Introduction
Methodology
Mixed methods design
Study setting
Quantitative methods
Design
Sample
Data collection
Analysis
Qualitative design, participants, interviews and analysis
Design
Participants
Data collection
Data analysis
Rigor
Results
Quantitative results
Variable | Sub-scale | Not reported n (%) (n = 337) | Reported n (%) (n = 490) | Overall N (%) (N = 827) |
P-value |
---|---|---|---|---|---|
Maternal age (years) | ≤19 | 35 (10.9) | 35 (7.2) | 70 (8.7) |
0.024
|
20–24 a
| 91 (28.3) | 105 (21.6) | 196 (24.2) | ||
25–29 | 89 (27.6) | 146 (30.0) | 235 (29.0) | ||
30–34 | 66 (20.5) | 112 (23.0) | 178 (22.0) | ||
≥35 a
| 41 (12.7) | 89 (18.3) | 130 (16.1) | ||
Level of care | Primary a
| 33 (9.8) | 81 (16.5) | 114 (13.8) |
0.022
|
Secondary | 257 (76.3) | 346 (70.6) | 603 (72.9) | ||
Tertiary | 47 (13.9) | 63 (12.9) | 110 (13.3) | ||
Mobile phone | Personal phone | 285 (84.6) | 437 (89.2) | 722 (87.3) | 0.146 |
Household | 21 (6.2) | 22 (4.5) | 43 (5.2) | ||
None | 31 (9.2) | 31 (6.3) | 62 (7.5) | ||
Place of residence | Urban a
| 179 (54.1) | 311 (66.2) | 490 (61.2) |
< 0.0001
|
Rural a
| 152 (45.9) | 159 (33.8) | 311 (38.8) | ||
Religion | Christian | 307 (91.1) | 428 (92.4) | 735 (91.9) | 0.514 |
Moslem | 30 (8.9) | 35 (7.6) | 65 (8.1) | ||
Ethnicity | Ewe a
| 246 (73.4) | 311 (66.5) | 557 (69.4) |
0.007
|
Guan a
| 29 (8.7) | 76 (16.2) | 105 (13.1) | ||
Other tribes b
| 60 (17.9) | 81 (17.3) | 141 (17.6) | ||
Marital status | Married | 235 (71.0) | 333 (73.2) | 568 (72.3) | 0.239 |
Cohabitating | 45 (13.6) | 70 (15.4) | 115 (14.6) | ||
Single | 51 (15.4) | 52 (11.4) | 103 (13.1) | ||
Woman’s education | Primary | 59 (17.8) | 69 (14.9) | 128 (16.1) | 0.727 |
Junior high c
| 157 (47.4) | 232 (50.1) | 389 (49.0) | ||
Senior high c
| 68 (20.5) | 96 (20.7) | 164 (20.7) | ||
Tertiary | 47 (14.2) | 66 (14.3) | 113 (14.2) | ||
Partner’s education | Primary | 27 (8.2) | 41 (9.0) | 68 (8.7) | 0.142 |
Junior high c
| 115 (35.1) | 168 (36.8) | 283 (36.1) | ||
Senior high a c
| 114 (34.8) | 125 (27.4) | 239 (30.5) | ||
Tertiary | 72 (22.0) | 122 (26.8) | 194 (24.7) | ||
Woman’s occupation | Unemployed | 78 (23.1) | 85 (18.3) | 163 (20.3) | 0.211 |
Informal sector | 218 (64.7) | 314 (67.5) | 532 (66.3) | ||
Salaried worker | 41 (12.2) | 66 (14.2) | 107 (13.3) | ||
Partner’s occupation | Unemployed | 24 (7.3) | 20 (4.3) | 44 (5.6) |
0.019
|
Informal sector | 226 (68.7) | 293 (63.7) | 519 (65.8) | ||
Salaried worker a
| 79 (24.0) | 147 (32.0) | 226 (28.6) | ||
Household size | 1–5 members | 245 (81.9) | 362 (84.4) | 607 (83.4) | 0.419 |
≥6 members | 54 (18.1) | 67 (15.6) | 121 (16.6) |
Variables | Not reported Mean (SD) | Reported Mean (SD) | Overall Mean (SD) |
P-value |
---|---|---|---|---|
Maternal age (years) | 26.95 (6.20) | 28.33 (6.20) | 27.78 (6.239) | 0.002 |
Gestational age (weeks) a
| 17.15 (7.08) | 14.52 (6.64) | 15.64 (6.95) | < 0.0001 |
Persons in household | 3.98 (2.28) | 3.96 (2.27) | 3.97 (2.27) | 0.888 |
Parity (live children) | 1.33 (1.35) | 1.45 (1.28) | 1.40 (1.31) | 0.226 |
Gravida (pregnancies) | 2.71 (1.66) | 2.73 (1.49) | 2.72 (1.56) | 0.854 |
Number of miscariages b
| 0.90 (1.13) | 0.60 (0.80) | 0.71 (0.95) | 0.002 |
Random sugar (mmol/l) c
| 5.02 (1.10) | 5.17 (1.10) | 5.11 (1.10) | 0.064 |
Systolic BP (mmHg) c
| 107.88 (11.64) | 108.05 (11.48) | 107.98 (11.54) | 0.844 |
Diastolic BP (mmHg) c
| 65.92 (9.71) | 65.38 (9.36) | 65.61 (9.50) | 0.431 |
Weight (kg) c
| 62.01 (12.59) | 62.38 (12.94) | 62.22 (12.79) | 0.675 |
Height (cm) c
| 160.83 (9.38) | 162.73 (7.88) | 161.94 (8.58) | 0.003 |
Body mass index (kg/m2) | 24.01 (5.11) | 23.47 (4.96) | 23.69 (5.03) | 0.154 |
Variable | Reference | Sub-scales | uOR | 95% CI | SE |
P-value |
---|---|---|---|---|---|---|
Maternal age (years) | < 20 years | 20–24 | 1.15 | 0.66–1.99 | 0.32 | 0.608 |
25–29 | 1.64 | 0.95–2.80 | 0.44 | 0.071 | ||
30–34 | 1.69 | 0.97–2.96 | 0.48 | 0.064 | ||
≥35 | 2.17 | 1.19–3.94 | 0.66 | 0.011 | ||
Level of care | Secondary | Primary care | 1.82 | 1.17–2.81 | 0.40 | 0.007 |
Tertiary care | 0.99 | 0.66–1.50 | 0.20 | 0.983 | ||
Mobile phone | Own phone | In household | 0.68 | 0.36–1.26 | 0.21 | 0.226 |
None | 0.65 | 0.38–1.09 | 0.17 | 0.107 | ||
Residence | Urban | Rural | 0.60 | 0.45–0.80 | 0.08 | 0.001 |
Ethnicity | Non-indigenes | Indigenes | 0.71 | 0.52–0.97 | 0.11 | 0.035 |
Religion | Christian | Moslem | 0.83 | 0.50–1.39 | 0.21 | 0.493 |
Marital status | Co-habiting | Married | 0.91 | 0.60–1.37 | 0.19 | 0.656 |
Single | 0.65 | 0.38–1.12 | 0.17 | 0.124 | ||
Woman’s education | Primary | Junior high | 1.26 | 0.84–1.88 | 0.25 | 0.254 |
Senior high | 1.20 | 0.75–1.92 | 0.28 | 0.429 | ||
Tertiary | 1.20 | 0.72–2.01 | 0.31 | 0.483 | ||
Partner’s education | Primary | Junior high | 0.96 | 0.56–1.65 | 0.26 | 0.888 |
Senior high | 0.72 | 0.41–1.24 | 0.20 | 0.244 | ||
Tertiary | 1.11 | 0.63–1.96 | 0.32 | 0.704 | ||
Woman’s occupation | Salaried worker | Unemployed | 0.67 | 0.41–1.11 | 0.17 | 0.123 |
Informal job | 0.89 | 0.58–1.37 | 0.19 | 0.609 | ||
Partner’s occupation | Salaried worker | Unemployed | 0.44 | 0.23–0.86 | 0.14 | 0.016 |
Informal job | 0.69 | 0.50–0.96 | 0.11 | 0.029 | ||
Household size | 1–5 members | ≥6 members | 0.83 | 0.56–1.24 | 0.16 | 0.384 |
Variable | Sub-scales | Overall N (%) | uOR | 95% CI | SE |
P-value |
---|---|---|---|---|---|---|
Gestation age at screening a
| < 12 weeks | 275 (39.7) | 1.85 | 1.35–2.54 | 0.29 |
< 0.0001
|
Gravida b
| Primigravida | 193 (24.5) | 0.78 | 0.56–1.09 | 0.13 | 0.158 |
Parity | Nullipara | 219 (29.3) | 0.64 | 0.41–0.99 | 0.14 |
0.045
|
1–2 | 385 (51.5) | 0.82 | 0.55–1.23 | 0.16 | 0.357 | |
3+ | 143 (19.1) | Ref | ||||
Sex of children | Males only | 159 (19.9) | 1.07 | 0.70–1.63 | 0.23 | 0.750 |
Females only | 155 (19.4) | 1.38 | 0.89–2.14 | 0.30 | 0.139 | |
Both sexes | 198 (24.8) | Ref | ||||
Pregnancy planned | Yes | 486 (60.8) | 1.03 | 0.77–1.37 | 0.15 | 0.820 |
Glad about pregnancy | Yes | 729 (91.5) | 1.26 | 0.76–2.08 | 0.32 | 0.357 |
Body mass index | Underweight | 85 (11.50) | 0.73 | 0.46–1.18 | 0.17 | 0.208 |
Normal | 404 (54.67) | Ref | ||||
Overweight | 167 (22.60) | 0.63 | 0.44–0.91 | 0.11 |
0.014
| |
Obese | 83 (11.23) | 0.77 | 0.48–1.25 | 0.19 | 0.307 | |
Previous delivery place c
| Hospital | 397 (49.5) | 1.12 | 0.74–1.70 | 0.23 | 0.572 |
History of marriages | Yes | 117 (14.1) | 1.04 | 0.64–1.68 | 0.25 | 0.856 |
Pregnancy complications d
| Yes | 11 (1.4) | 1.05 | 0.30–3.68 | 0.67 | 0.937 |
Delivery complications f
| Yes | 30 (3.7) | 3.16 | 1.18–8.45 | 1.58 |
0.021
|
Prior cesarean section | Yes | 62 (8.0) | 1.33 | 0.75–2.37 | 0.39 | 0.319 |
Any child dead | Yes | 43 (5.4) | 1.13 | 0.60–2.14 | 0.36 | 0.691 |
Dipstick urine glucose | Trace + | 35 (4.3) | 0.55 | 0.28–1.09 | 0.19 | 0.091 |
Dipstick urine protein | Trace + | 165 (22.1) | 1.23 | 0.86–1.76 | 0.22 | 0.250 |
Sickle cell disease | Positive | 24 (3.0) | 1.44 | 0.61–3.41 | 0.63 | 0.403 |
Asthma | Yes | 16 (2.0) | 1.58 | 0.54–4.61 | 0.86 | 0.395 |
Diabetes | Yes | 4 (0.5) | 2.15 | 0.22–20.85 | 2.49 | 0.506 |
Diabetes (family) | Yes | 47 (5.9) | 1.15 | 0.63–2.12 | 0.35 | 0.634 |
Hypertension | Yes | 29 (3.6) | 1.17 | 0.54–2.53 | 0.45 | 0.672 |
Hypertension (family) | Yes | 143 (17.8) | 0.85 | 0.59–1.23 | 0.15 | 0.406 |
Previous surgery | Yes | 32 (4.0) | 2.18 | 0.96–4.92 | 0.90 | 0.060 |
Variable | Reference | Sub-scales | aOR | 95% CI | SE |
P-value |
---|---|---|---|---|---|---|
Maternal age | 20–24 | < 19 | 1.73 | 0.71–4.19 | 0.78 | 0.224 |
25–29 | 2.10 | 1.16–3.79 | 0.63 | 0.014 | ||
30–34 | 1.96 | 0.99–3.89 | 0.68 | 0.054 | ||
≥35 | 3.56 | 1.49–8.47 | 1.57 | 0.004 | ||
Level of care | Secondary | Tertiary | 0.46 | 0.22–0.96 | 0.17 | 0.033 |
Primary | 1.33 | 0.66–3.16 | 0.51 | 0.452 | ||
Mobile phone | Own phone | In household | 0.64 | 0.23–1.76 | 0.33 | 0.390 |
No phone | 0.65 | 0.18–2.25 | 0.41 | 0.502 | ||
Place of residence | Urban | Rural | 0.53 | 0.34–0.85 | 0.12 | 0.007 |
Ethnicity | Indigenes | Non-indigenes | 1.41 | 0.84–2.36 | 0.37 | 0.189 |
Education | Tertiary | Primary | 2.40 | 0.78–7.40 | 1.37 | 0.125 |
Junior high | 3.21 | 1.19–8.69 | 1.63 | 0.021 | ||
Senior high | 2.19 | 0.84–5.71 | 1.07 | 0.109 | ||
Occupation | Informal | Unemployed | 0.83 | 0.45–1.53 | 0.25 | 0.561 |
Salaried job | 1.46 | 0.56–3.77 | 0.71 | 0.430 | ||
Partner’s occupation | Informal | Unemployed | 1.13 | 0.42–3.01 | 0.56 | 0.805 |
Salaried job | 2.02 | 1.16–3.51 | 0.57 | 0.013 | ||
Gestational age | 13–20 weeks | < 13 weeks | 1.73 | 1.10–2.72 | 0.39 | 0.017 |
Parity | Nullipara | 1–2 | 1.16 | 0.36–3.68 | 0.68 | 0.796 |
3–4 | 2.34 | 0.60–9.18 | 1.63 | 0.220 | ||
5+ | 0.42 | 0.061–2.90 | 0.415 | 0.382 | ||
Children’s sex | Both sexes | Males only | 2.64 | 1.25–5.58 | 1.00 | 0.011 |
Females only | 4.37 | 1.98–9.66 | 1.76 | < 0.0001 | ||
Birth complications | No | Yes | 2.75 | 0.64–11.68 | 2.03 | 0.169 |
Previous surgery | No | Yes | 3.51 | 0.88–13.91 | 2.46 | 0.073 |
Urine glucose | Negative | Trace + | 0.54 | 0.20–1.47 | 0.27 | 0.232 |
Urine protein | Negative | Trace + | 1.59 | 0.95–2.66 | 0.41 | 0.077 |
Diabetes | No | Yes | 0.47 | 0.037–5.99 | 0.61 | 0.564 |
Hypertension | No | Yes | 2.07 | 0.56–7.71 | 1.39 | 0.275 |
Body mass index | Normal | Underweight | 0.67 | 0.35–1.31 | 0.23 | 0.247 |
Overweight | 0.45 | 0.25–0.78 | 0.12 | 0.005 | ||
Obese | 0.53 | 0.25–1.12 | 0.20 | 0.099 |
Qualitative results
Feelings about the test
“As for the test, it is good. If you will continue to do it … … . it should be done for all pregnant women who go for antenatal.” [Participant, IW 15]
Acceptability of test procedures
“ … .because it was three tests that it was done so it is normal if we spent that time. If it was just one test that took that much time it would have been bad but since it is three of them … .. it's okay.” [Participant, IW 19]
Professionalism of health workers
“I think you treated me well, better than when I went to [mentioning the hospital] because when I came to you people, I was given time to rest and returned after an hour. Even when people started feeling dizzy, you people you were encouraging them” [Participant, IW 46]
Information on the test
“We were expecting the result so that if there is any problem, we will know the kind of things we should eat, … how to go about the changes because when you are pregnant, there are some things you can't eat and there are some things you should just eat in small quantities.”[Participant, IW 29]