A structural equation analysis on the relationship between maternal health services utilization and newborn health outcomes: a cross-sectional study in Eastern Uganda

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dc.contributor.authorMuhumuza Kananura, Rornald
dc.contributor.authorWamala, Robert
dc.contributor.authorEkirapa-Kiracho, Elizabeth
dc.contributor.authorTetui, Moses
dc.contributor.authorKiwanuka, Suzanne N.
dc.contributor.authorWaiswa, Peter
dc.contributor.authorAtuhaire, Leonard K.
dc.date.accessioned2022-02-28T17:55:48Z
dc.date.available2022-02-28T17:55:48Z
dc.date.issued2017
dc.description.abstractNeonatal and maternal health services have a bearing on neonatal mortality. Direct and indirect factors affecting neonatal health outcomes therefore require understanding to enable well-targeted interventions. This study, therefore, assessed the interrelationship between newborn health outcomes and maternal service utilization factors. Methods: We investigated maternal health utilization factors using health facility delivery and at least four Antenatal Care (ANC) visits; and newborn health outcomes using newborn death and low birth weight (LBW). We used data from a household cross-sectional survey that was conducted in 2015 in Kamuli, Pallisa and Kibuku districts. We interviewed 1946 women who had delivered in the last 12 months. The four interrelated (Endogenous) outcomes were ANC attendance, health facility delivery, newborn death, and LBW. We performed analysis using a structural equation modeling technique. Results: A history of newborn death (aOR = 12.64, 95% CI 5.31–30.10) and birth of a LBW baby (aOR = 3.51, 95% CI 1. 48–8.37) were directly related to increased odds of newborn death. Factors that reduced the odds of LBW as a mediating factor for newborn death were ANC fourth time attendance (aOR = 0.62, 95% CI 0.45–0.85), having post-primary level education (aOR = 0.68, 95% CI 0.46–0.98) compared to none and being gravida three (aOR = 0.49, 95% CI 0.26–0.94) compared to being gravida one. Mother’s age group, 20–24 (aOR = 0.24, 95% CI 0.08–0.75) and 25–29 years (aOR = 0.20, 95% CI 0.05–0.86) compared to 15–19 years was also associated with reduced odds of LBW. Additionally, ANC visits during the first trimester (aOR = 2.04, 95% CI 1. 79–2.34), and village health teams (VHTs) visits while pregnant (aOR = 1.14, 95% CI 1.01–1.30) were associated with increased odds of at least four ANC visits, which is a mediating factor for health facility delivery, LBW and newborn death. Surprisingly, newborn death was not significantly different between health facility and community deliveries.Conclusions: Attending ANC at least four times was a mediating factor for reduced newborn death and low birth weight. Interventions in maternal health and newborn health should focus on factors that increase ANC fourth time attendance and those that reduce LBW especially in resource-limited settings. Targeting women with high-risk pregnancies is also crucial for reducing newborn deaths.en_US
dc.identifier.citationKananura, R. M., Wamala, R., Ekirapa-Kiracho, E., Tetui, M., Kiwanuka, S. N., Waiswa, P., & Atuhaire, L. K. (2017). A structural equation analysis on the relationship between maternal health services utilization and newborn health outcomes: a cross-sectional study in Eastern Uganda. BMC pregnancy and childbirth, 17(1), 1-12. DOI 10.1186/s12884-017-1289-5en_US
dc.identifier.other10.1186/s12884-017-1289-5
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2329
dc.language.isoenen_US
dc.publisherBMC pregnancy and childbirthen_US
dc.subjectInterrelationshipen_US
dc.subjectStructural equation modelingen_US
dc.subjectMaternal health utilizationen_US
dc.subjectNewborn outcomesen_US
dc.titleA structural equation analysis on the relationship between maternal health services utilization and newborn health outcomes: a cross-sectional study in Eastern Ugandaen_US
dc.typeArticleen_US
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