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Patterns and determinants of dropout from maternity care continuum in Nigeria.
Akinyemi, Joshua O; Afolabi, Rotimi F; Awolude, Olutosin A.
Afiliación
  • Akinyemi JO; College of Medicine, University of Ibadan, Ibadan, Nigeria. odunjoshua@yahoo.com.
  • Afolabi RF; College of Medicine, University of Ibadan, Ibadan, Nigeria.
  • Awolude OA; College of Medicine, University of Ibadan, Ibadan, Nigeria.
BMC Pregnancy Childbirth ; 16(1): 282, 2016 09 27.
Article en En | MEDLINE | ID: mdl-27678192
BACKGROUND: The maternal, newborn and child health care continuum require that mother/child pair should receive the full package of antenatal, intrapartum and postnatal care in order to derive maximum benefits. Continuity of care is a challenge in sub-Saharan Africa. In this study, we investigate the patterns and factors associated with dropout in the continuum of maternity (antenatal, delivery and postnatal) care in Nigeria. METHOD: Using women recode file from the 2013 Nigeria Demographic and Health Survey, we analysed data on 20,467 women with an index birth within 5 years prior to data collection. Background characteristics and pattern of dropouts were summarised using descriptive statistics. The outcome variable was dropout which we explored in three stages: antenatal, antenatal-delivery, delivery-6 weeks postnatal visit. Multilevel logistic regression models were fitted to identify independent predictors of dropout at each stage. Measure of effect was expressed as Odds Ratio (OR) with 95 % confidence interval (CI). RESULTS: Overall, 12,392 (60.6 %) of all women received antenatal care among whom 38.1 % dropout and never got skilled delivery assistance. Of those who received skilled delivery care, 50.8 % did not attend postnatal visit. The predictors of dropout between antenatal care and delivery include problem with getting money for treatment (OR = 1.18, CI: 1.04-1.34), distance to health facility (OR = 1.31, CI: 1.13-1.52), lack of formal education, being in poor wealth quintile (OR = 2.22, CI: 1.85-2.67), residing in rural areas (OR = 1.98, CI: 1.63-2.41). Regional differences between North East, North West and South West were significant. Between delivery and postnatal visit, the same factors were also associated with dropout. CONCLUSION: The rate of dropout from maternity care continuum is high in Nigeria and driven by low or lack of formal education, poverty and healthcare access problems (distance to facility and difficulty with getting money for treatment). Unexpectedly, dropouts are high in South east and South south as well as in the Northern regions. Intervention programs focusing on community outreach about the benefits of continuum of maternal healthcare package should be introduced especially for women in rural areas and lower socio-economic strata.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pacientes Desistentes del Tratamiento / Aceptación de la Atención de Salud / Continuidad de la Atención al Paciente / Accesibilidad a los Servicios de Salud / Servicios de Salud Materna Tipo de estudio: Etiology_studies / Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Adult / Female / Humans / Newborn / Pregnancy País/Región como asunto: Africa Idioma: En Revista: BMC Pregnancy Childbirth Asunto de la revista: OBSTETRICIA Año: 2016 Tipo del documento: Article País de afiliación: Nigeria Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pacientes Desistentes del Tratamiento / Aceptación de la Atención de Salud / Continuidad de la Atención al Paciente / Accesibilidad a los Servicios de Salud / Servicios de Salud Materna Tipo de estudio: Etiology_studies / Prognostic_studies Aspecto: Determinantes_sociais_saude / Equity_inequality Límite: Adult / Female / Humans / Newborn / Pregnancy País/Región como asunto: Africa Idioma: En Revista: BMC Pregnancy Childbirth Asunto de la revista: OBSTETRICIA Año: 2016 Tipo del documento: Article País de afiliación: Nigeria Pais de publicación: Reino Unido