nach oben

International Journal of Public Health

Erschienen in:

30.04.2019 | Review

Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis

verfasst von: Md Nuruzzaman Khan, Melissa L. Harris, Desalegn Markos Shifti, Alexander Suuk Laar, Deborah Loxton

Erschienen in: International Journal of Public Health | Ausgabe 5/2019

Einloggen, um Zugang zu erhalten

Abstract

Objectives

To examine the association between unintended pregnancy and maternal healthcare services utilization in low- and lower-middle-income countries.

Methods

A systematic literature search of Medline, Cinahl, Embase, PsycINFO, Cochrane Library, Popline, Maternity and Infant Care, and Scopus databases published since the beginning of the Millennium Development Goals (i.e. January 2000) to June 2018 was performed. We estimated the pooled odds ratios using random effect models and performed subgroup analysis by participants and study characteristics.

Results

A total of 38 studies were included in the meta-analysis. Our study found the occurrence of unintended pregnancy was associated with a 25–39% reduction in the use of antenatal, delivery, and postnatal healthcare services. Stratified analysis found the differences of healthcare services utilization across types of pregnancy unintendedness (e.g. mistimed, unwanted).

Conclusions

Integrating family planning and maternal healthcare services should be considered to encourage women with unintended pregnancies to access maternal healthcare services.

Nur mit Berechtigung zugänglich

Abosse Z, Woldie M, Ololo S (2010) Factors influencing antenatal care service utilization in hadiya zone. Ethiop J Health Sci 20:75–82PubMedPubMedCentral

Achyut P, Mishra A, Montana L, Sengupta R, Calhoun LM, Nanda P (2015) Integration of family planning with maternal health services: an opportunity to increase postpartum modern contraceptive use in urban Uttar Pradesh, India. J Fam Plann Reprod Health Care 42:107–115CrossRefPubMedPubMedCentral

Ali SA, Tikmani SS, Qidwai W (2016) Prevalence and determinants of unintended pregnancy: systematic review. Middle East J Fam Med 14:37CrossRef

Amo-Adjei J, Tuoyire DA (2016) Effects of planned, mistimed and unwanted pregnancies on the use of prenatal health services in sub-Saharan Africa: a multicountry analysis of demographic and health survey data. Tropical Med Int Health 21:1552–1561CrossRef

Barrett G, Wellings K (2002) What is a ‘planned’pregnancy? Empirical data from a British study. Soc Sci Med 55:545–557CrossRefPubMed

Bassani DG, Surkan PJ, Olinto MTA (2009) Inadequate use of prenatal services among Brazilian women: the role of maternal characteristics. Int Perspect Sex Reprod Health 35:15–20CrossRefPubMed

Bearak J, Popinchalk A, Alkema L, Sedgh G (2018) Global, regional, and subregional trends in unintended pregnancy and its outcomes from 1990 to 2014: estimates from a Bayesian hierarchical model. The Lancet Global Health 6:e380–e389CrossRefPubMedPubMedCentral

Bitew T, Hanlon C, Kebede E, Honikman S, Onah MN, Fekadu A (2017) Antenatal depressive symptoms and utilisation of delivery and postnatal care: a prospective study in rural Ethiopia. BMC Pregnancy Childbirth 17:206CrossRefPubMedPubMedCentral

Chao F, You D, Pedersen J, Hug L, Alkema L (2018) National and regional under-5 mortality rate by economic status for low-income and middle-income countries: a systematic assessment. The Lancet Global Health 6:e535–e547CrossRefPubMedPubMedCentral

Chompikul J, Isaranurug S (2008) Factors related to the utilization of antenatal care services among pregnant women at health centers in Aceh Besar district, Nanggroe Aceh Darussalam province, Indonesia. J Publ Health Dev 6:99–108

Cripe SM, Sanchez SE, Perales MT, Lam N, Garcia P, Williams MA (2008) Association of intimate partner physical and sexual violence with unintended pregnancy among pregnant women in Peru. Int J Gynecol Obstet 100:104–108CrossRef

Dahiru T, Oche OM (2015) Determinants of antenatal care, institutional delivery and postnatal care services utilization in Nigeria. Pan Afr Med J 21:321CrossRefPubMedPubMedCentral

Dansereau E et al (2016) Coverage and timing of antenatal care among poor women in 6 Mesoamerican countries. BMC Pregnancy Childbirth 16:234CrossRefPubMedPubMedCentral

Dibaba Y, Fantahun M, Hindin MJ (2013) The effects of pregnancy intention on the use of antenatal care services: systematic review and meta-analysis. Reprod Health 10:50CrossRefPubMedPubMedCentral

Duval S, Tweedie R (2000) Trim and fill: a simple funnel-plot–based method of testing and adjusting for publication bias in meta-analysis. Biometrics 56:455–463CrossRefPubMed

Egger M, Smith GD, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634CrossRefPubMedPubMedCentral

Feyisso M, Girma A, Yimam H, Hailu S (2017) Magnitude of unintended pregnancy and its determinants among pregnant women visiting Dilla University Referral Hospital, South Ethiopia. J Women’s Health Care 6:2167-0420CrossRef

Fullman N et al (2018) Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: a systematic analysis from the Global Burden of Disease Study 2016. The Lancet 391:2236–2271CrossRef

Green S, Higgins J (2005) Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration and John Wiley & Sons Ltd, Chichester

Guliani H, Sepehri A, Serieux J (2013) Determinants of prenatal care use: evidence from 32 low-income countries across Asia, Sub-Saharan Africa and Latin America. Health Policy Plan 29:589–602CrossRefPubMed

Gupta S, Yamada G, Mpembeni R, Frumence G, Callaghan_Koru JA, Stevenson R, Brandes N, Baqui AH (2014) Factors associated with four or more antenatal care visits and its decline among pregnant women in Tanzania between 1999 and 2010. PLoS ONE 9:e101893CrossRefPubMedPubMedCentral

Herrera CA et al (2017) Governance arrangements for health systems in low-income countries: an overview of systematic reviews. The Cochrane Library, London

Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557CrossRefPubMedPubMedCentral

Hunt P, Bueno de Mesquita J (2007) Reducing maternal mortality: the contribution of the right to the highest attainable standard of health. The University of Essex, United Kingdom

Islam M (2007) The safe motherhood initiative and beyond. Bull World Health Organ 85(10):735CrossRefPubMedPubMedCentral

Kanté AM, Chung CE, Larsen AM, Exavery A, Tani K, Phillips JF (2015) Factors associated with compliance with the recommended frequency of postnatal care services in three rural districts of Tanzania. BMC Pregnancy Childbirth 15:341CrossRefPubMedPubMedCentral

Kaufmann RB, Morris L, Spitz AM (1997) Comaparison of two question sequences for assessing pregnancy intentions. Am J Epidemiol 145:810–816CrossRefPubMed

Kuuire VZ et al (2017) Timing and utilisation of antenatal care service in Nigeria and Malawi. Global Public Health 12:711–727CrossRefPubMed

Kuzara J, Woodriff Sprinkel A, Mekuria FT, Rubardt M, Maguiraga F, Sissoko K, Hastings P (2018) Addressing social and gender norms to improve uptake of maternal health services in Mali: a descriptive study of CARE’s Project Hope for Mothers and Newborns (PEMN). Culture Health Sex 20:1–14CrossRef

Mahler H (1987) The safe motherhood initiative: a call to action. Lancet (London, England) 1:668CrossRef

Modesti PA et al (2016) Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PLoS ONE 11:e0147601CrossRefPubMedPubMedCentral

Mohan D, Gupta S, LeFevre A, Bazant E, Killewo J, Baqui AH (2015) Determinants of postnatal care use at health facilities in rural Tanzania: multilevel analysis of a household survey. BMC Pregnancy Childbirth 15:282CrossRefPubMedPubMedCentral

Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269CrossRefPubMed

Nair M, Ariana P, Webster P (2012) What influences the decision to undergo institutional delivery by skilled birth attendants? A cohort study in rural Andhra Pradesh, India. Rural Remote Health 12:2311PubMed

Ochako R, Gichuhi W (2016) Pregnancy wantedness, frequency and timing of antenatal care visit among women of childbearing age in Kenya. Reprod Health 13:51CrossRefPubMedPubMedCentral

Pallitto CC, Campbell JC, O’Campo P (2005) Is intimate partner violence associated with unintended pregnancy? A review of the literature. Trauma, Violence Abuse 6:217–235CrossRefPubMed

Pantoja T et al (2017) Implementation strategies for health systems in low-income countries: an overview of systematic reviews. The Cochrane Library, London

Paredes I, Hidalgo L, Chedraui P, Palma J, Eugenio J (2005) Factors associated with inadequate prenatal care in Ecuadorian women. Int J Gynecol Obstet 88:168–172CrossRef

Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH (2008) Poverty and access to health care in developing countries. Ann N Y Acad Sci 1136:161–171CrossRefPubMed

Rahman MM, Rahman MM, Tareque MI, Ferdos J, Jesmin SS (2016) Maternal pregnancy intention and professional antenatal care utilization in Bangladesh: a nationwide population-based survey. PLoS ONE 11:e0157760CrossRefPubMedPubMedCentral

Regassa N (2011) Antenatal and postnatal care service utilization in southern Ethiopia: a population-based study. Afr Health Sci 11(3):390–397PubMedPubMedCentral

Sedgh G, Hussain R (2014) Reasons for contraceptive nonuse among women having unmet need for contraception in developing countries. Stud Fam Plann 45:151–169CrossRefPubMed

Sedgh G, Bankole A, Oye-Adeniran B, Adewole IF, Singh S, Hussain R (2006) Unwanted pregnancy and associated factors among Nigerian women. Int Fam Plan Perspect 32(4):175–184CrossRefPubMed

Singh A, Singh A, Mahapatra B (2013) The consequences of unintended pregnancy for maternal and child health in rural India: evidence from prospective data. Matern Child Health J 17:493–500CrossRefPubMed

Tafere TE, Afework MF, Yalew AW (2018) Antenatal care service quality increases the odds of utilizing institutional delivery in Bahir Dar city administration, North Western Ethiopia: a prospective follow up study. PLoS ONE 13:e0192428CrossRef

Tebekaw Y, James Mashalla Y, Thupayagale-Tshweneagae G (2015) Factors influencing Women’s preferences for places to give birth in Addis Ababa, Ethiopia. Obstet Gynecol Int 2015:439748CrossRefPubMedPubMedCentral

Tegegne TK, Chojenta C, Loxton D, Smith R, Kibret KT (2018) The impact of geographic access on institutional delivery care use in low and middle-income countries: systematic review and meta-analysis. PLoS ONE 13:e0203130CrossRefPubMedPubMedCentral

Tesfaye G, Loxton D, Chojenta C, Semahegn A, Smith R (2017) Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis. Reprod Health 14(1):150CrossRefPubMedPubMedCentral

Thompson SG, Higgins JP (2002) How should meta-regression analyses be undertaken and interpreted? Stat Med 21:1559–1573CrossRefPubMed

Titaley CR, Dibley MJ, Roberts CL (2009) Factors associated with non-utilization of postnatal care services in Indonesia. J Epidemiol Community Health 63:827–831CrossRefPubMed

UN (2015) Transforming our world: the 2030 agenda for sustainable development. United Nations, New York

UN (2018) Millennium Development Goals (MDGs) The United Nation, USA Retrieved 10 June 2017 from http://www.whoint/news-room/fact-sheets/detail/millennium-development-goals-(mdgs)

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, Initiative S (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med 4:e296CrossRef

Wado YD, Afework MF, Hindin MJ (2014) Effects of maternal pregnancy intention, depressive symptoms and social support on risk of low birth weight: a prospective study from southwestern Ethiopia. PLoS ONE 9:e96304CrossRefPubMedPubMedCentral

WHO (2015) State of inequality: reproductive, maternal, newborn and child health. The World Health Organization, Geneva

WHO (2016) New guidelines on antenatal care for a positive pregnancy experience. The world health Organization, Geneva, Swezarland Accessed from https://www.whoint/reproductivehealth/news/antenatal-care/en/. 1 Jan 2019

WHO (2018a) Maternal Mortality. The world health Organization, Geneva, Swezarland Accessed from http://www.whoint/news-room/fact-sheets/detail/maternal-mortalityon. 10 Oct 2018

WHO (2018b) New borns: Reducing mortality. The world health Organization, Geneva, Swezarland Accessed from http://www.whoint/news-room/fact-sheets/detail/newborns-reducing-mortality. 20 Oct 2018

World Bank (2017) World Bank Country and Lending Groups: Country Classification. URL: https://datahelpdesk.worldbank.org/knowledgebase/articles/906519-world-bank-country-and-lending-groups. Accessed 8 Oct 2018

Zegeye K, Gebeyehu A, Melese T (2014) The role of geographical access in the Utilization of institutional delivery service in rural Jimma Horro District, Southwest Ethiopia. Primary Health Care 4(2167–1079):1000150

Titel: Effects of unintended pregnancy on maternal healthcare services utilization in low- and lower-middle-income countries: systematic review and meta-analysis
verfasst von: Md Nuruzzaman Khan
Melissa L. Harris
Desalegn Markos Shifti
Alexander Suuk Laar
Deborah Loxton
Publikationsdatum: 30.04.2019
Verlag: Springer International Publishing
Erschienen in: International Journal of Public Health / Ausgabe 5/2019
Print ISSN: 1661-8556
Elektronische ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-019-01238-9

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 5/2019

Challenges for research, policy and practice in the field of Roma health

Grounding evidence in experience to support people-centered health services

Associations between psychological factors and accelerometer-measured physical activity in urban Asian adults

A comparison of health expectancies over 10 years: implications for elderly service needs in Hong Kong

Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease?

What Roma nonadherence is likely and what drives it? Reply to Broz and Nunes