Dataset Information

Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013.

ABSTRACT: Objectives: To identify factors associated with the continuum of maternal, newborn and child health care in The Gambia.

Design: A secondary statistical analysis using Demographic and Health Survey conducted in 2013.

Setting: The Gambia.

Participants: 1308 married women (or with a partner) whose most recent children were aged 12-23 months at the time of the survey.

Outcome measures: The main outcome was continuum of care for maternal, newborn and child health. The modified composite coverage index was calculated to express the completion level of continuum of care.

Results: The following factors were associated with the continuum of maternal, newborn and child health care: women's autonomy in decision-making of her own healthcare (?=0.063, p=0.015), having higher educated husbands (?=0.138, p<0.001), listening to the radio at least once a week (?=0.078, p=0.006), having a child with birth order less than 5 (?=0.069, p=0.037), initiating the first antenatal care within 16 weeks of pregnancy (?=0.170, p<0.001), having been informed of signs of pregnancy complications (?=0.057, p=0.029), living in rural areas (?=-0.107, p=0.006) and having higher burden due to distance to health facility (?=-0.100, p<0.001), with an explanatory power of 15.5% (R²=0.155).

Conclusions: Efforts on future policies and programmes should focus on the concept of continuum of care considering the associated factors. In particular, more attention should be given to providing country-wide family planning and education to women, men and community members in The Gambia.

SUBMITTER: Oh J

PROVIDER: S-EPMC7692971 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013.

Oh Jiyoung J Moon Juyoung J Choi Jae Wook JW Kim Kyunghee K

BMJ open 20201126 11

<h4>Objectives</h4>To identify factors associated with the continuum of maternal, newborn and child health care in The Gambia.<h4>Design</h4>A secondary statistical analysis using Demographic and Health Survey conducted in 2013.<h4>Setting</h4>The Gambia.<h4>Participants</h4>1308 married women (or with a partner) whose most recent children were aged 12-23 months at the time of the survey.<h4>Outcome measures</h4>The main outcome was continuum of care for maternal, newborn and child health. The m ...[more]

PMID: 33243786

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Project description:ObjectivesTo assess problems with accessing healthcare and its associated factors among reproductived-age women in the Gambia using the Gambia Demographic and Health Survey 2019/2020.DesignA community-based cross-sectional study.SettingThis study was based on a large, community-based cross-sectional survey, conducted from 2019 to 2020 in the Gambia. The survey employed a stratified two-stage cluster sampling technique to recruit study participants. Descriptive statistics and logistic regression models were used to summarise descriptive data and identify factors associated with problems of accessing healthcare, respectively. A p value of less than 0.05 and 95% CI were used to determine statistical significance.ParticipantsA total of 11 865 reproductive-aged women (15-49 years) were included in the study. The mean age of the women was 28.21 with an SD of 9.33 and ranges 15-49 years. Regarding marital status, 7526 (63.43%) were married.ResultsThe magnitude of problems with accessing healthcare among reproductive-aged women in the Gambia was 45.5% (95% CI: 44.6%, 46.4%). Age (adjusted OR (AOR)=1.48, 95% CI: 1.12, 1.95), being from rural residence (AOR=1.28, 95% CI: 1.07, 1.53), parity (AOR=1.07, 95% CI: 1.03, 1.12), middle (AOR=0.54, 95% CI: 0.46, 0.64) and greater wealth (AOR=0.30, 95% CI: 0.25, 0.37), giving birth at health institutions (AOR=0.69, 95% CI: 0.58, 0.80), currently working (AOR=0.77, 95% CI: 0.68, 0.86) and geographical region were significantly associated with problems of accessing healthcare.ConclusionProblems of accessing healthcare among women of reproductive age were high in the Gambia. Age, region, working status, parity, residence, wealth and place of delivery were the identified factors associated with problems of accessing healthcare. Policymakers and public health experts should consider those factors while designing maternal healthcare programmes. Affordable healthcare service programmes should be designed to increase healthcare access in the Gambia.

Project description:BackgroundThe presence of COVID-19 has led to the disruption of health systems globally, including essential reproductive, maternal, newborn and child health (RMNCH) services. This study aimed to assess the challenges faced by women who used RMNCH services in Nigeria's epicentre, their satisfaction with care received during the COVID-19 pandemic and the factors associated with their satisfaction.MethodsThis cross-sectional survey was conducted in Lagos, southwest Nigeria among 1,241 women of reproductive age who had just received RMNCH services at one of twenty-two health facilities across the primary, secondary and tertiary tiers of health care. The respondents were selected via multi-stage sampling and face to face exit interviews were conducted by trained interviewers. Client satisfaction was assessed across four sub-scales: health care delivery, health facility, interpersonal aspects of care and access to services. Bivariate and multivariate analyses were used to assess the relationship between personal characteristics and client satisfaction.ResultsAbout 43.51% of respondents had at least one challenge in accessing RMNCH services since the COVID-19 outbreak. Close to a third (31.91%) could not access service because they could not leave their houses during the lockdown and 18.13% could not access service because there was no transportation. The mean clients' satisfaction score among the respondents was 43.25 (SD: 6.28) out of a possible score of 57. Satisfaction scores for the interpersonal aspects of care were statistically significantly lower in the PHCs and general hospitals compared to teaching hospitals. Being over 30 years of age was significantly associated with an increased clients' satisfaction score (ß = 1.80, 95%CI: 1.10-2.50).ConclusionThe COVID-19 lockdown posed challenges to accessing RMNCH services for a significant proportion of women surveyed. Although overall satisfaction with care was fairly high, there is a need to provide tailored COVID-19 sensitive inter-personal care to clients at all levels of care.

Dataset Information

Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013.

Publications

Factors associated with the continuum of care for maternal, newborn and child health in The Gambia: a cross-sectional study using Demographic and Health Survey 2013.

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