Cargando…
Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016
BACKGROUND: With the formulation of the National Safe Motherhood Policy in 1998, safe motherhood has forever been a priority program in Nepal. Under the safe motherhood program, every woman is provided with essential maternal health care services until now through the four-tire district health care...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238496/ https://www.ncbi.nlm.nih.gov/pubmed/32429901 http://dx.doi.org/10.1186/s12884-020-02976-y |
_version_ | 1783536542529093632 |
---|---|
author | Neupane, Bidusha Rijal, Sujan G.C., Srijana Basnet, Til Bahadur |
author_facet | Neupane, Bidusha Rijal, Sujan G.C., Srijana Basnet, Til Bahadur |
author_sort | Neupane, Bidusha |
collection | PubMed |
description | BACKGROUND: With the formulation of the National Safe Motherhood Policy in 1998, safe motherhood has forever been a priority program in Nepal. Under the safe motherhood program, every woman is provided with essential maternal health care services until now through the four-tire district health care system. There is a considerable increase in the utilization of antenatal care (ANC) by a skilled health provider from 2011 to 2016, 58 to 84%, respectively. However, inequality, exclusion, and under-utilization in health care services continue in many regions of Nepal. The present study aimed to explore the different types of socio-demographic factors associated with current ANC service utilization in Nepal. METHODS: A cross-sectional study was conducted using the Nepal Demographic and Health Surveys data (DHS-7, 2016–2017). We estimated the latest pregnancy and live births in recent 5 years with the utilization of ANC services, and socio-economic differentials in these indicators under the framework of the Andersen behavioral model. RESULTS: Two in three (69.8%) with last birth accessed at least four ANC visits. The rate of live birth was about 98.6% in the ANC4+ group, higher than that of 96.8% in the ANC4- group (χ2: 14.742, P < 0.001). In the multilevel logistic regression analysis, we found that women from province 2 (OR: 0.48; 95%CI: 0.32–0.74) and province 6 (OR: 0.46; 95%CI: 0.30–0.71) were significantly less likely to visit ANC 4 or more times. Age (OR: 0.95; 95%CI: 0.93–0.96) was also significantly associated with the frequency of ANC visits. Level of Women’s education and education of her partner were both significantly associated with the ANC visits: women (OR: 4.64; 95%CI: 3.05–7.05) and her partner (OR: 1.45; 95%CI: 1.01–2.06) having higher education were most likely to go for the recommended number of ANC visits. Moreover, women having exposure to multimedia were more likely to go for four or more ANC check-ups. CONCLUSIONS: The results highlight the need for governments and health care providers to develop special health promotion program with a focus on the vulnerable and disadvantaged and to use multi-media for maternal health literacy improvement flexibly, and maternal health system strengthening. |
format | Online Article Text |
id | pubmed-7238496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-72384962020-05-27 Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 Neupane, Bidusha Rijal, Sujan G.C., Srijana Basnet, Til Bahadur BMC Pregnancy Childbirth Research Article BACKGROUND: With the formulation of the National Safe Motherhood Policy in 1998, safe motherhood has forever been a priority program in Nepal. Under the safe motherhood program, every woman is provided with essential maternal health care services until now through the four-tire district health care system. There is a considerable increase in the utilization of antenatal care (ANC) by a skilled health provider from 2011 to 2016, 58 to 84%, respectively. However, inequality, exclusion, and under-utilization in health care services continue in many regions of Nepal. The present study aimed to explore the different types of socio-demographic factors associated with current ANC service utilization in Nepal. METHODS: A cross-sectional study was conducted using the Nepal Demographic and Health Surveys data (DHS-7, 2016–2017). We estimated the latest pregnancy and live births in recent 5 years with the utilization of ANC services, and socio-economic differentials in these indicators under the framework of the Andersen behavioral model. RESULTS: Two in three (69.8%) with last birth accessed at least four ANC visits. The rate of live birth was about 98.6% in the ANC4+ group, higher than that of 96.8% in the ANC4- group (χ2: 14.742, P < 0.001). In the multilevel logistic regression analysis, we found that women from province 2 (OR: 0.48; 95%CI: 0.32–0.74) and province 6 (OR: 0.46; 95%CI: 0.30–0.71) were significantly less likely to visit ANC 4 or more times. Age (OR: 0.95; 95%CI: 0.93–0.96) was also significantly associated with the frequency of ANC visits. Level of Women’s education and education of her partner were both significantly associated with the ANC visits: women (OR: 4.64; 95%CI: 3.05–7.05) and her partner (OR: 1.45; 95%CI: 1.01–2.06) having higher education were most likely to go for the recommended number of ANC visits. Moreover, women having exposure to multimedia were more likely to go for four or more ANC check-ups. CONCLUSIONS: The results highlight the need for governments and health care providers to develop special health promotion program with a focus on the vulnerable and disadvantaged and to use multi-media for maternal health literacy improvement flexibly, and maternal health system strengthening. BioMed Central 2020-05-19 /pmc/articles/PMC7238496/ /pubmed/32429901 http://dx.doi.org/10.1186/s12884-020-02976-y Text en © The Author(s) 2020 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. |
spellingShingle | Research Article Neupane, Bidusha Rijal, Sujan G.C., Srijana Basnet, Til Bahadur Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 |
title | Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 |
title_full | Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 |
title_fullStr | Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 |
title_full_unstemmed | Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 |
title_short | Andersen’s model on determining the factors associated with antenatal care services in Nepal: an evidence-based analysis of Nepal demographic and health survey 2016 |
title_sort | andersen’s model on determining the factors associated with antenatal care services in nepal: an evidence-based analysis of nepal demographic and health survey 2016 |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238496/ https://www.ncbi.nlm.nih.gov/pubmed/32429901 http://dx.doi.org/10.1186/s12884-020-02976-y |
work_keys_str_mv | AT neupanebidusha andersensmodelondeterminingthefactorsassociatedwithantenatalcareservicesinnepalanevidencebasedanalysisofnepaldemographicandhealthsurvey2016 AT rijalsujan andersensmodelondeterminingthefactorsassociatedwithantenatalcareservicesinnepalanevidencebasedanalysisofnepaldemographicandhealthsurvey2016 AT gcsrijana andersensmodelondeterminingthefactorsassociatedwithantenatalcareservicesinnepalanevidencebasedanalysisofnepaldemographicandhealthsurvey2016 AT basnettilbahadur andersensmodelondeterminingthefactorsassociatedwithantenatalcareservicesinnepalanevidencebasedanalysisofnepaldemographicandhealthsurvey2016 |