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Barriers to Utilization of Antenatal Care Services in Eastern Nepal

BACKGROUND: World Health Organization recommends at least four pregnancy check-ups for normal pregnancies. Ministry of Health and Population Nepal has introduced various strategies to promote prenatal care and institutional delivery to reduce maternal and child deaths. However, maternal health servi...

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Autores principales: Deo, Krishna Kumar, Paudel, Yuba Raj, Khatri, Resham Bahadur, Bhaskar, Ravi Kumar, Paudel, Rajan, Mehata, Suresh, Wagle, Rajendra Raj
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536371/
https://www.ncbi.nlm.nih.gov/pubmed/26322302
http://dx.doi.org/10.3389/fpubh.2015.00197
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author Deo, Krishna Kumar
Paudel, Yuba Raj
Khatri, Resham Bahadur
Bhaskar, Ravi Kumar
Paudel, Rajan
Mehata, Suresh
Wagle, Rajendra Raj
author_facet Deo, Krishna Kumar
Paudel, Yuba Raj
Khatri, Resham Bahadur
Bhaskar, Ravi Kumar
Paudel, Rajan
Mehata, Suresh
Wagle, Rajendra Raj
author_sort Deo, Krishna Kumar
collection PubMed
description BACKGROUND: World Health Organization recommends at least four pregnancy check-ups for normal pregnancies. Ministry of Health and Population Nepal has introduced various strategies to promote prenatal care and institutional delivery to reduce maternal and child deaths. However, maternal health service utilization is low in some selected socio-economic and ethnic groups. Hence, this study aims to assess barriers to the recommended four antenatal care (4ANC) visits in eastern Nepal. METHODS: A cross-sectional quantitative study was conducted in Sunsari district. A total of 372 randomly selected women who delivered in the last year preceding the survey were interviewed using a semi-structured questionnaire. Bivariate and multivariate logistic regression analysis was carried out to identify barriers associated with 4ANC visits. RESULTS: More than two-third women (69%) attended at least 4ANC visits. The study revealed that women exposed to media had higher chance of receiving four or more ANC visits with an adjusted odds ratio (aOR = 3.5, 95% CI: 1.2–10.1) in comparison to women who did not. Women from an advantaged ethnic group had more chance of having 4ANC visits than respondents from a disadvantaged ethnic group (aOR = 2.4, 95% CI: 2.1–6.9). Similarly, women having a higher level of autonomy were nearly three times more likely (aOR = 2.9, 95% CI: 1.5–5.6) and richer women were twice (aOR = 2.3, 95% CI: 1.1–5.3) as likely to have at least 4ANC visits compared to women who had a lower level of autonomy and were economically poor. CONCLUSION: Being from disadvantaged ethnicity, lower women’s autonomy, poor knowledge of maternal health service and incentive upon completion of ANC, less media exposure related to maternal health service, and lower wealth rank were significantly associated with fewer than the recommended 4ANC visits. Thus, maternal health programs need to address such socio-cultural barriers for effective health care utilization.
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spelling pubmed-45363712015-08-28 Barriers to Utilization of Antenatal Care Services in Eastern Nepal Deo, Krishna Kumar Paudel, Yuba Raj Khatri, Resham Bahadur Bhaskar, Ravi Kumar Paudel, Rajan Mehata, Suresh Wagle, Rajendra Raj Front Public Health Public Health BACKGROUND: World Health Organization recommends at least four pregnancy check-ups for normal pregnancies. Ministry of Health and Population Nepal has introduced various strategies to promote prenatal care and institutional delivery to reduce maternal and child deaths. However, maternal health service utilization is low in some selected socio-economic and ethnic groups. Hence, this study aims to assess barriers to the recommended four antenatal care (4ANC) visits in eastern Nepal. METHODS: A cross-sectional quantitative study was conducted in Sunsari district. A total of 372 randomly selected women who delivered in the last year preceding the survey were interviewed using a semi-structured questionnaire. Bivariate and multivariate logistic regression analysis was carried out to identify barriers associated with 4ANC visits. RESULTS: More than two-third women (69%) attended at least 4ANC visits. The study revealed that women exposed to media had higher chance of receiving four or more ANC visits with an adjusted odds ratio (aOR = 3.5, 95% CI: 1.2–10.1) in comparison to women who did not. Women from an advantaged ethnic group had more chance of having 4ANC visits than respondents from a disadvantaged ethnic group (aOR = 2.4, 95% CI: 2.1–6.9). Similarly, women having a higher level of autonomy were nearly three times more likely (aOR = 2.9, 95% CI: 1.5–5.6) and richer women were twice (aOR = 2.3, 95% CI: 1.1–5.3) as likely to have at least 4ANC visits compared to women who had a lower level of autonomy and were economically poor. CONCLUSION: Being from disadvantaged ethnicity, lower women’s autonomy, poor knowledge of maternal health service and incentive upon completion of ANC, less media exposure related to maternal health service, and lower wealth rank were significantly associated with fewer than the recommended 4ANC visits. Thus, maternal health programs need to address such socio-cultural barriers for effective health care utilization. Frontiers Media S.A. 2015-08-14 /pmc/articles/PMC4536371/ /pubmed/26322302 http://dx.doi.org/10.3389/fpubh.2015.00197 Text en Copyright © 2015 Deo, Paudel, Khatri, Bhaskar, Paudel, Mehata and Wagle. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Public Health
Deo, Krishna Kumar
Paudel, Yuba Raj
Khatri, Resham Bahadur
Bhaskar, Ravi Kumar
Paudel, Rajan
Mehata, Suresh
Wagle, Rajendra Raj
Barriers to Utilization of Antenatal Care Services in Eastern Nepal
title Barriers to Utilization of Antenatal Care Services in Eastern Nepal
title_full Barriers to Utilization of Antenatal Care Services in Eastern Nepal
title_fullStr Barriers to Utilization of Antenatal Care Services in Eastern Nepal
title_full_unstemmed Barriers to Utilization of Antenatal Care Services in Eastern Nepal
title_short Barriers to Utilization of Antenatal Care Services in Eastern Nepal
title_sort barriers to utilization of antenatal care services in eastern nepal
topic Public Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4536371/
https://www.ncbi.nlm.nih.gov/pubmed/26322302
http://dx.doi.org/10.3389/fpubh.2015.00197
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