Accessibility, quality of care and prenatal care use in the Philippines

doi:10.1016/0277-9536(87)90286-3

Social Science & Medicine

Volume 24, Issue 11, 1987, Pages 927-944

https://doi.org/10.1016/0277-9536(87)90286-3 Get rights and content

Abstract

The patterns and determinants of prenatal care are examined through the use of a randomly selected sample of 3000 rural and urban women who were studied prospectively during pregnancy and at three or four days postpartum. A large number of policy factors were found to influence the choice of most frequently used type of traditional, modern public or modern private prenatal care and the number of visits to each type of care, but few affected the first month of visit. The quality of care provided, accessibility to this care, and insurance available to the mother all had important effects on prenatal patterns. Large differences exist in the set of feasible policy options for improving prenatal care in urban and rural areas.

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There are more references available in the full text version of this article.

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Geographical divide led inequality in accessing maternal healthcare services between hills and valley regions of Manipur state, India
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Second, as the number of borne children increases, women may develop confidence and tend to believe that modern health care is not necessary and may rely on past experience and knowledge from previous pregnancies and birth.27 Third, a higher birth order indicates the greater family size and hence lack of time and money to seek formal health care.28 The problem due to cost, travel, and waiting time in accessing maternal health care services in the hilly district of Manipur is well documented in the previous studies.7,29
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The objective is to examine the spatial variations and to identify the determinants of antenatal care (ANC) utilization while controlling for the spatial dependence in the data.
This is an ecological study on ANC utilization data from District Level Household Survey-4 (2012–2013) in India.
A secondary data analysis was performed on the derived data. The unit of analysis in this ecological study was 275 districts from 20 states of India. The study comprises ever married women of reproductive age. Determinants of ANC utilization were obtained using ordinary least square (OLS), spatial lag, and spatial error models. Model adequacy check was performed using the Akaike information criterion, R-squared, log likelihood, and Schwarz criterion. The software used is GeoDa and Quantum Geographic Information System.
The presence of spatial autocorrelation (Moron's I = 0.6210) enforces the usage of geographic properties while modeling. The geographic clustering of low-rate districts was observed in states in Northeast India. In the present study, the model adequacy check reveals that the spatial error model performs better than the spatial lag and OLS models. The spatial pattern of the percentage of pregnant women with full ANC was observed to be associated with literacy (P = 0.04), birth order (P < 0.001), Janani Suraksha Yojana beneficiaries (P = 0.048), and availability of health infrastructure, staff, and services (P = 0.023).
The present study findings provide valuable insights into factors affecting ANC utilization. In addition to available ANC services, customized safe motherhood interventions and region-specific awareness programs would enhance the utilization, ensuring better maternal and child health.
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The point that extending the all-weather road network to village communities brings with it new hazards to health as well as new opportunities to get and stay well is hardly new. There are numerous references in the literature to the fact that the provision of all-weather roads improves the rural population's access to health facilities, as well as the specific findings that trip-time and -cost hinder the uptake of formal health care (see, e.g., Wong et al., 1987; Gertler and van der Gaag, 1990; Mwabu et al., 1993). Yet there appears to be nothing on whether the provision of such roads actually affects morbidity.
This paper investigates the effects of India's rural roads programme (PMGSY) on morbidity, using data on 279 households drawn from 30 villages in upland Orissa. The households were surveyed in 2010 and 2013, yielding an unbalanced panel of 1580 individuals, 1076 of whom were present in both years. Ten of the villages had received a direct all-weather road connection between 2004 and 2013. To estimate the programme's effects, the villages were treated as units within the whole network of roads and medical facilities. The provision of a connection, whether direct or in the neighbourhood, was associated with the following reductions in morbidity (random-effects estimates): for each km of unpaved track so replaced, an inhabitant's probability of suffering a bout of incapacitating illness fell by 4.5 percentage points and the expected duration of such illness by 0.53 days. The village fixed-effects estimates are qualitatively the same, but smaller and less precise. A simple indicator variable for the presence or absence of such a connection yields qualitatively similar estimates, but with very large standard errors, which confirms the importance of employing fine measures of the network regressors.
Utilization of Maternal Health Care Services among Married Adolescent Women: Insights from the Nigeria Demographic and Health Survey, 2008
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Citation Excerpt :
Although it is usually unclear why higher order adolescent women are less likely to utilize skilled delivery services (Santhya, Jejeebhoy, & Ghosh, 2008), few studies argued that lower parity women tend to give careful attention to seeking assistance during delivery because of their inexperience with pregnancy and greater health risks for women and child (Bell et al., 2003; Raj, Saggurti, Balaiah, & Silverman, 2009). Also, lower utilization of maternal healthcare services among higher parity women could be due to time and resource constraints faced by those with larger families (Wong, Popkin, Guilkey, & Akin, 1987; Elo, 1992; Bhatia & Cleland, 1995). This study underscores the immediate need for more research and exploration into the factors that restrict the utilization of maternal healthcare services by higher order births among young women.
An ongoing social catastrophe of very poor performance in maternal health coupled with an unacceptably high number of maternal deaths is evident in Nigeria, especially among adolescent women. This study examines the factors associated with selected maternity services—married adolescent women who have had at least four antenatal care (ANC) visits, those who have undergone safe delivery care, and those who received postnatal care within 42 days of delivery.
Data from Nigeria Demographic and Health Survey, 2008, were used. An eligible sample of 2,434 married adolescent (aged 15–19 years) women was included in the analysis. Pearson chi-square test and binary logistic regression were performed to fulfill the study objective.
It was found that about 35% of adolescent women had at least four ANC visits, a little over 25% had undergone safe delivery care, and nearly 32% received postnatal care within 42 days of delivery. Women's education, husband's education, wealth quintile, and region of residence were documented as the most important factors associated with maternal healthcare service utilization. The ANC visit was found to be vital in the utilization of safe delivery and postnatal care.
Findings indicate that programs to improve maternal healthcare have not succeeded in overcoming the socioeconomic obstacles in the way of adolescents' utilizing maternity services. In the long run, the content and service delivery strategy of maternity programs must be designed in keeping with the socioeconomic context with special attention to adolescent women who are uneducated, poor, and residing in rural areas.
Assessing the utilization of maternal and child health care among married adolescent women: Evidence from India
2012, Journal of Biosocial Science

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Accessibility, quality of care and prenatal care use in the Philippines

Abstract

The Demand for Primary Health Care in the Third World

An attempt to reduce infant and child mortality in Bohol, Philippines

Stud. Family Planng

Demand for primary health care services in the Bicol region of the Philippines

Econ. Devl. Cult. Change

Philippine Economic Indicators