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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�...

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Autores principales: Ahmed, Saifuddin, Creanga, Andreea A., Gillespie, Duff G., Tsui, Amy O.
Formato: Texto
Lenguaje:English
Publicado: Public Library of Science 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890410/
https://www.ncbi.nlm.nih.gov/pubmed/20585646
http://dx.doi.org/10.1371/journal.pone.0011190
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author Ahmed, Saifuddin
Creanga, Andreea A.
Gillespie, Duff G.
Tsui, Amy O.
author_facet Ahmed, Saifuddin
Creanga, Andreea A.
Gillespie, Duff G.
Tsui, Amy O.
author_sort Ahmed, Saifuddin
collection PubMed
description 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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spelling pubmed-28904102010-06-28 Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries Ahmed, Saifuddin Creanga, Andreea A. Gillespie, Duff G. Tsui, Amy O. PLoS One Research Article 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). Public Library of Science 2010-06-23 /pmc/articles/PMC2890410/ /pubmed/20585646 http://dx.doi.org/10.1371/journal.pone.0011190 Text en Ahmed et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Ahmed, Saifuddin
Creanga, Andreea A.
Gillespie, Duff G.
Tsui, Amy O.
Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries
title Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries
title_full Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries
title_fullStr Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries
title_full_unstemmed Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries
title_short Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries
title_sort economic status, education and empowerment: implications for maternal health service utilization in developing countries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890410/
https://www.ncbi.nlm.nih.gov/pubmed/20585646
http://dx.doi.org/10.1371/journal.pone.0011190
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