Correlates of continuum of maternal health services among Nepalese women: Evidence from Nepal Multiple Indicator Cluster Survey.

Authors:
Binaya Chalise
Binaya Chalise
Nepal Health Research Council
Bihungum Bista
Bihungum Bista
Nepal Health Research Council
Achyut Raj Pandey
Achyut Raj Pandey
Nepal Health Research Council
Subash Thapa
Subash Thapa
Nepal Institute of Health Sciences

PLoS One 2019 19;14(4):e0215613. Epub 2019 Apr 19.

Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.

Continuum of Care (CoC) is an essential strategy to prevent maternal and child deaths where health services are arranged in a pathway throughout pregnancy, childbirth and after delivery. However, CoC is still a challenge in Nepal. This study aimed to investigate the correlates of CoC from pregnancy to the postnatal period in Nepalese women aged 15 to 49 years. Secondary analysis was performed on the data from Nepal Multiple Indicator Cluster Survey. This led to a sample size of 2086 women who had a live birth within two years preceding the survey. We constructed three outcome models and conducted multivariable logistic regression, to assess socio-economic and demographic correlates of CoC from pregnancy to childbirth to postnatal period. Overall, 41% of the women received Antenatal Care (ANC), delivery from Skilled Birth Attendant (SBA) as well as the Postnatal Care (PNC) during their most recent birth. Women from rural areas (aOR 0.25, 95%CI: 0.18, 0.36) had reduced odds of receiving CoC while women belonging to advantaged ethnic group (aOR 1.61, 95%CI: 1.18 2.19), from middle wealth status (aOR 2.56, 95%CI: 1.68, 3.91) and upper (aOR 4.50, 95%CI: 3.07, 6.59) wealth status, and women having access to media (aOR 1.76, 95%CI: 1.31, 2.37) had higher odds of receiving CoC from pregnancy to postnatal period. Having more than two births reduced the odds of CoC by 30% (aOR 0.70, 95%CI: 0.50, 0.98). These factors were also significantly associated with ANC services and the continuum from ANC to delivery SBA. The findings suggest that the majority of Nepalese women lack a continuity of care during their pregnancy and childbirth, and several socioeconomic factors affect the spectrum of CoC. Efforts to improve maternal health services utilization in a continuum require strategies that remove demand and supply barriers of health care utilization.

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215613PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6474612PMC
April 2019

Publication Analysis

Top Keywords

nepalese women
12
postnatal period
12
pregnancy childbirth
12
health services
12
coc pregnancy
12
anc delivery
8
coc
8
cluster survey
8
nepal multiple
8
multiple indicator
8
correlates coc
8
maternal health
8
reduced odds
8
receiving coc
8
wealth status
8
pregnancy postnatal
8
indicator cluster
8
odds receiving
8
women
8
aor
6

Similar Publications