Association Between Sociodemographic Characteristics and Assisted Childbirth by Qualified Personnel in Madagascar
Abstract
Objective: This study aims to analyze the association between the likelihood of giving birth in a healthcare facility and various sociodemographic characteristics in Madagascar.
Materials and methods: This study utilized data from the 2021 Madagascar Demographic and Health Survey which included a representative sample of women of reproductive age (15-49 years). The sociodemographic variables analyzed included age, birth order, education level, region residence and economic status with the place of delivery being the primary dependent variable. Data analysis was conducted using R software. A chi-square test was applied to assess associations between variables, with a significance threshold set at 5%.
Results: The prevalence of institutional childbirth services usage in Madagascar was 37.4% (35.1-39.7). The results showed that women under 20 years had an assistance rate of 36.7% (33.9-39.4), while the rate for primiparas reached 49.9% (48.5-51.3). Prenatal visits, mother’s age, birth order, region, residence, education level, and economic quintile significantly influenced access to care, with p-values < 0.0001. Only 17.5% (15.6-19.4) of women in the lowest quintile received qualified assistance at childbirth.
Conclusion: The results highlight the impact of age, birth order, residence, education level, region and socioeconomic status on access to childbirth services, necessitating a multisectoral approach to improve equity.
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26. Weldemariam S, Kiros A, Welday M. Utilization of institutional delivery service and associated factors among mothers in North West Ethiopian. BMC Res Notes. 2018;11(1):194.
27. Afulani PA. Rural/urban and socioeconomic differentials in quality of antenatal care in Ghana. PloS One. 2015;10(2):e0117996.
28. Gage AJ, Guirlène Calixte M. Effects of the physical accessibility of maternal health services on their use in rural Haiti. Popul Stud (Camb). 2006;60(3):271-88.
29. Edward B. Factors influencing the utilisation of antenatal care content in Uganda. Australas Med J. 2011;4(9):516-26.
30. Weldegiorgis SK, Feyisa M. Why Women in Ethiopia Give Birth at Home? A Systematic Review of Literature. Int J Womens Health. 2021;13:1065-79.
2. Say L, Chou D, Gemmill A, Tunçalp Ö, Moller AB, Daniels J, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-33.
3. Trends in maternal mortality 2000 to 2020: estimates by WHO, UNICEF, UNFPA, World Bank Group and UNDESA/Population Division. Geneva: World Health Organization; 2023;p13. Licence: CC BY-NC-SA 3.0 IGO.
4. Say L, Raine R. A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context. Bull World Health Organ. 2007;85(10):812-9.
5. Simkhada B, Teijlingen ER, Porter M, Simkhada P. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. J Adv Nurs. 2008;61(3):244-60.
6. Gabrysch S, Campbell OMR. Still too far to walk:
Literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 2009;9(1):34.
7. Institut National de la Statistique (INSTAT). RGPH3_Niveaux tendances et caracteristiques de la mortalite à Madagascar. Antananarivo, Madagascar: INSTAT; 2021.
8. Institut National de la Statistique (INSTAT), ICF. Enquête démographique et de santé à Madagascar (EDSMD-V) 2021. Antananarivo, Madagascar; Rockville, Maryland, USA: INSTAT et ICF; 2022.
9. Ministère de la santé publique (MSANP). Plan de développement du secteur santé 2020-2024. Antananarivo, Madagascar: MSANP; 2020. 176 p.
10. Assefa L, Alemayehu M, Debie A. Magnitude of institutional delivery service utilization and associated factors among women in pastoral community of Awash Fentale district Afar Regional State, Ethiopia. BMC Res Notes. 2018;11(1):162.
11. United Nations Population Fund. Priorisation du réseau SONU et cartes des soins obstétricaux et néonatals d’urgence à Madagascar. Antananarivo, Madagascar: UNFPA; 2022. 236 p.
12. Nigusie A, Azale T, Yitayal M. Institutional delivery service utilization and associated factors in Ethiopia: a systematic review and META-analysis. BMC Pregnancy Childbirth. 2020;20(1):364.
13. Chakraborty N, Islam MA, Chowdhury RI, Bari W, Akhter HH. Determinants of the use of maternal health services in rural Bangladesh. Health Promot Int. 2003;18(4):327-37.
14. Ababulgu FA, Bekuma TT. Delivery Site Preferences and Associated Factors among Married Women of Child Bearing Age in Bench Maji Zone, Ethiopia. Ethiop J Health Sci. 2016;26(1):45-54.
15. Chernet AG, Dumga KT, Cherie KT. Home Delivery Practices and Associated Factors in Ethiopia. J Reprod Infertil. 2019;20(2):102-8.
16. Tekelab T, Yadecha B, Melka AS. Antenatal care and women's decision making power as determinants of institutional delivery in rural area of Western Ethiopia. BMC Res Notes. 2015;8:769.
17. Babalola S, Fatusi A. Determinants of use of maternal health services in Nigeria - looking beyond individual and household factors. BMC Pregnancy Childbirth. 2009;9(1):43.
18. Kebede B, Gebeyehu A, Andargie G. Use of previous maternal health services has a limited role in reattendance for skilled institutional delivery: Cross-sectional survey in Northwest Ethiopia. Int J Womens Health. 2013;5:79-85.
19. Yebyo H, Alemayehu M, Kahsay A. Why do women
deliver at home? Multilevel modeling of Ethiopian National Demographic and Health Survey data. PLoS One. 2015;10(4):e0124718.
20. Yeji F, Shibanuma A, Oduro A, Debpuur C, Kikuchi K, Owusu-Agei S, et al. Continuum of Care in a Maternal, Newborn and Child Health Program in Ghana: Low Completion Rate and Multiple Obstacle Factors. PloS One. 2015;10(12):e0142849.
21. Kidanu S, Degu G, Tiruye TY. Factors influencing institutional delivery service utilization in Dembecha district, Northwest Ethiopia: A community based cross sectional study. Reprod Health. 2017;14(1):98.
22. Kifle D, Azale T, Gelaw YA, Melsew YA. Maternal health care service seeking behaviors and associated factors among women in rural Haramaya District, Eastern Ethiopia: a triangulated community-based cross-sectional study. Reprod Health. 2017;14(1):6.
23. Ahmed M, Demissie M, Medhanyie AA, Worku A, Berhane Y. Utilization of Institutional Delivery Service in a Predominantly Pastoralist Community of Northeast Ethiopia. Ethiop J Health Sci. 2018;28(4):403-12.
24. Tsegay R, Aregay A, Kidanu K, Alemayehu M, Yohannes G. Determinant factors of home delivery among women in Northern Ethiopia: a case control study. BMC Public Health. 2017;17(1):289.
25. Mekie M, Taklual W. Delivery place preference and its
associated factors among women who deliver in the last 12 months in Simada district of Amhara Region, Northwest Ethiopia: a community based cross sectional study. BMC Res Notes. 2019;12(1):114.
26. Weldemariam S, Kiros A, Welday M. Utilization of institutional delivery service and associated factors among mothers in North West Ethiopian. BMC Res Notes. 2018;11(1):194.
27. Afulani PA. Rural/urban and socioeconomic differentials in quality of antenatal care in Ghana. PloS One. 2015;10(2):e0117996.
28. Gage AJ, Guirlène Calixte M. Effects of the physical accessibility of maternal health services on their use in rural Haiti. Popul Stud (Camb). 2006;60(3):271-88.
29. Edward B. Factors influencing the utilisation of antenatal care content in Uganda. Australas Med J. 2011;4(9):516-26.
30. Weldegiorgis SK, Feyisa M. Why Women in Ethiopia Give Birth at Home? A Systematic Review of Literature. Int J Womens Health. 2021;13:1065-79.
| Files | ||
| Issue | Vol 18, No 4 (December 2024) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/jfrh.v18i4.17427 | |
| Keywords | ||
| Assisted Childbirth Equity Madagascar Maternal Mortality Prenatal Visits | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Bemanana H. Association Between Sociodemographic Characteristics and Assisted Childbirth by Qualified Personnel in Madagascar. J Family Reprod Health. 2024;18(4):261-268.
