Evidence map›Paper›PMID 34620615›Full record

ArticleBMJ global health2021

Pregnancy-related healthcare utilisation in Agincourt, South Africa, 1993-2018: a longitudinal surveillance study of rural mothers.

Daniel E Sack, Ryan G Wagner, Daniel Ohene-Kwofie, Chodziwadziwa W Kabudula, Jessica Price, Carren Ginsburg, Carolyn M Audet

Abstract read
In one paragraph

Article in BMJ global health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Daniel E SackVanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA daniel.e.sack@vanderbilt.edu.ORCID 0000-0003-0864-8875
Ryan G WagnerMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0003-2741-3676
Daniel Ohene-KwofieMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Chodziwadziwa W KabudulaMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Jessica PriceMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.ORCID 0000-0002-4020-6850
Carren GinsburgMedical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Carolyn M AudetVanderbilt Institute of Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007347 · NIGMS · VANDERBILT UNIVERSITY · PI WILLIAMS, CHRISTOPHER S. · 1985 to 2023
$26.3M
Vanderbilt-Emory-Cornell-Duke Global Health Fellowship Consortium-Expanding Diversity for Global Equity (EDGE)D43TW009337 · FIC · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ALIYU, MUKTAR HASSAN, HEIMBURGER, DOUGLAS CORBETT · 2017 to 2021
$6.3M
Partners-based HIV Treatment for Sero-concordant Couples attending Antenatal Care: Increasing family-based support for PrEP adherence among discordant couples through storytellingR01MH113478 · NIMH · VANDERBILT UNIVERSITY MEDICAL CENTER · PI AUDET, CAROLYN · 2017 to 2021
$3.2M
A Couples-Based Intervention and Postpartum Contraceptive Uptake in Zambézia Province, MozambiqueF30MH123219 · NIMH · VANDERBILT UNIVERSITY · PI SACK, DANIEL ELI · 2020 to 2022
$105k
FIC NIH HHS D43 TW009337NIGMS NIH HHS T32 GM007347NIMH NIH HHS F30 MH123219NIMH NIH HHS R01 MH113478Wellcome Trust 058893/Z/99/A
6 · The paper itself

Abstract

introductionPregnancy-related health services, an important mediator of global health priorities, require robust health infrastructure. We described pregnancy-related healthcare utilisation among rural South African women from 1993 to 2018, a period of social, political and economic transition.

methodsWe included participants enrolled in the Agincourt Health and Socio-Demographic Surveillance System in Mpumalanga Province, South Africa, a population-based longitudinal cohort, who reported pregnancy between 1993 and 2018. We assessed age, antenatal visits, years of education, pregnancy intention, nationality, residency status, previous pregnancies, prepregnancy and postpregnancy contraceptive use, and student status over the study period and modelled predictors of antenatal care utilisation (ordinal), skilled birth attendant presence (logistic) and delivery at a health facility (logistic).

resultsBetween 1993 and 2018, 51 355 pregnancies occurred. Median antenatal visits, skilled birth attendant presence and healthcare facility deliveries increased over time. Delivery in 2018 vs 2004 was associated with an increased likelihood of ≥1 additional antenatal visits (adjusted OR (aOR) 10.81, 95% CI 9.99 to 11.71), skilled birth attendant presence (aOR 4.58, 95% CI 3.70 to 5.67) and delivery at a health facility (aOR 3.78, 95% CI 3.15 to 4.54). Women of Mozambican origin were less likely to deliver with a skilled birth attendant (aOR 0.42, 95% CI 0.39 to 0.45) or at a health facility (aOR 0.43, 95% CI 0.41 to 0.46) versus South Africans. Temporary migrants reported fewer antenatal visits (aOR 0.35, 95% CI 0.33 to 0.38) but were more likely to deliver with a skilled birth attendant (aOR 1.91, 95% CI 1.66 to 2.2) or at a health facility (aOR 1.4, 95% CI 1.24 to 1.58) versus permanent residents.

conclusionPregnancy-related healthcare utilisation and skilled birth attendant presence at delivery have increased steadily since 1993 in rural northeastern South Africa, aligning with health policy changes enacted during this time. However, mothers of Mozambican descent are still less likely to use free care, which requires further study and policy interventions.

Indexed as

Delivery, ObstetricMothersFemaleHumansPatient Acceptance of Health CarePregnancyPrenatal CareSouth Africaepidemiologyhealth systemsmaternal healthobstetrics

Identifiers

PMID34620615
PMCPMC8499259

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.