Cargando…

Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries

BACKGROUND: An effective continuum of maternal care ensures that mothers receive essential health packages from pre-pregnancy to delivery, and postnatally, reducing the risk of maternal death. However, across Africa, coverage of skilled birth attendance is lower than coverage for antenatal care, ind...

Descripción completa

Detalles Bibliográficos
Autores principales: Chukwuma, Adanna, Wosu, Adaeze C., Mbachu, Chinyere, Weze, Kelechi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445515/
https://www.ncbi.nlm.nih.gov/pubmed/28545422
http://dx.doi.org/10.1186/s12884-017-1337-1
_version_ 1783238909219569664
author Chukwuma, Adanna
Wosu, Adaeze C.
Mbachu, Chinyere
Weze, Kelechi
author_facet Chukwuma, Adanna
Wosu, Adaeze C.
Mbachu, Chinyere
Weze, Kelechi
author_sort Chukwuma, Adanna
collection PubMed
description BACKGROUND: An effective continuum of maternal care ensures that mothers receive essential health packages from pre-pregnancy to delivery, and postnatally, reducing the risk of maternal death. However, across Africa, coverage of skilled birth attendance is lower than coverage for antenatal care, indicating mothers are not retained in the continuum between antenatal care and delivery. This paper explores predictors of retention of antenatal care clients in skilled birth attendance across Africa, including sociodemographic factors and quality of antenatal care received. METHODS: We pooled nationally representative data from Demographic and Health Surveys conducted in 28 African countries between 2006 and 2015. For the 115,374 births in our sample, we estimated logistic multilevel models of retention in skilled birth attendance (SBA) among clients that received skilled antenatal care (ANC). RESULTS: Among ANC clients in the study sample, 66% received SBA. Adjusting for all demographic covariates and country indicators, the odds of retention in SBA were higher among ANC clients that had their blood pressure checked, received information about pregnancy complications, had blood tests conducted, received at least one tetanus injection, and had urine tests conducted. CONCLUSIONS: Higher quality of ANC predicts retention in SBA in Africa. Improving quality of skilled care received prenatally may increase client retention during delivery, reducing maternal mortality.
format Online
Article
Text
id pubmed-5445515
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-54455152017-05-30 Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries Chukwuma, Adanna Wosu, Adaeze C. Mbachu, Chinyere Weze, Kelechi BMC Pregnancy Childbirth Research Article BACKGROUND: An effective continuum of maternal care ensures that mothers receive essential health packages from pre-pregnancy to delivery, and postnatally, reducing the risk of maternal death. However, across Africa, coverage of skilled birth attendance is lower than coverage for antenatal care, indicating mothers are not retained in the continuum between antenatal care and delivery. This paper explores predictors of retention of antenatal care clients in skilled birth attendance across Africa, including sociodemographic factors and quality of antenatal care received. METHODS: We pooled nationally representative data from Demographic and Health Surveys conducted in 28 African countries between 2006 and 2015. For the 115,374 births in our sample, we estimated logistic multilevel models of retention in skilled birth attendance (SBA) among clients that received skilled antenatal care (ANC). RESULTS: Among ANC clients in the study sample, 66% received SBA. Adjusting for all demographic covariates and country indicators, the odds of retention in SBA were higher among ANC clients that had their blood pressure checked, received information about pregnancy complications, had blood tests conducted, received at least one tetanus injection, and had urine tests conducted. CONCLUSIONS: Higher quality of ANC predicts retention in SBA in Africa. Improving quality of skilled care received prenatally may increase client retention during delivery, reducing maternal mortality. BioMed Central 2017-05-25 /pmc/articles/PMC5445515/ /pubmed/28545422 http://dx.doi.org/10.1186/s12884-017-1337-1 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. 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.
spellingShingle Research Article
Chukwuma, Adanna
Wosu, Adaeze C.
Mbachu, Chinyere
Weze, Kelechi
Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries
title Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries
title_full Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries
title_fullStr Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries
title_full_unstemmed Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries
title_short Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries
title_sort quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 african countries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5445515/
https://www.ncbi.nlm.nih.gov/pubmed/28545422
http://dx.doi.org/10.1186/s12884-017-1337-1
work_keys_str_mv AT chukwumaadanna qualityofantenatalcarepredictsretentioninskilledbirthattendanceamultilevelanalysisof28africancountries
AT wosuadaezec qualityofantenatalcarepredictsretentioninskilledbirthattendanceamultilevelanalysisof28africancountries
AT mbachuchinyere qualityofantenatalcarepredictsretentioninskilledbirthattendanceamultilevelanalysisof28africancountries
AT wezekelechi qualityofantenatalcarepredictsretentioninskilledbirthattendanceamultilevelanalysisof28africancountries