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Author: search.filters.author.Adebowale, A. S.Subject: search.filters.subject.Antenatal care

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    Coverage-level and predictors of maternity continuum of care in Nigeria: implications for maternal, newborn and child health programming
    (BioMed Central, 2023) Oyedele, O. K.; Fagbamigbe, A. F.; Akinyemi, O. J.; Adebowale, A. S.
    Background Completing maternity continuum of care from pregnancy to postpartum is a core strategy to reduce the burden of maternal and neonatal mortality dominant in sub-Saharan Africa, particularly Nigeria. Thus, we evaluated the level of completion, dropout and predictors of women uptake of optimal antenatal care (ANC) in pregnancy, continuation to use of skilled birth attendants (SBA) at childbirth and postnatal care (PNC) utilization at postpartum in Nigeria. Methods A cross-sectional analysis of nationally representative 21,447 pregnancies that resulted to births within five years preceding the 2018 Nigerian Demographic Health Survey. Maternity continuum of care model pathway based on WHO recommendation was the outcome measure while explanatory variables were classified as; socio-demographic, maternal and birth characteristics, pregnancy care quality, economic and autonomous factors. Descriptive statistics describes the factors, backward stepwise regression initially assessed association (p<0.10), multivariable binary logistic regression and complementary-log–log model quantifies association at a 95% confidence interval (α=0.05). Results Coverage decrease from 75.1% (turn-up at ANC) to 56.7% (optimal ANC) and to 37.4% (optimal ANC and SBA) while only 6.5% completed the essential continuum of care. Dropout in the model pathway however increase from 17.5% at ANC to 20.2% at SBA and 30.9% at PNC. Continuation and completion of maternity care are positively drive by women; with at least primary education (AOR=1.27, 95%CI=1.01–1.62), average wealth index (AOR=1.83, 95%CI=1.48 –2.25), southern geopolitical zone (AOR=1.61, 95%CI=1.29–2.01), making health decision alone (AOR=1.39, 95%CI=1.16–1.66), having nurse as ANC provider (AOR=3.53, 95%CI=2.01–6.17) and taking at least two dose of tetanus toxoid vaccine (AOR=1.25, 95%CI=1.06–1.62) while women in rural residence (AOR=0.78, 95%CI=0.68–0.90) and initiation of ANC as late as third trimester (AOR=0.44, 95%CI=0.34–0.58) negatively influenced continuation and completion. Conclusions 6.5% coverage in maternity continuum of care completion is very low and far below the WHO recommended level in Nigeria. Women dropout more at postnatal care than at skilled delivery and antenatal. Education, wealth, women health decision power and tetanus toxoid vaccination drives continuation and completion of maternity care. Strategies optimizing these factors in maternity packages will be supreme to strengthen maternal, newborn and child health.
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    Survival analysis and prognostic factors of the timing of first antenatal care visit in Nigeria
    (Elsevier Ltd., 2019) Fagbamigbe, A. F.; Abel, C.; Mashabe, B.; Adebowale, A. S.
    Objectives: This study assessed the timing of the first ANC visit among pregnant women and identified its prognostic factors. Design: Data obtained from 2013 Nigerian DHS, a cross-sectional and nationally representative survey, were used. Methods: We included women who had had at least a childbirth or got a pregnancy terminated within the five years preceding the survey or currently pregnant as of the time of the survey. The outcome variable is the timing of the first ANC visit to skilled ANC service provider. Those who were either currently pregnant or lost pregnancy but have not accessed ANC were censored. Basic descriptive statistics and survival analysis techniques involving four models were used to analyze the data at p = 0.05. Data was weighted and adjustment made for survey design and sampling errors. Results: Almost half of the respondents were aged 25–34 years. Only 65.5% had at least one contact with skilled ANC providers and such visits were initiated mostly (58%) in the second trimester. The overall incidence rate of accessing ANC per month is 110 per 1000 women. Women with higher education had a higher adjusted hazard of accessing ANC than uneducated women (aHR = 2.89, 95% CI: 2.68–3.11). Older women from households in richer wealth quintile are more likely to initiate ANC. Women from households in richer wealth quintiles, those who had no problem in accessing ANC facilities, those with higher education, residing in urban areas and in the Southern region had a higher tendency of earlier ANC initiation. Conclusion: ANC utilization in Nigeria is low and the timings of first visits are delayed. For Nigeria to achieve timely and adequate use of ANC services, health facilities should be more accessible and women should be empowered in terms of education, autonomy, and earnings in addition to changes in social cultural practices that prevent ANC uptakes.
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    Practice, knowledge and perceptions of antenatal care services among pregnant women and nursing mothers in Southwest Nigeria
    (Global Health and Education Projects, Inc., 2013) Fagbamigbe, A. F.; Akanbiemu, F. A.; Adebowale, A. S.; Olumide A, A. M.; Korter, G.
    High maternal death in Nigeria is a concern to public health practitioners. Knowledge and perception of antenatal care (ANC) by pregnant women and nursing mothers are important in usage of ANC facilities. This study bridged existing gap in inadequate report of perception and knowledge about ANC services. We conducted cross-sectional study among 460 randomly selected pregnant women and nursing mothers in Okitipupa local government area and used questionnaire to collect data on antenatal issues. ANC Knowledge was measured using point scores. We analyzed the data using descriptive statistics and Chi-square test (α=5.0%). Almost two third of respondents (64.1%) had negative perception about ANC. ANC know ledge of about 15% was good, 61.1% moderate and 58(12.9%) was low. Age, husbands’ education level, place of ANC ser vice, sources of information about ANC were significantly associated to knowledge and perceptions of ANC. Knowledge and utilization of ANC were high, but perception was inadequate.