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The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa
Facility births and antenatal care (ANC) are key to improving maternal health. This study evaluates the relationship between physician and nurse/midwife densities and the use of key maternal health services in sub-Saharan Africa (SSA). We matched individual-level maternal health service indicators f...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The American Society of Tropical Medicine and Hygiene
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922518/ https://www.ncbi.nlm.nih.gov/pubmed/35026729 http://dx.doi.org/10.4269/ajtmh.21-0727 |
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author | Rosser, Joelle I. Aluri, Kelly Z. Kempinsky, Arielle Richardson, Shannon Bendavid, Eran |
author_facet | Rosser, Joelle I. Aluri, Kelly Z. Kempinsky, Arielle Richardson, Shannon Bendavid, Eran |
author_sort | Rosser, Joelle I. |
collection | PubMed |
description | Facility births and antenatal care (ANC) are key to improving maternal health. This study evaluates the relationship between physician and nurse/midwife densities and the use of key maternal health services in sub-Saharan Africa (SSA). We matched individual-level maternal health service indicators from Demographic and Health Surveys between 2008 and 2017, to country-level physician and nurse/midwife per-capita densities, across 35 SSA countries. We performed univariate and multivariate probit regression analyses to evaluate the association between healthcare worker (HCW) densities and facility births as our primary outcome and additional ANC services as secondary outcomes. We controlled for established maternal health predictors, including literacy, child marriage, reported problems accessing healthcare, GDP per capita, political instability, and government effectiveness scores. HCW density across SSA was low at 0.13 physicians and 0.91 nurses/midwives per 1,000 people, compared with 2010 worldwide mean densities of 1.33 and 3.07, respectively. The probability of facility birth increased by 9.8% (95% CI: 2.1–17.5%) for every additional physician per 1,000 people and 8.9% (95% CI: 7.1–9.7%) for every additional nurse/midwife per 1,000 people. HCW densities were also associated with increased likelihood of ANC by the respective provider type, and with antenatal testing for preeclampsia (urine and blood pressure checks). Other ANC services demonstrated variable relationships with HCW densities based on provider type. In 35 SSA countries, HCW density was positively associated with many key measures of maternal health service utilization including facility birth and ANC testing for preeclampsia. |
format | Online Article Text |
id | pubmed-8922518 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The American Society of Tropical Medicine and Hygiene |
record_format | MEDLINE/PubMed |
spelling | pubmed-89225182022-03-21 The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa Rosser, Joelle I. Aluri, Kelly Z. Kempinsky, Arielle Richardson, Shannon Bendavid, Eran Am J Trop Med Hyg Research Article Facility births and antenatal care (ANC) are key to improving maternal health. This study evaluates the relationship between physician and nurse/midwife densities and the use of key maternal health services in sub-Saharan Africa (SSA). We matched individual-level maternal health service indicators from Demographic and Health Surveys between 2008 and 2017, to country-level physician and nurse/midwife per-capita densities, across 35 SSA countries. We performed univariate and multivariate probit regression analyses to evaluate the association between healthcare worker (HCW) densities and facility births as our primary outcome and additional ANC services as secondary outcomes. We controlled for established maternal health predictors, including literacy, child marriage, reported problems accessing healthcare, GDP per capita, political instability, and government effectiveness scores. HCW density across SSA was low at 0.13 physicians and 0.91 nurses/midwives per 1,000 people, compared with 2010 worldwide mean densities of 1.33 and 3.07, respectively. The probability of facility birth increased by 9.8% (95% CI: 2.1–17.5%) for every additional physician per 1,000 people and 8.9% (95% CI: 7.1–9.7%) for every additional nurse/midwife per 1,000 people. HCW densities were also associated with increased likelihood of ANC by the respective provider type, and with antenatal testing for preeclampsia (urine and blood pressure checks). Other ANC services demonstrated variable relationships with HCW densities based on provider type. In 35 SSA countries, HCW density was positively associated with many key measures of maternal health service utilization including facility birth and ANC testing for preeclampsia. The American Society of Tropical Medicine and Hygiene 2022-03 2022-01-17 /pmc/articles/PMC8922518/ /pubmed/35026729 http://dx.doi.org/10.4269/ajtmh.21-0727 Text en © 2022 by The American Society of Tropical Medicine and Hygiene https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution (CC-BY) License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Rosser, Joelle I. Aluri, Kelly Z. Kempinsky, Arielle Richardson, Shannon Bendavid, Eran The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa |
title | The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa |
title_full | The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa |
title_fullStr | The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa |
title_full_unstemmed | The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa |
title_short | The Effect of Healthcare Worker Density on Maternal Health Service Utilization in Sub-Saharan Africa |
title_sort | effect of healthcare worker density on maternal health service utilization in sub-saharan africa |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8922518/ https://www.ncbi.nlm.nih.gov/pubmed/35026729 http://dx.doi.org/10.4269/ajtmh.21-0727 |
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