Quality of antenatal care predicts retention in skilled birth attendance: a multilevel analysis of 28 African countries

BMC Pregnancy and Childbirth

Research Article

Kelechi Weze¹  Adanna Chukwuma²  Chinyere Mbachu³  Adaeze C. Wosu⁴ 

[1] Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA;Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, 02115, Boston, MA, USA;World Bank Group, 1818 H St. NW, 20433, Washington, DC, USA;Health Policy Research Group, College of Medicine, University of Nigeria, Enugu, Nigeria;Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, 21205, Baltimore, MD, USA;

关键词: Antenatal;    Continuum;    Delivery;    Birth;    Quality;    Determinants;    Maternal health;   

DOI  :  10.1186/s12884-017-1337-1

 received in 2016-12-31, accepted in 2017-05-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAn effective continuum of maternal care ensures that mothers receive essential health packages from pre-pregnancy to delivery, and postnatally, reducing the risk of maternal death. However, across Africa, coverage of skilled birth attendance is lower than coverage for antenatal care, indicating mothers are not retained in the continuum between antenatal care and delivery. This paper explores predictors of retention of antenatal care clients in skilled birth attendance across Africa, including sociodemographic factors and quality of antenatal care received.MethodsWe pooled nationally representative data from Demographic and Health Surveys conducted in 28 African countries between 2006 and 2015. For the 115,374 births in our sample, we estimated logistic multilevel models of retention in skilled birth attendance (SBA) among clients that received skilled antenatal care (ANC).ResultsAmong ANC clients in the study sample, 66% received SBA. Adjusting for all demographic covariates and country indicators, the odds of retention in SBA were higher among ANC clients that had their blood pressure checked, received information about pregnancy complications, had blood tests conducted, received at least one tetanus injection, and had urine tests conducted.ConclusionsHigher quality of ANC predicts retention in SBA in Africa. Improving quality of skilled care received prenatally may increase client retention during delivery, reducing maternal mortality.

【 授权许可】

CC BY   
© The Author(s). 2017

【 图 表 】

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