A multilevel Bayesian Markov Chain Monte Carlo Poisson modelling of factors associated with components of antenatal care offered to pregnant women in Nigeria

BMC Health Services Research

Research

Jackline Mosinya Nyaberi¹  Adeniyi Francis Fagbamigbe²  Ayo Stephen Adebowale³  Vincent Setlhare⁴  Oluwasomidoyin O. Bello⁵  Anthony Ike Wegbom⁶  Olugbenga Sunday Olaseinde⁷  Omon Stellamaris Fagbamigbe⁸ 

[1] Department of Environmental Health and Disease Control, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya;Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria;Division of Population and Behavioural Science, School of Medicine, Health Data Science Unit, University of St Andrews, St Andrews, UK;Institute of Applied Health Sciences, School of Medicine, Medical Sciences & Nutrition, University of Aberdeen, Aberdeen, UK;Research Institute for Health & Wellbeing, Coventry University, Coventry, UK;Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria;Population Health and Research Entity, North-West University, Mafikeng, South Africa;Department of Family Medicine and Public Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana;Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria;Department of Public Health Sciences, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria;Department of Sociology, Adekunle Ajasin University, Akungba Akoko, Nigeria;Portsmouth Business School, Faculty of Business and Law, University of Portsmouth, Portsmouth, UK;Data insight and analytics, Sopra Steria Limited, Hemel Hempstead, United Kingdom;

关键词: Antenatal care;    Nigeria;    WHO guidelines;    ANC contacts;    Supplements;    Quality of care;    ANC components;   

DOI  :  10.1186/s12913-023-09710-2

 received in 2021-05-31, accepted in 2023-06-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe most recent WHO guideline on antenatal care (ANC) utilization reaffirmed the necessary and compulsory care and services a pregnant woman should receive to maximize the importance and gains of ANC. While most studies focused on the time of initiation and number of ANC contacts, emphasis was rarely placed on the components of ANC offered to women. This study assessed how complete the components of ANC received by pregnant women are as a proxy for the quality of ANC services offered in Nigeria. We also assessed the clustering of the components and state-level differentials and inequalities in the components of ANC received in Nigeria.MethodsWe used nationally representative cross-sectional data from the 2018 Nigeria Demographic Health Survey. We analysed the data of 11,867 women who had at least one ANC contact during the most recent pregnancy within five years preceding the survey. The assessed components were tetanus injection, blood pressure, urine test, blood test, iron supplement, malaria intermittent preventive treatment in pregnancy (IPTp), and told about danger signs. Others are intestinal parasite drugs (IPD)intermittent and HIV/PMTCT counsel. Descriptive statistics, bivariable and multivariable multilevel Bayesian Monte Carlo Poisson models were used.ResultsIn all, 94% had blood pressure measured, 91% received tetanus injection, had iron supplement-89%, blood test-87%, urine test-86%, IPTp-24%, danger signs-80%, HIV/PMTC-82% and IPD-22%. The overall prevalence of receiving all 9 components was 5% and highest in Ogun (24%) and lowest in Kebbi state (0.1%). The earlier the initiation of ANC, the higher the number of contacts, and the higher the quality of ANC received. Respondents with higher education have a 4% (adjusted incidence risk ratio (aIRR): 1.04, 95% credible interval (CrI): 1.01–1.09) higher risk of receiving more components of ANC relative to those with no education. The risk of receiving more ANC components was 5% (aIRRR: 1.05, 95% CI: 1.01–1.10) higher among pregnant women aged 40 to 49 years than those aged 15 to 19 years. Women who decide their healthcare utilization alone had a 2% higher risk of getting more components than those whose spouses are the only decision taker of healthcare use. Other significant factors were household wealth status, spouse education, ethnicity, place of ANC, and skill of ANC provider. Pregnant women who had their blood pressure measured were very likely to have blood and urine tests, tetanus injections, iron supplements, and HIV talks.ConclusionsOnly one in every 20 pregnant women received all the 9 ANC components with wide disparities and inequalities across the background characteristics and the States of residence in Nigeria. There is a need to ensure that all pregnant women receive adequate components. Stakeholders should increase supplies, train, and create awareness among ANC providers and pregnant women in particular.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2023_38_Article_IEq310.gif

41116_2023_38_Article_IEq309.gif

41116_2023_38_Article_IEq307.gif

41116_2023_38_Article_IEq306.gif

41116_2023_38_Article_IEq305.gif

41116_2023_38_Article_IEq300.gif

41116_2023_38_Article_IEq299.gif

41116_2023_38_Article_IEq298.gif

41116_2023_38_Article_IEq297.gif

41116_2023_38_Article_IEq296.gif

41116_2023_38_Article_IEq295.gif

41116_2023_38_Article_IEq294.gif

41116_2023_38_Article_IEq293.gif

41116_2023_38_Article_IEq291.gif

41116_2023_38_Article_IEq290.gif

41116_2023_38_Article_IEq288.gif

41116_2023_38_Article_IEq285.gif

12888_2023_4990_Article_IEq8.gif

12888_2023_4990_Article_IEq3.gif

12888_2023_4990_Article_IEq1.gif

Fig. 1

41116_2023_38_Article_IEq262.gif

41116_2023_38_Article_IEq259.gif

41116_2023_38_Article_IEq240.gif