ArticleGlobalization and health2021
Universal coverage of the first antenatal care visit but poor continuity of care across the maternal and newborn health continuum among Nepalese women: analysis of levels and correlates.
Article in Globalization and health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 23 citations in OpenAlex.
- Implementation status of the free newborn care program in Gandaki Province, Nepal.BMC health services research · 2025Article
- Inequalities in antenatal care service utilization in Nepal: evidence from nationally representative Nepal multiple indictor cluster surveys 2014 and 2019.BMC public health · 2025Article
- Continuum of care for maternal and newborn health services in Nepal: An analysis from demographic and health survey 2022.PloS one · 2025Article
- Assessment of maternal healthcare services among the women of reproductive age in the rural municipality of Nepal: a cross-sectional study.BMJ public health · 2025Article
- Article
- Disease Burden and Geographic Inequalities in 15 Types of Neonatal Infectious Diseases in 131 Low- and Middle-Income Countries and Territories.Health data science · 2024Article
- A repeated cross-sectional study of the association of community health worker intervention with the maternal continuum of care in rural Liberian communities.BMC pregnancy and childbirth · 2023Article
- Predicting maternal healthcare seeking behaviour in Afghanistan: exploring sociodemographic factors and women's knowledge of severity of illness.BMC pregnancy and childbirth · 2023Article
- Continuity and care coordination of primary health care: a scoping review.BMC health services research · 2023Article
- Spatial distribution and associated factors of dropout from health facility delivery after antenatal booking in Ethiopia: a multi-level analysis.BMC women's health · 2023Article
- Input, process, and output factors contributing to quality of antenatal care services: a scoping review of evidence.BMC pregnancy and childbirth · 2022Article
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Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRoutine maternity care visits (MCVs) such as antenatal care (ANC), institutional delivery, and postnatal care (PNC) visits are crucial to utilisation of maternal and newborn health (MNH) interventions during pregnancy-postnatal period. In Nepal, however, not all women complete these routine MCVs. Therefore, this study examined the levels and correlates of (dis)continuity of MCVs across the antenatal-postnatal period.
methodsWe conducted further analysis of the 2016 Nepal Demographic and Health Survey. A total of 1,978 women aged 15-49 years, who had live birth two years preceding the survey, were included in the analysis. The outcome variable was (dis)continuity of routine MCVs (at least four ANC visits, institutional delivery, and PNC visit) across the pathway of antennal through to postnatal period. Independent variables included several social determinants of health under structural, intermediary, and health system domains. Multinomial logistic regression was conducted to identify the correlates of routine MCVs. Relative risk ratios (RR) were reported with 95% confidence intervals at a significance level of p<0.05.
resultsApproximately 41% of women completed all routine MCVs with a high proportion of discontinuation around childbirth. Women of disadvantaged ethnicities, from low wealth status, who were illiterate had higher RR of discontinuation of MCVs (compared to completion of all MCVs). Similarly, women who speak Bhojpuri, from remote provinces (Karnali and Sudurpaschim), who had a high birth order (≥4), who were involved in the agricultural sector, and who had unwanted last birth had a higher RR of discontinuation of MCVs. Women discontinued routine MCVs if they had poor awareness of health mother-groups and perceived the problem of not having female providers.
conclusionsRoutine monitoring using composite coverage indicators is required to track the levels of (dis)continuity of routine MCVs at the maternity care continuum. Strategies such as raising awareness on the importance of maternity care, care provision from female health workers could potentially improve the completion of MCVs. In addition, policy and programmes for continuity of maternity care are needed to focus on women with socioeconomic and ethnic disadvantages and from remote provinces.
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