Interrelationships between early antenatal care, health facility delivery and early postnatal care among women in Uganda: a structural equation analysis
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Global Health Action
Abstract
Early medical checkups during and after delivery are key strategies to detect,
prevent and treat maternal health concerns. Knowledge of interrelationships between early
Antenatal Care (ANC), skilled delivery and early postnatal care (EPNC) is essential for focused
and well-targeted interventions. This paper investigated the interconnectedness between
maternal health services in Uganda.
Objective: This study examines the predictors of interrelationships between early antenatal
care, health facility delivery and early postnatal care.
Methods: We used a sample of 10,152 women of reproductive ages (15–49), who delivered a
child five years prior to the 2016 Uganda Demographic and Health Survey. A generalized
Structural Equation Model and STATA 13.0 software were used.
Results: Early ANC was a mediating factor for health facility delivery (aOR=1.04; 95% CI=1.01-
1.14) and EPNC (aOR=1.1; 95% CI=1.05-1.26). Increased odds of early ANC utilization was
directly associated with: Adult women aged 35-49 (aOR=1.18; 95% CI=1.10-1.35), having
completed primary seven (aOR=1.68; 95% CI=1.56-1.84); distance to a health facility
(aOR=1.35; 95% CI=1.23-1.73) and costs (aOR=1.85; 95% CI=1.31-2.12) not being a problem,
available community workers (aOR=1.06; 95% CI=1.04-1.17), pregnancy complications
(aOR=2.04; 95% CI=1.85-2.26) and desire for pregnancy (aOR=1.15; 95% CI=1.07-1.36).
Through early ANC utilization, being married (aOR=1.16; (=1.04*1.10)), no distance issues
((aOR=1.40; (=1.04*1.35)) and complications (aOR=2.12; (=1.04*2.04)) indirectly influenced
utilization of health facility delivery. Women aged 20-34 (aOR=1.01; (=0.92*1.1)), completing
primary seven (aOR=1.85; (=1.69*1.1)) and no cost problems (aOR=2.04; (=1.85*1.1)) indirectly
influenced EPNC.
Conclusion: Early antenatal care was a mediating factor for health facility delivery and EPNC;
and hence, there is need for more focus on factors for increased early antenatal care
utilization. Women with higher education and those with no cost problems were more likely
to have early ANC utilization, skilled delivery and EPNC; therefore there is need to design and
implement policies targeting social and economically disadvantaged women.
Description
Keywords
Generalized structural equation model, Maternal healthcare, Interconnectedness
Citation
Ruth Atuhaire, Leonard K Atuhaire, Robert Wamala & Elizabeth Nansubuga (2020) Interrelationships between early antenatal care, health facility delivery and early postnatal care among women in Uganda: a structural equation analysis, Global Health Action, 13:1, 1830463, DOI: 10.1080/16549716.2020.1830463