Factors Associated with Maternal Health Service Utilization in Cote d’Ivoire: Analysis of the 2011 Ivorian Demographic and Health Survey
Science Journal of Public Health
Volume 7, Issue 4, July 2019, Pages: 115-122
Received: Mar. 5, 2019; Accepted: May 8, 2019; Published: Aug. 8, 2019
Views 60      Downloads 20
Authors
Kpebo Djoukou Olga Denise, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire; Department of Public Health and Biostatistics, Training and Research Unit in Medical Sciences, University Felix Houphouet Boigny, Abidjan, Cote d’Ivoire; Research Department in Reproductive Health of Cote d’Ivoire, National Institute of Public Health, Abidjan, Cote d’Ivoire
Koumi Mélèdje Marie-Dorothée, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire; Research Department in Reproductive Health of Cote d’Ivoire, National Institute of Public Health, Abidjan, Cote d’Ivoire
Agbré Yacé Marie-Laurette, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire; Research Department in Reproductive Health of Cote d’Ivoire, National Institute of Public Health, Abidjan, Cote d’Ivoire
Tano-Kamelan Akoua, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire; Research Department in Reproductive Health of Cote d’Ivoire, National Institute of Public Health, Abidjan, Cote d’Ivoire
Essis Esme Marie Laure, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire; Research Department in Reproductive Health of Cote d’Ivoire, National Institute of Public Health, Abidjan, Cote d’Ivoire
Yavo Williams, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire
Kouassi Dinard, Maternal and Child Health Unit, National Institute of Public Health, Abidjan, Cote d’Ivoire
Article Tools
Follow on us
Abstract
Adequate and timely utilization of maternal health services, namely antenatal care and skilled birth attendants, represents a significant intervention for reducing maternal deaths. In Cote d'Ivoire, despite a very high maternal mortality ratio, these services are poorly used. Understanding the factors influencing such poor utilization is critical in designing effective strategies to address this problem. The objective of this study was to analyze factors associated with the use of ANC and Skilled Births Attendants in Cote d’Ivoire. Using data from the 2011 Ivorian Demographic and Health Survey, multivariate logistic regression analysis was conducted to explore determinants of ANC attendance and Skilled Births Attendants at delivery, among 15-49 years old women. Results showed that the coverage of at least 4 ANC and SBA at delivery were low, 43,4% and 59,1% respectively. Factors associated with the use of these services were women's and partner's education, household wealth index, media exposure, women's autonomy in health-related decision making and parity. Besides, utilization of at least 4 ANC was also positively associated with the presence of a skilled attendant at birth. These results imply that the determinants of maternal health service utilization are multi-sectoral and thus, need a multi-sectoral approach to tackle it. Policy makers, program managers, and researchers should also explore effective ways of increasing service utilization among less educated women, women from poor households, multipara, and those who are not achieving ANC.
Keywords
Antenatal Care, Skilled Delivery Attendant, Maternal Health Service, Determinants, Cote d’Ivoire
To cite this article
Kpebo Djoukou Olga Denise, Koumi Mélèdje Marie-Dorothée, Agbré Yacé Marie-Laurette, Tano-Kamelan Akoua, Essis Esme Marie Laure, Yavo Williams, Kouassi Dinard, Factors Associated with Maternal Health Service Utilization in Cote d’Ivoire: Analysis of the 2011 Ivorian Demographic and Health Survey, Science Journal of Public Health. Vol. 7, No. 4, 2019, pp. 115-122. doi: 10.11648/j.sjph.20190704.12
Copyright
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
[1]
WHO, UNICEF, UNFPA, World Bank Group, United Nations Population Division. Trends in Maternal Mortality: 1990 to 2015. Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division [Internet]. Available on Disponible sur: https://www.who.int/reproductivehealth/publication/monitoring/maternal-mortality-2015/en/
[2]
Babalola S, Fatusi A. Determinants of use of maternal health services in Nigeria-looking beyond individual and household factors. BMC pregnancy and childbirth. 2009; 9 (1): 43.
[3]
Magadi MA, Agwanda AO, Obare FO. A comparative analysis of the use of maternal health services between teenagers and older mothers in sub-Saharan Africa: evidence from Demographic and Health Surveys (DHS). Social science & medicine. 2007; 64 (6): 1311–1325.
[4]
Yaya S, Uthman OA, Amouzou A, Ekholuenetale M, Bishwajit G. Inequalities in maternal health care utilization in Benin: a population-based cross-sectional study. BMC Pregnancy and Childbirth [Internet]. déc 2018 [cité 4 oct 2018]; 18 (1). Disponible sur: https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-018-1846-6
[5]
PMNCH. The Global Strategy for women’s, children, and adolescents’ health (2016-2030) [Internet]. Disponible sur: https://www.who.int/pmnch/media/news/2018/ewec-global-strategy-commitments-2018-report/en
[6]
WHO. Strategies toward ending preventable maternal mortality (EPMM) [Internet]. 2015. Disponible sur: https://www.who.int/reproductivehealth/topics/maternal-perinatal/epmm/en/
[7]
Mpembeni RN, Killewo JZ, Leshabari MT, Massawe SN, Jahn A, Mushi D, et al. Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC pregnancy and childbirth. 2007; 7 (1): 29.
[8]
Fournier P, Dumont A, Tourigny C, Dunkley G, Dramé S. Improved access to comprehensive emergency obstetric care and its effect on institutional maternal mortality in rural Mali. Bulletin of the World Health Organization. 2009; 87: 30–38.
[9]
Buor D, Bream K. An analysis of the determinants of maternal mortality in sub-Saharan Africa. Journal of Women’s Health. 2004; 13 (8): 926–938.
[10]
Graham WJ, Bell JS, Bullough CH. Can skilled attendance at delivery reduce maternal mortality in developing countries? Safe motherhood strategies: a review of the evidence. 2001;
[11]
Birmeta K, Dibaba Y, Woldeyohannes D. Determinants of maternal health care utilization in Holeta town, central Ethiopia. BMC Health Services Research [Internet]. déc 2013 [cité 28 sept 2018];13(1). Disponible sur: http://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-13-256.
[12]
Abebe F, Berhane Y, Girma B. Factors associated with home delivery in Bahirdar, Ethiopia: A case control study. BMC Research Notes. 24 nov 2012; 5 (1): 653.
[13]
Carroli G, Rooney C, Villar J. How effective is antenatal care in preventing maternal mortality and serious morbidity? An overview of the evidence. Paediatric and Perinatal Epidemiology. janv 2001; 15 (s1): 1-42.
[14]
Prata N, Passano P, Sreenivas A, Gerdts CE. Maternal Mortality in Developing Countries: Challenges in Scaling-Up Priority Interventions. Womens Health (Lond Engl). 1 mars 2010; 6 (2): 311-27.
[15]
Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries. Shea BJ, éditeur. PLoS ONE. 23 juin 2010; 5 (6): e11190.
[16]
Simkhada B, Teijlingen ER van, Porter M, Simkhada P. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. Journal of advanced nursing. 2008; 61 (3): 244–260.
[17]
Wilunda C, Quaglio G, Putoto G, Takahashi R, Calia F, Abebe D, et al. Determinants of utilization of antenatal care and skilled birth attendant at delivery in South West Shoa Zone, Ethiopia: a cross sectional study. Reprod Health [Internet]. 25 août 2015 [cité 24 oct 2018];12. Disponible sur: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592558/
[18]
Rurangirwa AA, Mogren I, Nyirazinyoye L, Ntaganira J, Krantz G. Determinants of poor utilization of antenatal care services among recently delivered women in Rwanda; a population-based study. BMC Pregnancy Childbirth. 15 may 2017; 17 (1): 142.
[19]
National Institute of Statistics (INS) and ICF International 2012. Demographic and Health Survey and Multiple Indicators Clustered Survey in Ivory Coast 2011-2012. Calverton, Maryland, USA: INS and ICF International.
[20]
Cisse A. Analysis of health care utilization in Côte d’Ivoire. 2011.
[21]
Gohou V, Ronsmans C, Kacou L, Yao K, Bohoussou KM, Houphouet B, et al. Responsiveness to life-threatening obstetric emergencies in two hospitals in Abidjan, Côte d’Ivoire. Tropical Medicine & International Health. 2004; 9(3): 406–415.
[22]
Tarekegn SM, Lieberman LS, Giedraitis V. Determinants of maternal health service utilization in Ethiopia: analysis of the 2011 Ethiopian Demographic and Health Survey. BMC Pregnancy and Childbirth [Internet]. déc 2014 [cité 28 sept 2018]; 14 (1). Disponible sur: http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/1471-2393-14-161
[23]
Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic Status, Education and Empowerment: Implications for Maternal Health Service Utilization in Developing Countries. PLOS ONE. 23 juin 2010; 5 (6): e11190.
[24]
Arthur E. Wealth and antenatal care use: implications for maternal health care utilization in Ghana. Health Economics Review. 6 août 2012; 2 (1): 14.
[25]
Mengesha ZB, Biks GA, Ayele TA, Tessema GA, Koye DN. Determinants of skilled attendance for delivery in Northwest Ethiopia: a community based nested case control study. BMC Public Health. 12 févr 2013; 13 (1): 130.
[26]
Bloom SS, Wypij D, Gupta MD. Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography. 2001; 38 (1): 67–78.
[27]
Furuta M, Salway S. Women’s position within the household as a determinant of maternal health care use in Nepal. International family planning perspectives. 2006; 17–27.
[28]
Simkhada B, Teijlingen ER van, Porter M, Simkhada P. Factors affecting the utilization of antenatal care in developing countries: systematic review of the literature. Journal of advanced nursing. 2008; 61 (3): 244–260.
[29]
Gabrysch S, Campbell OM. Still too far to walk: literature review of the determinants of delivery service use. BMC pregnancy and childbirth. 2009; 9 (1): 34.
[30]
Celik Y, Hotchkiss DR. The socio-economic determinants of maternal health care utilization in Turkey. Social science & medicine. 2000; 50 (12): 1797–1806.
[31]
Navaneetham K, Dharmalingam A. Utilization of maternal health care services in Southern India. Social science & medicine. 2002; 55 (10): 1849–1869.
[32]
Bhatia JC, Cleland J. Determinants of maternal care in a region of South India. 1995.
ADDRESS
Science Publishing Group
1 Rockefeller Plaza,
10th and 11th Floors,
New York, NY 10020
U.S.A.
Tel: (001)347-983-5186