ArticleBMC health services research2020
When it rains, it pours: detecting seasonal patterns in utilization of maternal healthcare in Mozambique using routine data.
Article in BMC health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Impact of extreme precipitation events on facility-based births in 21 sub-Saharan African countries.Nature communications · 2026Article
- Barriers and Enablers to All-Oral Multi-Drug Resistance Tuberculosis Treatment Adherence in Traditional Authorities Chimwala and Chowe, Mangochi District, Malawi.Malawi medical journal : the journal of Medical Association of Malawi · 2025Article
- The impact of precipitation on ANC service utilisation and healthcare access in Malawi.Scientific reports · 2025Article
- Seasonal variations in public perceptions of diphtheria in Northern Nigeria.BMC public health · 2025Article
- Spatial Access to Continuous Maternal and Perinatal Health Care Services in Low-Resource Settings: Cross-Sectional Study.JMIR public health and surveillance · 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
- Maternal and Child Health Services Utilization During COVID-19 in Eastern Ethiopia.International journal of public health · 2024Article
- Impacts of seasonal flooding on geographical access to maternal healthcare in the Barotse Floodplain, Zambia.International journal of health geographics · 2023Article
- Article
- Estimating the effects of COVID-19 on essential health services utilization in Uganda and Bangladesh using data from routine health information systems.Frontiers in public health · 2023Article
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4 authors.
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Abstract
backgroundClimatic conditions and seasonal trends can affect population health, but typically, we consider the effect of climate on the epidemiology of communicable diseases. However, climate can also have an effect on access to care, particularly in remote rural areas of low- and middle-income countries. In this study, we investigate associations between the rainy season and the utilization of maternal health services in Mozambique.
methodsWe examined patterns in the number of women receiving antenatal care (ANC) and delivering at a health facility for 2012-2019, using data from Mozambique's Health Management Information Systems. We investigated the association between seasonality (rainfall) and maternal health service utilization (ANC and institutional delivery) at national and provincial level. We fit a negative binomial regression model for institutional delivery and used it to estimate the yearly reduction in institutional deliveries due to the rainy season, with other factors held constant. We used the Lives Saved Tool (LiST) to model increases in mortality due to this estimated decrease in institutional delivery associated with the rainy season.
resultsIn our national analysis, the rate of ANC visits was 1% lower during the rainy season, adjusting for year and province (IRR = 0.99, 95% CI: 0.96-1.03). The rate of institutional deliveries was 6% lower during the rainy season than the dry season, after adjusting for time and province (IRR = 0.94, 95% CI: 0.92-0.96). In provincial analyses, all provinces except for Maputo-Cidade, Maputo-Province, Nampula, and Niassa showed a statistically significantly lower rate of institutional deliveries in the rainy season. None were statistically significantly lower for ANC. We estimate that, due to reductions in institutional delivery attributable only to the rainy season, there were 74 additional maternal deaths and 726 additional deaths of children under the age of 1 month in 2021, that would not have died if the mothers had instead delivered at a facility.
conclusionFewer women deliver at a health facility during the rainy season in Mozambique than during the dry season. Barriers to receiving care during pregnancy and childbirth must be addressed using a multisectoral approach, considering the impact of geographical inequities.
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