Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data

  • BMC Pregnancy and Childbirth, Volume 21, No. 1, Year 2021

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Study Justification:
– Maternal health is a global priority, and maternal deaths are a significant concern, particularly in sub-Saharan Africa.
– Lack of access to antenatal care and skilled assistance during delivery contributes to maternal deaths.
– This study aims to assess the determinants of antenatal care and skilled birth attendance utilization among childbearing women in Guinea.
Highlights:
– The study analyzed data from the 2018 Guinea Demographic and Health Survey.
– The sample included 4,917 childbearing women.
– The study used chi-square tests and multivariable logistic regression for analysis.
– Various factors were found to influence antenatal care and skilled birth attendance utilization in Guinea.
– Factors such as age, education level, partner’s education level, wealth quintile, pregnancy planning, religion, decision-making autonomy, media access, and household composition were associated with higher odds of utilization.
Recommendations for Lay Reader and Policy Maker:
– Design community-based interventions, such as miniature local antenatal care clinics and early screening services.
– Prioritize women’s education and vocational training to improve utilization.
– Improve media accessibility, especially among the poor and those in rural settings.
– Address socio-cultural norms that hinder the utilization of antenatal care and skilled birth attendance services.
Key Role Players:
– Ministry of Health: Responsible for implementing interventions and policies related to maternal health.
– Community Health Workers: Involved in providing antenatal care and promoting utilization.
– Educators and Vocational Training Centers: Contribute to women’s education and vocational training.
– Media Organizations: Play a role in improving media accessibility and disseminating information.
– Non-Governmental Organizations: Support the implementation of community-based interventions and address socio-cultural norms.
Cost Items for Planning Recommendations:
– Construction and maintenance of miniature local antenatal care clinics.
– Training programs for community health workers.
– Education and vocational training programs for women.
– Media campaigns and programs to improve accessibility.
– Research and development of interventions to address socio-cultural norms.
– Monitoring and evaluation of implemented interventions.
Please note that the cost items provided are general categories and not actual cost estimates.

The strength of evidence for this abstract is 8 out of 10.
The evidence in the abstract is rated 8 because it provides specific findings from a study conducted using the 2018 Guinea Demographic and Health Survey data. The study used a large sample size of 4,917 childbearing women and employed chi-square tests and multivariable logistic regression for analysis. The results show significant associations between various factors and the utilization of antenatal care and skilled birth attendance services. The abstract also concludes by suggesting actionable steps to improve maternal health in Guinea, such as designing community-based interventions and addressing socio-cultural norms. To improve the evidence, it would be helpful to provide more details on the methodology used, such as the specific variables included in the analysis and any limitations of the study.

Background: Globally, maternal health remains a major priority. Most of maternal deaths globally occur in sub-Saharan Africa, with most of these deaths linked to lack of access to antenatal care and skilled assistance during delivery. This study assessed the determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea. Methods: Data for this study were obtained from the 2018 Guinea Demographic and Health Survey (GDHS). Data of 4,917 childbearing women were considered as our analytical sample. The outcome variables for the study were utilization of antenatal care and skilled birth attendance. Analysis was carried out using chi-square tests and multivariable logistic regression. Results: The results showed that women aged 15-24 (AOR=1.29, CI=1.03-1.62), women who had secondary/higher level of education (AOR=1.70, CI=1.33-2.19), and those whose partners had secondary/higher level of education (AOR=1.46, CI=1.22-1.75), women in the richest wealth quintile (AOR=5.09, CI=3.70-7.00), those with planned pregnancies (AOR=1.50, CI=1.23-1.81), Muslim women (AOR=1.65, CI=1.38-2.12), those who take healthcare decisions alone (AOR=1.53, CI=1.24-1.89), and those who listened to radio less than once a week (AOR= 1.30, CI=1.10-1.53) had higher odds of antenatal care uptake. Also, women with secondary/higher level of education (AOR=1.83, CI=1.25-2.68), those whose partners had secondary/higher level of education (AOR=1.40, CI=1.11-1.76), those in the richest wealth quintile (AOR=10.79, CI=6.64-17.51), those with planned pregnancies (AOR=1.25, CI=1.03-1.52), Christian women (AOR=4.13, CI=3.17-5.39), those living in urban areas (AOR=3.00, CI=2.29-3.94), women with one birth (AOR= 1.58, CI=1.20-2.06), those who take healthcare decisions alone (AOR=1.87, CI=1.46-2.39), those who read newspaper at least once a week (AOR= 1.19, CI=1.01-1.40), those who watched television at least once week (AOR=1.69, CI=1.30-2.19), and those in female-headed households (AOR=1.52, CI=1.20-1.92) were more likely to utilize the services of skilled birth attendants. Conclusion: The study proved that various socio-economic and contextual factors influence antenatal care and skilled birth attendance in Guinea. These findings suggest the need to design community-based interventions (e.g., miniature local ANC clinics, early screening services) that prioritize women’s education and vocational training, media accessibility, especially among the poor, and those residing in rural settings. Such interventions should not ignore the influence of other socio-cultural norms that hinder the utilization of antenatal care and skilled birth attendance services in Guinea.

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The study “Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data” provides valuable insights into improving access to maternal health in Guinea. Based on the study’s findings, the following recommendations can be developed into innovations:

1. Community-based ANC clinics: Design and implement miniature local antenatal care (ANC) clinics in communities, especially in rural areas. These clinics can provide accessible and comprehensive ANC services, including early screening and health education, to pregnant women.

2. Women’s education and vocational training: Prioritize women’s education and vocational training to empower them with knowledge and skills related to maternal health. This can include programs that provide education on the importance of ANC and skilled birth attendance, as well as training for women to become skilled birth attendants themselves.

3. Media accessibility: Improve media accessibility, particularly among the poor and those residing in rural settings. This can involve initiatives to increase radio and television coverage, as well as promoting the use of newspapers for disseminating information on maternal health services and their benefits.

4. Address socio-cultural norms: Develop interventions that address socio-cultural norms that hinder the utilization of ANC and skilled birth attendance services. This can involve community engagement and awareness campaigns to challenge harmful beliefs and practices, promote gender equality, and encourage women’s autonomy in making healthcare decisions.

By implementing these recommendations, Guinea can work towards improving access to maternal health services, reducing maternal mortality rates, and ensuring better health outcomes for women and their newborns.
AI Innovations Description
The study “Determinants of antenatal care and skilled birth attendance services utilization among childbearing women in Guinea: evidence from the 2018 Guinea Demographic and Health Survey data” provides valuable insights into improving access to maternal health in Guinea. Based on the study’s findings, the following recommendations can be developed into innovations:

1. Community-based ANC clinics: Design and implement miniature local antenatal care (ANC) clinics in communities, especially in rural areas. These clinics can provide accessible and comprehensive ANC services, including early screening and health education, to pregnant women.

2. Women’s education and vocational training: Prioritize women’s education and vocational training to empower them with knowledge and skills related to maternal health. This can include programs that provide education on the importance of ANC and skilled birth attendance, as well as training for women to become skilled birth attendants themselves.

3. Media accessibility: Improve media accessibility, particularly among the poor and those residing in rural settings. This can involve initiatives to increase radio and television coverage, as well as promoting the use of newspapers for disseminating information on maternal health services and their benefits.

4. Address socio-cultural norms: Develop interventions that address socio-cultural norms that hinder the utilization of ANC and skilled birth attendance services. This can involve community engagement and awareness campaigns to challenge harmful beliefs and practices, promote gender equality, and encourage women’s autonomy in making healthcare decisions.

By implementing these recommendations, Guinea can work towards improving access to maternal health services, reducing maternal mortality rates, and ensuring better health outcomes for women and their newborns.
AI Innovations Methodology
To simulate the impact of the main recommendations on improving access to maternal health in Guinea, the following methodology can be used:

1. Community-based ANC clinics: Implement miniature local ANC clinics in selected communities, especially in rural areas. Collect data on the number of pregnant women accessing ANC services before and after the implementation of these clinics. Compare the utilization rates of ANC services in the target communities with control communities without the clinics. Analyze the data using statistical methods to determine the impact of the clinics on improving access to ANC.

2. Women’s education and vocational training: Implement women’s education and vocational training programs in selected areas. Collect data on the number of women participating in these programs and their knowledge and attitudes towards maternal health before and after the programs. Conduct surveys or interviews to assess the impact of the programs on women’s utilization of ANC and skilled birth attendance services. Compare the data with control groups that did not receive the training to determine the effectiveness of the programs.

3. Media accessibility: Implement initiatives to improve media accessibility, such as increasing radio and television coverage in selected areas. Collect data on media consumption habits and knowledge of maternal health services among the target population before and after the initiatives. Conduct surveys or interviews to assess the impact of increased media accessibility on women’s utilization of ANC and skilled birth attendance services. Compare the data with control groups that did not have increased media accessibility to evaluate the effectiveness of the initiatives.

4. Address socio-cultural norms: Develop interventions to address socio-cultural norms that hinder the utilization of maternal health services. Implement community engagement and awareness campaigns in selected areas. Collect data on changes in knowledge, attitudes, and practices related to maternal health among the target population before and after the interventions. Conduct surveys or interviews to assess the impact of the interventions on women’s utilization of ANC and skilled birth attendance services. Compare the data with control groups that did not receive the interventions to determine the effectiveness of the campaigns.

By analyzing the data collected from these simulations, it will be possible to evaluate the impact of the recommendations on improving access to maternal health services in Guinea. This information can then be used to refine and scale up the interventions that prove to be effective in increasing utilization rates of ANC and skilled birth attendance services.


Statistics:
Citations: 14
Identifiers:
DOI: 10.1186/s12884-020-03489-4
Research Areas:
Community Interventions, Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Social Determinants, Workforce
Study Countries:
Guinea
Study Design:
Cross Sectional Study
Study Approach:
Quantitative
Participants Gender:
Female
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