographic and Health Surveys and Service Provision Assessment surveys. Records of women aged 15 to 49 years who had a childbirth in the last 5 years were linked to obstetric facilities within 5km, 10km and 15km from their households using Kernel Density Estimation. Log-binomial models were fitted to estimate the joint effects of proximity to comprehensive facilities on place of delivery and two EmOC methods (1. the facility’s recent performance of signal functions only, and 2. a composite index of obstetric care), and whether this varied by urban/rural setting. Proximity to comprehensive facilities was significantly associated with facility delivery in Malawi among women living 5km of a comprehensive facility (using EmOC method 2), in addition, living further (15km) from facilities with high capacity of EmOC was associated with reduced likelihood for facility delivery in urban settings in stratified analyses. In contrast, positive associations were present in Haiti in both urban and rural settings, with the likelihood of facility delivery being higher with greater proximity of women to comprehensive facilities, regardless of methods to define EmOC. Women living within 5km of a comprehensive facility in Haiti were the most likely to deliver in facilities based on EmOC method 1 (APR: 1.81, 95% CI 1.56, 2.09). Findings from Malawi elucidates the relevance of context and suggests the need for research in diverse settings.
format Online
Article
Text
id pubmed-10021570
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-100215702023-03-17 Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti Amadi-Mgbenka, Chioma T. Borrell, Luisa N. Jones, Heidi E. Maroko, Andrew Bolumar, Francisco PLOS Glob Public Health Research Article Proximity of households to comprehensive obstetric care is a key determinant for preventing maternal mortality due to obstetric emergencies. The relationship between proximity to comprehensive care and facility delivery is further complicated by the use of varied methods in measuring facility obstetric capacity–which may misrepresent the real scenario of obstetric care availability in a service environment. We investigated the joint effects of proximity and two emergency obstetric care assessment (EmOC) methods on women’s place of delivery in Malawi and Haiti. Household level and health facility data were obtained from the 2013–2018 Demographic and Health Surveys and Service Provision Assessment surveys. Records of women aged 15 to 49 years who had a childbirth in the last 5 years were linked to obstetric facilities within 5km, 10km and 15km from their households using Kernel Density Estimation. Log-binomial models were fitted to estimate the joint effects of proximity to comprehensive facilities on place of delivery and two EmOC methods (1. the facility’s recent performance of signal functions only, and 2. a composite index of obstetric care), and whether this varied by urban/rural setting. Proximity to comprehensive facilities was significantly associated with facility delivery in Malawi among women living 5km of a comprehensive facility (using EmOC method 2), in addition, living further (15km) from facilities with high capacity of EmOC was associated with reduced likelihood for facility delivery in urban settings in stratified analyses. In contrast, positive associations were present in Haiti in both urban and rural settings, with the likelihood of facility delivery being higher with greater proximity of women to comprehensive facilities, regardless of methods to define EmOC. Women living within 5km of a comprehensive facility in Haiti were the most likely to deliver in facilities based on EmOC method 1 (APR: 1.81, 95% CI 1.56, 2.09). Findings from Malawi elucidates the relevance of context and suggests the need for research in diverse settings. Public Library of Science 2022-02-02 /pmc/articles/PMC10021570/ /pubmed/36962282 http://dx.doi.org/10.1371/journal.pgph.0000184 Text en https://creativecommons.org/publicdomain/zero/1.0/This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Amadi-Mgbenka, Chioma T.
Borrell, Luisa N.
Jones, Heidi E.
Maroko, Andrew
Bolumar, Francisco
Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti
title Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti
title_full Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti
title_fullStr Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti
title_full_unstemmed Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti
title_short Effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in Malawi and Haiti
title_sort effect of emergency obstetric care and proximity to comprehensive facilities on facility-based delivery in malawi and haiti
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021570/
https://www.ncbi.nlm.nih.gov/pubmed/36962282
http://dx.doi.org/10.1371/journal.pgph.0000184
work_keys_str_mv AT amadimgbenkachiomat effectofemergencyobstetriccareandproximitytocomprehensivefacilitiesonfacilitybaseddeliveryinmalawiandhaiti
AT borrellluisan effectofemergencyobstetriccareandproximitytocomprehensivefacilitiesonfacilitybaseddeliveryinmalawiandhaiti
AT jonesheidie effectofemergencyobstetriccareandproximitytocomprehensivefacilitiesonfacilitybaseddeliveryinmalawiandhaiti
AT marokoandrew effectofemergencyobstetriccareandproximitytocomprehensivefacilitiesonfacilitybaseddeliveryinmalawiandhaiti
AT bolumarfrancisco effectofemergencyobstetriccareandproximitytocomprehensivefacilitiesonfacilitybaseddeliveryinmalawiandhaiti