Evidence map›Paper›PMID 38594181›Full record

Trial reportBMJ open2024

Factors influencing pregnancy care and institutional delivery in rural Mali: a secondary baseline analysis of a cluster-randomised trial.

Rakesh Ghosh, Aminata Nene Konipo, Emily Treleaven, Sasha Rozenshteyn, Jessica Beckerman, Caroline Whidden, Ari Johnson, Kassoum Kayentao, Jenny Liu

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02694055 (Proactive Community Case Management and Child Survival), which is not on this 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, top 93% of its field
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.

NCT02694055 nacompletednot on this map

Proactive Community Case Management and Child Survival: A Cluster-Randomized Controlled Trial

TypeinterventionalSponsorUniversity of California, San FranciscoRan2016 to 2020Enrolled135,149ConditionsUnder-five Child Mortality, Access to Health CareArmsProactive Community Case Management, Integrated Community Case Management, Removal of point-of-care user fees, Infrastructure improvements at primary health centre, Training of primary health centre staff
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 0 citations in OpenAlex.

  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

9 authors at 3 institutions in 5 countries.

Rakesh GhoshInstitute for Health & Aging, University of California San Francisco, San Francisco, California, USA Rakesh.Ghosh@ucsf.edu.ORCID 0000-0002-7839-4148
Aminata Nene KonipoMUSO, Route de 501 Lodgements SEMA, Bamako, Mali.
Emily TreleavenInstitute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.ORCID 0000-0002-2667-9416
Sasha RozenshteynInstitute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.
Jessica BeckermanMUSO, Route de 501 Lodgements SEMA, Bamako, Mali.
Caroline WhiddenMUSO, Route de 501 Lodgements SEMA, Bamako, Mali.
Ari JohnsonMUSO, Route de 501 Lodgements SEMA, Bamako, Mali.
Kassoum KayentaoMUSO, Route de 501 Lodgements SEMA, Bamako, Mali.ORCID 0000-0001-6877-0093
Jenny LiuInstitute for Health & Aging, Department of Social and Behavioral Sciences, University of California, San Francisco, San Francisco, California, USA.
Sema Construction (United States) · USUniversity of California, San Francisco · USUniversity of Michigan · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThe vast majority of the 300 000 pregnancy-related deaths every year occur in South Asia and sub-Saharan Africa. Increased access to quality antepartum and intrapartum care can reduce pregnancy-related morbidity and mortality worldwide. We used a population-based cross-sectional cohort design to: (1) examine the sociodemographic risk factors and structural barriers associated with pregnancy care-seeking and institutional delivery, and (2) investigate the influence of residential distance to the nearest primary health facility in a rural population in Mali.

methodsA baseline household survey of Malian women aged 15-49 years was conducted between December 2016 and January 2017, and those who delivereda baby in the 5 years preceding the survey were included. This study leverages the baseline survey data from a cluster-randomised controlled trial to conduct a secondary analysis. The outcomes were percentage of women who received any antenatal care (ANC) and institutional delivery; total number of ANC visits; four or more ANC visits; first ANC visit in the first trimester.

resultsOf the 8575 women in the study, two-thirds received any ANC in their last pregnancy, one in 10 had four or more ANC visits and among those that received any ANC, about one-quarter received it in the first trimester. For every kilometre increase in distance to the nearest facility, the likelihood of the outcomes reduced by 5 percentage points (0.95; 95% CI 0.91 to 0.98) for any ANC; 4 percentage points (0.96; 95% CI 0.94 to 0.98) for an additional ANC visit; 10 percentage points (0.90; 95% CI 0.86 to 0.95) for four or more ANC visits; 6 percentage points (0.94; 95% CI 0.94 to 0.98) for first ANC in the first trimester. In addition, there was a 35 percentage points (0.65; 95% CI 0.56 to 0.76) decrease in likelihood of institutional delivery if the residence was within 6.5 km to the nearest facility, beyond which there was no association with the place of delivery. We also found evidence of increase in likelihood of receiving any ANC care and its intensity increased with having some education or owning a business.

conclusionThe findings suggest that education, occupation and distance are important determinants of pregnancy and delivery care in a rural Malian context. TRIAL REGISTRATION NUMBER: NCT02694055.

Indexed as

Prenatal CareRural PopulationCross-Sectional StudiesFemaleHumansMaliPatient Acceptance of Health CarePregnancycommunity-based participatory researchepidemiologic studiespublic health

Identifiers

PMID38594181
PMCPMC11015193
OpenAlexW4394685020

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.