Associations in the continuum of care for maternal, newborn and child health: A population-based study of 12 sub-Saharan Africa countries

Patrick Opiyo Owili, Miriam Adoyo Muga, Yiing Jenq Chou, Yi Hsin Elsa Hsu, Nicole Huang, Li Yin Chien

Research output: Contribution to journalArticle

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Abstract

Background: Despite the progress in the Millennium Development Goals (MDGs) 4 and 5, inequity in the utilization of maternal, newborn and child health (MNCH) care services still remain high in sub-Saharan Africa (SSA). The continuum of care for MNCH that recognizes a tight inter-relationship between maternal, newborn and child health at different time periods and location is key towards reducing inequity in health. In this study, we explored the distributions in the utilization MNCH services in 12 SSA countries and further investigated the associations in the continuum of care for MNCH. Methods: Using Demographic and Health Surveys data of 12 countries in SSA, structural equation modeling approach was employed to analyze the complex relationships in continuum of care for MNCH model. The Full Information Maximum Likelihood estimation procedure which account for the Missing at Random (MAR) and Missing Completely at Random (MCAR) assumptions was adopted in LISREL 8.80. The distribution of MNCH care utilization was presented before the estimated association in the continuum of care for MNCH model. Results: Some countries have a consistently low (Mali, Nigeria, DR Congo and Rwanda) or high (Namibia, Senegal, Gambia and Liberia) utilization in at least two levels of MNCH care. The path relationships in the continuum of care for MNCH from 'adequate antenatal care' to 'adequate delivery care' (0.32) and to 'adequate child's immunization' (0.36); from 'adequate delivery care' to 'adequate postnatal care' (0.78) and to 'adequate child's immunization' (0.15) were positively associated and statistically significant at p <0.001. Only the path relationship from 'adequate postnatal care' to 'adequate child's immunization' (-0.02) was negatively associated and significant at p <0.001. Conclusions: In conclusion, utilization of each level of MNCH care is related to the next level of care, that is - antenatal care is associated with delivery care which is then associated with postnatal and subsequently with child's immunization program. At the national level, identification of communities which are greatly contributing to overall disparity in health and a well laid out follow-up mechanism from pregnancy through to child's immunization program could serve towards improving maternal and infant health outcomes and equity.

Original languageEnglish
Article number414
JournalBMC Public Health
Volume16
Issue number1
DOIs
Publication statusPublished - May 17 2016

Fingerprint

Continuity of Patient Care
Africa South of the Sahara
Population
Child Care
Postnatal Care
Immunization
Immunization Programs
Prenatal Care
Delivery of Health Care
Health Status
Child Health
Infant Health
Maternal Health
Liberia
Patient Acceptance of Health Care
Namibia
Child Health Services
Rwanda
Gambia
Congo

Keywords

  • Continuum of care
  • Maternal
  • newborn and child health
  • Structural equation modeling
  • Sub-Saharan Africa

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Associations in the continuum of care for maternal, newborn and child health : A population-based study of 12 sub-Saharan Africa countries. / Owili, Patrick Opiyo; Muga, Miriam Adoyo; Chou, Yiing Jenq; Hsu, Yi Hsin Elsa; Huang, Nicole; Chien, Li Yin.

In: BMC Public Health, Vol. 16, No. 1, 414, 17.05.2016.

Research output: Contribution to journalArticle

Owili, Patrick Opiyo ; Muga, Miriam Adoyo ; Chou, Yiing Jenq ; Hsu, Yi Hsin Elsa ; Huang, Nicole ; Chien, Li Yin. / Associations in the continuum of care for maternal, newborn and child health : A population-based study of 12 sub-Saharan Africa countries. In: BMC Public Health. 2016 ; Vol. 16, No. 1.
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