Background
Methods
Study setting, population, and intervention
Analytical methods
Results
Characteristics |
N = 1301 |
---|---|
Women’s socio-demographic | |
Age (median (range); years) | 25 (15–48) |
Parity (%) | |
1 | 26.4 |
2 | 21.1 |
3–4 | 33.4 |
≥ 5 | 19.1 |
Religion (%) | |
Catholic | 23.5 |
Presbyterian | 13.1 |
Other Christian | 58.8 |
Other | 4.6 |
Ngoni ethnicity (%) | |
Yes | 88.7 |
No | 11.3 |
Marital status (%) | |
Married/living together | 88.7 |
Unmarried/divorced/widowed | 11.3 |
Education (median (range); years) | 4 (0–8) |
Reading level (%) | |
Cannot read simple sentence | 29.5 |
Reads part of sentence | 12.1 |
Reads the entire sentence | 58.4 |
Household wealth (quintiles; %) | |
1st (poorest) | 13.1 |
2nd | 26.1 |
3rd | 19.9 |
4th | 18.5 |
5th (richest) | 22.4 |
Indicators |
N = 1301 | |
---|---|---|
Family planning | Ever use of FP (%) | 74.5 |
Current usea of FP (%) | 52.8 | |
Place where FP services last obtained (%) | ||
Government facility | 84.8 | |
Private/mission-based facility | 12.9 | |
Other | 2.4 | |
Antenatal care | Antenatal care use at last pregnancy (%) | 99.4 |
Trimester when ANC initiated during last pregnancy (%) | ||
1st | 16.4 | |
2nd | 78.0 | |
3rd | 5.6 | |
Number of ANC visits during last pregnancy (mean/std dev) | 3.7 (1.1) | |
Delivery care | Last delivery occurred in a health facility (%) | 97.3 |
Facility ownership at last deliveryb (%) | ||
Government facility | 80.1 | |
Private/mission-based facility | 19.9 | |
Postnatal care | Postnatal care usec following last delivery (%) | 77.5 |
Timing of 1st postnatal checkc (mean (std dev); weeks) | 3.1 (1.7) | |
Number of postnatal checksc within 2 months postpartum (mean/std dev) | 3.1 (0.7) |
Quality of care items assessed | % |
---|---|
General perceptions on the quality of care offered at the closest health facility to the woman’s residence (N = 1301)
| |
Perception that facility is clean (%) |
96.5
|
Perception that staff ensures patients’ privacy (%) |
93.3
|
Perception that provider(s) is(are) always available (%) |
89.8
|
Perception that staff provides high quality services (%) |
89.1
|
Perception that unmarried women can access FP/RH services (%) |
68.5
|
Time to reach closest facility (%) | |
< 30 min |
14.5
|
30–59 min |
30.9
|
1–2 h |
36.7
|
> 2 h |
17.9
|
Family planning (N = 949)
| |
1. Did provider mention if the method protects against HIV infection?
|
67.2
|
2. Did provider discuss possible side effects ofthe method chosen?
|
88.3
|
3. Did you get the method you wanted?
|
89.7
|
4. Did provider explain how to use the method chosen?
|
94.3
|
5. Did the provider schedule a follow-up visit?
|
96.7
|
6. Did anyone at the health facility discourage you from using family planning?a
| 98.7 |
7. Did the health provider tell you that it was your decision whether you choose to use FP? | 98.7 |
8. Were you given all the information or explanations you needed? | 98.9 |
9. Were you treated with respect and dignity? | 99.1 |
10. Did you feel the information you shared during your visit would be kept confidential? | 99.3 |
11. Were you spoken to in a way that you could understand? | 99.4 |
12. Were you treated with kindness and understanding? | 99.5 |
13. Overall, did you feel it was your decision alone whether to use family planning? | 99.5 |
Antenatal care (N = 1291)
| |
1. Discussion of pregnancy danger signs
|
91.5
|
2. The importance of going to a health facility for antenatal checks | 97.1 |
3. The importance of HIV testing during pregnancy | 98.6 |
4. How to create a birth plan to prepare for the birth of your child | 98.6 |
5. The importance of exclusive breastfeeding | 98.8 |
Delivery care (N = 1262)
| |
1. Were you able to move around and choose the position that made you most comfortable?
|
51.4
|
2. Were you involved enough in decisions about your care?
|
73.6
|
3. Did you feel you got the pain relief you wanted?
|
78.7
|
4. Were you left alone by midwives or doctors at a time when it worried you?
a
|
84.3
|
5. Did the provider yell at or humiliate you in any way?
a
|
84.5
|
6. Were you treated with kindness and understanding? | 94.7 |
7. Were you spoken to in a way you could understand? | 94.7 |
8. Were you given the information or explanations you needed? | 94.8 |
9. Did the health provider check on you and your baby for any problems prior to discharge? | 95.1 |
10. Were you treated with respect and dignity? | 95.8 |
11. Did you have confidence and trust in the staff caring for you during your labor and childbirth? | 96.9 |
12. Was the labor or delivery room you were in clean? | 98.0 |
Postnatal care (N = 1005)
| |
1. Did the provider counsel you on danger signs to watch for in you and in your child?
|
90.4
|
2. Did the provider give you breastfeeding support and counseling? | 95.4 |
3. Did the provider counsel you on methods to avoid or delay another pregnancy? | 97.9 |
Indicators | ||
---|---|---|
Family planning N = 949 | Respondent got the method she wanted (%) | 89.7 |
Indexa of FP quality provision (mean/std dev) | 3.5 (0.8) | |
Completely satisfied with last FP services received (%) | 87.6 | |
Antenatal care N = 1291 | ANC from skilled provider (%) | 96.2 |
Pregnancy danger signs were discussed (%) | 91.5 | |
Completely satisfied with last ANC care received (%) | 88.2 | |
Delivery care N = 1262 | Skilled birth attendant (%) | 97.5 |
Time to first consult before delivery mean (std dev; hours) | 0.4 (2.1) | |
Indexb of delivery service quality provision (mean/std dev) | 3.8 (1.2) | |
Completely satisfied with last delivery care received (%) | 83.2 | |
Postnatal care N = 1005 | Skilled provider at 1st postnatal checkc (%) | 93.0 |
Postpartumc danger signs were discussed (%) | 90.4 | |
Completely satisfied with last postnatal carec received (%) | 87.9 |
Characteristics | Health service utilization (no = ref) -- OR (95% CI) | ||||
---|---|---|---|---|---|
Family planning | Antenatal care initiation in 1st trimester | Delivery care | Postnatal care | ||
Ever use | Current use | ||||
Socio-demographic | |||||
Parity (3–4 = ref) | |||||
1 |
0.22 (0.15, 0.32)
| 1.00 (0.74, 1.36) | 1.15 (0.77, 1.70) |
13.01 (1.71, 78.76)
| 1.04 (0.73, 1.47) |
2 |
0.61 (0.41, 0.92)
| 1.07 (0.77, 1.47) | 1.10 (0.73, 1.64) | 0.70 (0.31, 1.54) |
1.47 (1.00, 2.18)
|
≥5 | 1.02 (0.65, 1.61) | 1.13 (0.81, 1.58) | 0.69 (0.43, 1.09) | 0.94 (0.39, 2.25) | 1.14 (0.78, 1.65) |
Religion (Other Christian = ref) | |||||
Catholic | 0.83 (0.60, 1.16) | 0.94 (0.71, 1.24) | 0.82 (0.56, 1.21) | 0.93 (0.40, 2.19) | 0.86 (0.62, 1.19) |
Presbyterian | 0.97 (0.63, 1.50) |
0.74 (0.52, 1.05)
| 1.21 (0.79, 1.85) | 0.66 (0.25, 1.76) | 0.83 (0.55, 1.24) |
Other | 1.01 (0.54, 1.88) |
0.61 (0.34, 1.10)
| 0.70 (0.31, 1.55) | 0.83 (0.18, 3.80) | 0.72 (0.38, 1.35) |
Ngoni ethnicity (no = ref) | 0.75 (0.48, 1.19) | 0.85 (0.59, 1.25) | 0.70 (0.45, 1.09) | 0.76 (0.22, 2.62) |
0.61 (0.37, 0.99)
|
Married/living together (unmarried/divorced/widowed = ref) |
3.85 (2.64, 5.61)
|
3.86 (2.58, 5.78)
| 1.27 (0.76, 2.11) | 1.09 (0.39, 3.09) | 1.12 (0.73, 1.71) |
Reading level (reads the entire sentence = ref) | |||||
Cannot read simple sentence |
0.63 (0.46, 0.86)
|
0.78 (0.60, 1.02)
|
1.47 (1.05, 2.07)
| 1.24 (0.59, 2.62) | 0.93 (0.69, 1.25) |
Reads part of sentence |
1.74 (1.06, 2.87)
| 1.15 (0.80, 1.66) | 1.10 (0.68, 1.78) |
6.94 (0.95, 50.68)
| 1.13 (0.73, 1.75) |
Household wealth (5th/richest = ref) | |||||
1st (poorest) | 0.89 (0.55, 1.45) | 0.69 (0.45, 1.04) | 0.79 (0.46, 1.37) |
0.16 (0.03, 0.80)
| 0.78 (0.48, 1.25) |
2nd | 0.94 (0.62, 1.44) | 0.77 (0.55, 1.09) | 1.02 (0.65, 1.59) |
0.18 (0.04, 0.84)
|
0.64 (0.44, 0.95)
|
3rd | 1.04 (0.67, 1.62) | 0.84 (0.59, 1.20) | 1.01 (0.63, 1.61) |
0.15 (0.03, 0.72)
| 0.86 (0.56, 1.32) |
4th | 1.02 (0.66, 1.59) | 0.89 (0.62, 1.28) | 1.00 (0.62, 1.60) |
0.23 (0.05, 1.19)
| 0.93 (0.60, 1.44) |
Closest facility to the woman’s residence | |||||
Perception that staff provides high quality services (no = ref) | 1.00 (0.60, 1.68) | 1.18 (0.79, 1.77) | 1.34 (0.75, 2.39) | 2.04 (0.78, 5.29) | 1.54 (0.98, 2.43) |
Perception that staff ensures patients’ privacy (no = ref) | 1.38 (0.79, 2.43) | 1.35 (0.82, 2.22) | 0.72 (0.39, 1.34) | 0.53 (0.12, 2.42) | 1.43 (0.80, 2.58) |
Perception that provider(s) is always available (no = ref) | 0.88 (0.52, 1.47) | 1.01 (0.64, 1.58) | 0.88 (0.51, 1.52) | 1.65(0.52, 5.26) | 0.67 (0.40, 1.12) |
Perception that facility is clean (no = ref) | 0.78 (0.32, 1.88) | 1.00 (0.51, 1.94) | 2.45 (0.84, 7.11) | n/a | 1.24 (0.58, 2.65) |
Perception that unmarried women can access FP services |
1.31 (0.97, 1.77)
|
1.27 (0.99, 1.62)
| |||
Time to reach closest facility (1–2 h = ref) | |||||
<30 min |
1.54 (1.00, 2.36)
| 1.25 (0.87, 1.80) | 0.84 (0.53, 1.36) | 1.39 (0.37, 5.31) |
2.18 (1.34, 3.55)
|
30–59 min | 1.17 (0.84, 1.64) |
1.29 (0.97, 1.71)
| 0.86 (0.60, 1.23) | 1.10 (0.49, 2.49) | 1.10 (0.80, 1.52) |
>2 h | 0.96 (0.64, 1.45) | 1.01 (0.73, 1.41) |
0.60 (0.38, 0.97)
| 0.75 (0.30, 1.86) | 0.74 (0.51, 1.08) |
Characteristics | Complete satisfaction with services when last received (< complete satisfaction = ref) -- OR (95% CI) | |||
---|---|---|---|---|
Family planning | Antenatal care | Delivery care | Postnatal care | |
Socio-demographic | ||||
Parity (3–4 = ref) | ||||
1 | 0.75 (0.41, 1.39) | 0.84 (0.51, 1.39) | 0.82 (0.52, 1.29) | 1.05 (0.62, 1.78) |
2 | 0.67 (0.39, 1.15) | 0.87 (0.51, 1.49) | 0.69 (0.43, 1.12) | 0.96 (0.55, 1.66) |
≥5 | 0.72 (0.41, 1.27) | 0.64 (0.39, 1.06) | 0.95 (0.57, 1.58) | 0.98 (0.56, 1.74) |
Religion (Other Christian = ref) | ||||
Catholic | 1.24 (0.70, 2.21) | 0.95 (0.59, 1.52) | 1.26 (0.82, 1.95) | 1.08 (0.66, 1.77) |
Presbyterian |
0.52 (0.31, 0.89)
|
0.55 (0.34, 0.91)
| 0.70 (0.43, 1.14) | 0.85 (0.47, 1.51) |
Other |
0.43 (0.18, 1.01)
| 1.06 (0.42, 2.68) | 1.64 (0.69, 3.91) | 1.84 (0.61, 5.62) |
Ngoni ethnicity (no = ref) |
1.68 (0.94, 3.00)
|
1.78 (1.04, 3.05)
|
1.63 (1.00, 2.68)
|
1.80 (1.02, 3.16)
|
Married/living together (unmarried/divorced/widowed = ref) |
1.84 (0.96, 3.51)
| 1.50 (0.91, 2.48) |
0.60 (0.34, 1.08)
| 1.58 (0.91, 2.74) |
Reading level (reads the entire sentence = ref) | ||||
Cannot read simple sentence | 0.73 (0.45, 1.18) | 0.80 (0.52, 1.24) | 0.81 (0.54, 1.22) | 0.91 (0.58, 1.43) |
Reads part of sentence | 0.85 (0.45, 1.59) |
0.59 (0.35, 0.99)
| 0.66 (0.39, 1.10) | 1.05 (0.56, 2.00) |
Household wealth (5th/richest = ref) | ||||
1st (poorest) | 0.73 (0.39, 1.38) | 0.76 (0.40, 1.44) | 0.73 (0.42, 1.26) |
0.53 (0.28, 1.02)
|
2nd | 0.97 (0.54, 1.76) | 0.66 (0.38, 1.12) | 0.79 (0.47, 1.32) |
0.58 (0.32, 1.06)
|
3rd | 1.15 (0.60, 2.17) | 0.83 (0.47, 1.47) | 0.66 (0.38, 1.14) | 0.82 (0.42, 1.57) |
4th | 1.22 (0.62, 2.38) | 1.21 (0.65, 2.25) | 0.73 (0.43, 1.24) | 0.89 (0.46, 1.74) |
Closest facility to the woman’s residence | ||||
Perception that staff provides high quality services (no = ref) | 1.06 (0.52, 2.15) |
1.77 (1.00, 3.12)
|
1.97 (1.20, 3.26)
| 1.54 (0.75, 3.14) |
Perception that staff ensures patients’ privacy (no = ref) | 0.94 (0.39, 2.24) | 0.56 (0.25, 1.30) | 0.78 (0.42, 1.46) |
0.24 (0.07, 0.78)
|
Perception that provider(s) is always available (no = ref) | 1.33 (0.67, 2.68) |
1.65 (0.95, 2.87)
| 1.31 (0.79, 2.16) | 0.99 (0.51, 1.92) |
Perception that facility is clean (no = ref) |
2.21 (0.91, 5.35)
| 1.91 (0.80, 4.57) |
2.85 (1.38, 5.89)
|
3.53 (1.50, 8.30)
|
Perception that unmarried women can access FP services |
0.65 (0.41, 1.05)
| |||
Time to reach closest facility (1–2 h = ref) | ||||
<30 min |
0.53 (0.31, 0.93)
|
0.46 (0.27, 0.80)
|
0.54 (0.32, 0.89)
|
0.53 (0.31, 0.91)
|
30–59 min | 0.83 (0.51, 1.36) |
0.65 (0.41, 1.04)
| 1.02 (0.66, 1.58) | 1.10 (0.65, 1.87) |
>2 h |
2.71 (1.18, 6.21)
| 0.66 (0.38, 1.13) | 1.13 (0.69, 1.84) | 0.90 (0.49, 1.66) |
Maternal health service utilization indicators | ||||
Place where FP services last obtained (Government facility = ref)a
Private/mission-based facility | 1.57 (0.77, 3.23) | |||
Trimester when ANC initiated last pregnancy (2nd = ref) | ||||
1st | 1.05 (0.64, 1.73) | |||
3rd | 0.63 (0.30, 1.12) | |||
Number of ANC visits last pregnancy | 0.94 (0.78, 1.12) | |||
Facility ownership last delivery (Government facility = ref) Private/mission-based facility | 1.36 (.086, 2.15) | |||
Timing of 1st postnatal checkb (weeks) | 1.01 (0.89, 1.15) | |||
Number of checks within 2 months postpartumb
| 1.04 (0.77, 1.42) | |||
Quality of services when last received | ||||
Respondent got the FP method she wanted (no = ref) |
0.80 (0.63, 1.03)
| |||
Indexc of FP quality provision |
1.49 (1.21, 1.84)
| |||
ANC from skilled provider (no = ref) | 0.44 (0.14, 1.38) | |||
Pregnancy danger signs were discussed (no = ref) | 1.29 (0.70, 2.36) | |||
Skilled birth attendant (no = ref) | 0.51 (0.20, 1.33) | |||
Time to first consult before delivery (hours) | 1.03 (0.95, 1.12) | |||
Indexd of delivery service quality provision |
1.96 (1.70, 2.27)
| |||
Skilled provider at 1st postnatal checkb (no = ref) | 0.40 (0.14, 1.17) | |||
Postpartumb danger signs were discussed (no = ref) |
2.65 (1.46, 4.80)
|