Country compliance with WHO-recommended antenatal care guidelines

Equity analysis of the 2015–2016 Demography and Health Survey in Myanmar

Datos Bibliográficos

ID21879782
AutoresNgatho Samuel Mugo (0000-0002-9300-788X, The University of Sydney, autor de correspondencia), Kyaw Swa Mya (University of Public Health Yangon), Camille Raynes-Greenow (0000-0002-8802-6226, The University of Sydney)
Año2020
Volumen5
Número12
Páginase002169
Fecha de publicación2020-12-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaBMJ Global Health (JOURNAL)
Identificadores de la revistaISSN: 2059-7908 • E-ISSN: 2059-7908
EditorialBMJ (PUBLISHER • GB)
DOI10.1136/bmjgh-2019-002169
PMID33298468
OpenAlexW3112691090
IdiomaEN
Citas recibidas4
Referencias citadas38

INTRODUCTION: Early access to adequate antenatal care (ANC) from skilled providers is crucial for detecting and preventing obstetric complications of pregnancy. We aimed to assess factors associated with the utilisation of the new WHO ANC guidelines including the recommended number, on time initiation and adequate components of ANC contacts in Myanmar. METHODS: We examined data from 2943 mothers aged 15-49 years whose most recent birth occurred in the last 5 years prior to the 2015-2016 Myanmar Demographic and Health Survey. Factors associated with utilisation of the new WHO recommended ANC were explored using multinomial logistic regression and multivariate models. We used marginal standardisation methods to estimate the predicted probabilities of the factors significantly associated with the three measures of ANC. RESULTS: Approximately 18% of mothers met the new WHO recommended number of eight ANC contacts. About 58% of the mothers received adequate ANC components, and 47% initiated ANC within the first trimester of pregnancy. The predicted model shows that Myanmar could achieve 70% coverage of adequate components of ANC if all women were living in urban areas. Similarly, if ANC was through private health facilities, 63% would achieve adequate components of ANC. Pregnant women from urban areas (adjusted risk ratio (aRR): 4.86, 95% CI 2.44 to 9.68) were more than four times more likely to have adequate ANC components compared with women from rural areas. Pregnant women in the highest wealth quintile were three times more likely to receive eight or more ANC contacts (aRR: 3.20, 95% CI 1.61 to 6.36) relative to mothers from the lowest wealth quintile. On time initiation of the first ANC contact was fourfold for mothers aged 30-39 years relative to adolescent mothers (aRR: 4.07, 95% CI 1.53 to 10.84). CONCLUSION: The 2016 WHO ANC target is not yet being met by the majority of women in Myanmar. Our results highlight the need to address health access inequity for women who are from lower socioeconomic groups, or are younger, and those living in rural areas

Environmental health · Health facility · Health services · Logistic regression · Multinomial logistic regression · Population · Pregnancy · Statistics · Demography · Global Maternal and Child Health · Healthcare Systems and Reforms · Maternal and Perinatal Health Interventions · Medicine