Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.

<h4>Background</h4>It is widely accepted that maternal healthcare is vital for improving maternal and neonatal mortality rates. Furthermore, the continuum of care-the integrated delivery of antenatal, delivery and postnatal care-has been shown to be particularly important. Sub-Saharan Af...

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Main Authors: Catherine Louise Stewart, Jennifer Anne Hall
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2022-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0279613
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author Catherine Louise Stewart
Jennifer Anne Hall
author_facet Catherine Louise Stewart
Jennifer Anne Hall
author_sort Catherine Louise Stewart
collection DOAJ
description <h4>Background</h4>It is widely accepted that maternal healthcare is vital for improving maternal and neonatal mortality rates. Furthermore, the continuum of care-the integrated delivery of antenatal, delivery and postnatal care-has been shown to be particularly important. Sub-Saharan Africa has the highest neonatal and maternal mortality rates in the world; significant improvements in the provision and utilisation of the continuum are urgently needed, therefore the barriers preventing access need to be better understood. This study aimed to identify key factors associated with the utilisation of maternal healthcare, in the Mchinji District of Malawi.<h4>Methods</h4>4,244 pregnant women from the Mchinji District of Malawi were interviewed between March and December 2013. The overall utilisation of maternal healthcare was calculated by combining the use of antenatal, delivery and postnatal care into one variable-continuum of care. Univariate and multivariate logistic regressions were performed to determine the factors associated with utilisation of maternal healthcare.<h4>Results</h4>Utilisation of maternal healthcare in the Mchinji District was inadequate; only 24% of women received the recommended package. Being further from a healthcare facility (OR = 0.2, 95%CI = 0.04-0.96), having at least one live child (OR = 0.87, 95%CI = 0.84-0.99), previous experience of miscarriage (OR = 0.64, 95%CI = 0.50-0.82) or abuse (OR = 0.81, 95%CI = 0.69-0.95) reduced utilisation, whereas being in the richest 20% (OR = 1.33 95%CI = 1.08-1.65), having a planned pregnancy (OR = 1.3, 95%CI = 1.11-1.51) or more control over decisions (OR = 1.09, 95%CI = 0.80-1.49) increased utilisation.<h4>Conclusion</h4>Seven groups of women were identified as having an increased risk of low utilisation of maternal healthcare; women living >5km from a healthcare facility, within the poorest socio-economic group, experiencing an unplanned pregnancy, with at least one live child, experience of a previous miscarriage, no control over their healthcare decisions or experience of abuse. Policy makers should pay extra attention to these high-risk groups when designing and delivering strategies to improve maternal healthcare utilisation.
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spelling doaj.art-d98498300a504cad90da8742fdb7bae62023-01-05T05:31:19ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011712e027961310.1371/journal.pone.0279613Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.Catherine Louise StewartJennifer Anne Hall<h4>Background</h4>It is widely accepted that maternal healthcare is vital for improving maternal and neonatal mortality rates. Furthermore, the continuum of care-the integrated delivery of antenatal, delivery and postnatal care-has been shown to be particularly important. Sub-Saharan Africa has the highest neonatal and maternal mortality rates in the world; significant improvements in the provision and utilisation of the continuum are urgently needed, therefore the barriers preventing access need to be better understood. This study aimed to identify key factors associated with the utilisation of maternal healthcare, in the Mchinji District of Malawi.<h4>Methods</h4>4,244 pregnant women from the Mchinji District of Malawi were interviewed between March and December 2013. The overall utilisation of maternal healthcare was calculated by combining the use of antenatal, delivery and postnatal care into one variable-continuum of care. Univariate and multivariate logistic regressions were performed to determine the factors associated with utilisation of maternal healthcare.<h4>Results</h4>Utilisation of maternal healthcare in the Mchinji District was inadequate; only 24% of women received the recommended package. Being further from a healthcare facility (OR = 0.2, 95%CI = 0.04-0.96), having at least one live child (OR = 0.87, 95%CI = 0.84-0.99), previous experience of miscarriage (OR = 0.64, 95%CI = 0.50-0.82) or abuse (OR = 0.81, 95%CI = 0.69-0.95) reduced utilisation, whereas being in the richest 20% (OR = 1.33 95%CI = 1.08-1.65), having a planned pregnancy (OR = 1.3, 95%CI = 1.11-1.51) or more control over decisions (OR = 1.09, 95%CI = 0.80-1.49) increased utilisation.<h4>Conclusion</h4>Seven groups of women were identified as having an increased risk of low utilisation of maternal healthcare; women living >5km from a healthcare facility, within the poorest socio-economic group, experiencing an unplanned pregnancy, with at least one live child, experience of a previous miscarriage, no control over their healthcare decisions or experience of abuse. Policy makers should pay extra attention to these high-risk groups when designing and delivering strategies to improve maternal healthcare utilisation.https://doi.org/10.1371/journal.pone.0279613
spellingShingle Catherine Louise Stewart
Jennifer Anne Hall
Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.
PLoS ONE
title Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.
title_full Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.
title_fullStr Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.
title_full_unstemmed Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.
title_short Factors that affect the utilisation of maternal healthcare in the Mchinji District of Malawi.
title_sort factors that affect the utilisation of maternal healthcare in the mchinji district of malawi
url https://doi.org/10.1371/journal.pone.0279613
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