ArticleGlobalization and health2020
Maternal health services utilisation among primigravidas in Uganda: what did the MDGs deliver?
Article in Globalization and health, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Factors influencing the uptake of antenatal care in Uganda: a mixed methods systematic review.BMC pregnancy and childbirth · 2024Pooled it
- Compliance with WHO-recommended ≥8 antenatal contacts and associated factors among women at primary health facilities in Mbarara district, Uganda.SAGE open medicine · 2026Article
- Key barriers to the provision and utilization of maternal health services in low-and lower-middle-income countries; a scoping review.BMC women's health · 2024Article
- Utilization of Antenatal Care and Skilled Birth Delivery Services in Sub-Saharan Africa: A Systematic Scoping Review.International journal of environmental research and public health · 2024Article
- Barriers and strategies needed to improve maternal health services among pregnant adolescents in Uganda: a qualitative study.Global health action · 2022Article
- Spatial variation and inequities in antenatal care coverage in Kenya, Uganda and mainland Tanzania using model-based geostatistics: a socioeconomic and geographical accessibility lens.BMC pregnancy and childbirth · 2022Article
- Practices and barriers to screening for hyperglycaemia in pregnancy among providers of antenatal care in Jos, Nigeria.African journal of laboratory medicine · 2022Article
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4 authors.
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Abstract
backgroundAchieving maternal health outcomes in the SDGs requires the implementation of more targeted policies and strategies. While the MDGs may have deepened our understanding in this regard, we know little about the trends in maternal health services utilisation among primigravidas, and how age and geographical regions could have influenced these trends. In this study, we examined utilisation of antenatal and skilled delivery services among primigravidas in Uganda, a country with one of the highest maternal mortality ratios, and where early childbearing and its attendant challenges are common.
methodsGuided by Andersen's Behavioural Model, we fitted multivariate regression models to a pooled dataset of the 2006, 2011 and 2016 Ugandan Demographic and Health Survey (n = 3477) to understand the dynamics in Antenatal Care (ANC) and Skilled Birth Attendance (SBAs) utilisation among primigravidas. Post-estimation margins were employed to further highlight the effect of age and geographical regions.
resultsThe analyses show an improvement in access to maternal health services among primigravidas from 2006 to 2016. Compared to 2006, primigravidas in 2016 were 48%, 24% and 2.98 times more likely to have early ANC, four or more ANC visits, and SBAs, respectively. Altogether, a primigravida in 2016 relative to 2006 was 42% more likely to meet all three maternal health service indicators. Post-estimation margins analyses on age and geographical disparities revealed that younger primigravidas have lower probability, while primigravidas in Eastern Region, one of the most deprived in the country, have the lowest probability of accessing maternal health services. Also, the study found education, wealth, women's household decision-making power, place of residence as important determinants of ANC visits and SBAs.
conclusionsBased on our findings, it is important to address the vulnerabilities of primigravidas, particularly younger individuals, in accessing early ANC. Uganda should scale-up decentralisation and integration of maternal health delivery in local communities as a strategy of addressing lingering geographical disparities, and ultimately improve maternal health outcomes in the SDGs period.
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