Evaluation of differences in maternal and newborn health coverage across urban and rural areas: A pooled analysis of 88 countries
Öz
Objective: This study aims to determine whether the variables that reveal countries’ maternal and newborn health coverage differ between rural and urban areas.
Methods: The sample of the study consists of 88 countries. The data were obtained from the “Maternal and Newborn Health Coverage Database 2022” published by UNICEF and analyzed using IBM SPSS Statistics. The T-test, Mann–Whitney U test and factorial ANOVA were used to analyze the data.
Results: The percentage of women who attended at least four prenatal appointments was found to be higher among women living in urban areas (81.1%) than among women living in rural areas (72.3%) (p=0.008). More cesarean sections are performed in urban (14.6%) than in rural areas (7.6%) (p=0.001). Women living in urban areas (94.3%) give birth in a health institution more frequently than women living in rural areas (81.3%) (p=0.001). The percentage of births attended by skilled health personnel was found to be higher for women living in urban areas (81.1%) than for women living in rural areas (72.3%) (p=0.001). The percentage of mothers (80.6%) who received postnatal care within 2 days of giving birth was also higher in urban areas than in rural areas (70.2%) (p=0.001). There is an interaction effect of urban-rural area and income group on the antenatal care 1+visit variable (p=0.001), institutional deliveries variable (p=0.023), and skilled birth attendant variable (p=0.002).
Conclusion: This research reveals that women and newborns living in rural areas are disadvantaged compared with those in urban areas with regard to antenatal, delivery, and postnatal care. It is recommended that steps are taken to reduce socioeconomic inequalities in rural areas, subsidize maternity services in hospitals, and develop a referral system among health institutions in rural areas.
Anahtar Kelimeler
Access to Health Care Delivery Disparities Antenatal Care Postnatal Care
Kaynakça
- United Nations. Goal 3: Ensure healthy lives and promote well-being for all at all ages. [online]. Available at: https://www.un.org/sustainabledevelopment/health/. Accessed February 20, 2023.
- Kozhimannil KB, Interrante JD, Henning-Smith C, et al. Rural-urban differences in severe maternal morbidity and mortality in the US, 2007–15. Health Affairs 2019;38(12):2077-2085.
- Matthews Z, Channon A, Neal S, et al. Examining the “urban advantage” in maternal health care in developing countries. PLoS Med 2010;7(9):e1000327.
- McCormick MC, Shapiro S, Starfield BH. The regionalization of perinatal services. Summary of the evaluation of a national demonstration program. JAMA 1985;253(6):799–804.
- Yi B, Wu L, Liu H, et al. Rural-urban differences of neonatal mortality in a poorly developed province of China. BMC Public Health 2011;11,1-6.
- Lorch SA, Rogowski J, Profit J, et al. Access to risk-appropriate hospital care and disparities in neonatal outcomes in racial/ethnic groups and rural–urban populations. In Seminars in perinatology 2021;14(4):151409.
- Yanping W, Lei M, Li D, et al. A study on rural–urban differences in neonatal mortality rate in China, 1996–2006. Journal of Epidemiology & Community Health 2010;64(10):935-936.
- Barros AJ, Ronsmans C, Axelson H, et al. Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries. The Lancet 2012;379(9822):1225-1233.
- Liang J, Dai L, Zhu J, et al. Preventable maternal mortality: geographic/rural-urban differences and associated factors from the population-based maternal mortality surveillance system in China. BMC Public Health 2011;11,1-9.
- Rezende Chrisman J, Mattos IE, Koifman RJ, et al. Prevalence of very low birthweight, malformation, and low Apgar score among newborns in Brazil according to maternal urban or rural residence at birth. J Obstet Gynaecol Res 2016;42(5):496-504.
- Setia MS, Methodology Series Module 3: Cross-sectional Studies. Indian J Dermatol. 2016 May-Jun;61(3):261-4. doi: 10.4103/0019-5154.182410. PMID: 27293245; PMCID: PMC4885177.
- UNICEF. About UNICEF. [online] Available at: https://www.unicef.org/about-unicef. Accessed February 20, 2023.
- UNICEF. Maternal and Newborn Health Coverage. [online] Available at: https://data.unicef.org/resources/dataset/maternal-newborn-health/. Accessed February 14, 2023.
- Hamadeh N, Van Pompaey C, Metreau E. et al. New World Bank country classifications by income level: 2022-2023 [online]. Available at: https://blogs.worldbank.org/opendata/new-world-bank-country-classifications-income-level-2022-2023. Accessed August 1, 2023.
- Partridge S, Balayla J, Holcroft CA, et al. Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: a retrospective analysis of 28,729,765 US deliveries over 8 years. Am J Perinatol 2012;29(10):787-794.
- Margaret E, Nkechinyere C, Adeyanju O, et al. Emergency obstetric care: Urban versus rural comparison of health workers’ knowledge, attitude and practice in river state, Nigeria-implications for maternal health care in rivers state. Clinical Medicine and Diagnostics;2013:3(2).
- Saaka M, Akuamoah-Boateng J. Prevalence and determinants of rural-urban utilization of skilled delivery services in Northern Ghana. Scientifica 2020.
- Ghazi Tabatabaie M, Moudi Z, Vedadhir A. Home birth and barriers to referring women with obstetric complications to hospitals: a mixed-methods study in Zahedan, southeastern Iran. Reprod Health 2012;9:1-10.
- World Health Organization. Newborns: Improving survival and well-being. Newborns: Improving survival and well-being. [online]. Available at: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Accessed February 20, 2023.
- Anand S, Bärnighausen T. Human resources and health outcomes: cross-country econometric study. The Lancet 2004;364(9445):1603-1609.
- Paul VK. The current state of newborn health in low income countries and the way forward. In Seminars in Fetal and Neonatal Medicine 2006;11(1):7-14. WB Saunders.
- Ruktanonchai CW, Ruktanonchai NW, Nove A, Lopes S, et al. Equality in maternal and newborn health: modelling geographic disparities in utilisation of care in five East African countries. PLoS One 2016;11(8):e0162006.
- Machira K, Palamulen M. Rural–urban differences in the use of postnatal care services in Malawi. Journal of Egyptian Public Health Association 2017;92(1):1-10.
- Samuel O, Zewotir T, North D. Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa. Reprod Health 2021;18(1):1-12.
- Ushie BA, Udoh EE, Ajayi AI. Examining inequalities in access to delivery by caesarean section in Nigeria. PLoS One 2019;14(8):e0221778.
- Leone T, Padmadas SS, Matthews Z. Community factors affecting rising caesarean section rates in developing countries: an analysis of six countries. Soc Sci Med 2008;67(8):1236-1246.
- Sudhof L, Amoroso C, Barebwanuwe P, et al. Local use of geographic information systems to improve data utilisation and health services: mapping caesarean section coverage in rural Rwanda. Tropical Medicine & International Health 2013;18(1):18-26.
- Wyatt S, Silitonga PII, Febriani E, et al. Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017. BMJ open 2021;11(5): e045592.
- Long Q, Kempas T, Madede T, et al. Caesarean section rates in Mozambique. BMC pregnancy and childbirth 2015;15(1):1-9.
- Mumtaz S, Bahk J, Khang YH. Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013. PloS one 2017;12(10):e0186563.
- Hernández-Vásquez A, Chacón-Torrico H, Bendezu-Quispe G. Prevalence of home birth among 880,345 women in 67 low-and middle-income countries: a meta-analysis of demographic and health surveys. SSM Popul Health 2021;16:100955.
KENTSEL VE KIRSAL BÖLGELERDE ANNE VE YENİDOĞAN SAĞLIĞI KAPSAMINDAKİ FARKLILIKLARIN DEĞERLENDİRİLMESİ
Öz
Amaç: Bu araştırmanın amacı, ülkelerin anne ve yenidoğan sağlığı kapsamını ortaya koyan değişkenlerinin kırsal ve kentsel bölgelerde farklılaşıp farklılaşmadığını incelemektir. Kırsal ve kentsel nüfus arasındaki anne ve yenidoğan sağlığı kapsamını anlamak, nüfusların sağlık ihtiyaçlarını değerlendirmek ve sağlık eşitsizliklerini ele almak açısından önemlidir. Yöntem: Araştırmanın verileri, UNICEF tarafından yayınlanan “Maternal and Newborn Health Coverage Database 2022”den elde edilmiştir. Veriler, IBM SPSS Statistics (IBM SPSS Statistics for Windows, Version 26.0. Armonk, United States) ile analiz edilmiştir. Bulgular: Araştırma sonucunda kırsal ve kentsel bölgeler arasında doğum öncesi ziyaret, sezaryen oranı, bir sağlık kuruluşundaki doğumların yüzdesi, nitelikli sağlık personelinin katıldığı doğum yüzdesi, yenidoğan ve anne için doğum sonrası hizmet değişkenlerinin tamamının istatistiksel olarak anlamlı şekilde farklılık gösterdiği saptanmıştır. Sonuç: Bu araştırma, doğum öncesi hizmet, doğum ve doğum sonrası hizmet kapsamında kırsal bölgelerde yaşayan kadınların ve yenidoğanların kentsel bölgelere göre dezavantajlı olduğunu ortaya koymaktadır. Sağlık çalışanlarının kırsal alanlarda çalışmasını teşvik edici düzenlemeler yapılması, kırsal bölgelerde sosyo-ekonomik eşitsizlikleri azaltmaya yönelik adımlar atılması, doğum öncesi ve sonrası hizmetlere erişimde asgari hedefler konulması, hastanede doğum hizmetinin sübvanse edilmesi, kırsal alanlarda bulunan sağlık kurumları arasında sevk sisteminin geliştirilmesi önerilmektedir.
Anahtar Kelimeler
doğum doğum öncesi bakım eşitsizlikler sağlık hizmetlerine erişim doğum sonrası bakım
Kaynakça
- United Nations. Goal 3: Ensure healthy lives and promote well-being for all at all ages. [online]. Available at: https://www.un.org/sustainabledevelopment/health/. Accessed February 20, 2023.
- Kozhimannil KB, Interrante JD, Henning-Smith C, et al. Rural-urban differences in severe maternal morbidity and mortality in the US, 2007–15. Health Affairs 2019;38(12):2077-2085.
- Matthews Z, Channon A, Neal S, et al. Examining the “urban advantage” in maternal health care in developing countries. PLoS Med 2010;7(9):e1000327.
- McCormick MC, Shapiro S, Starfield BH. The regionalization of perinatal services. Summary of the evaluation of a national demonstration program. JAMA 1985;253(6):799–804.
- Yi B, Wu L, Liu H, et al. Rural-urban differences of neonatal mortality in a poorly developed province of China. BMC Public Health 2011;11,1-6.
- Lorch SA, Rogowski J, Profit J, et al. Access to risk-appropriate hospital care and disparities in neonatal outcomes in racial/ethnic groups and rural–urban populations. In Seminars in perinatology 2021;14(4):151409.
- Yanping W, Lei M, Li D, et al. A study on rural–urban differences in neonatal mortality rate in China, 1996–2006. Journal of Epidemiology & Community Health 2010;64(10):935-936.
- Barros AJ, Ronsmans C, Axelson H, et al. Equity in maternal, newborn, and child health interventions in Countdown to 2015: a retrospective review of survey data from 54 countries. The Lancet 2012;379(9822):1225-1233.
- Liang J, Dai L, Zhu J, et al. Preventable maternal mortality: geographic/rural-urban differences and associated factors from the population-based maternal mortality surveillance system in China. BMC Public Health 2011;11,1-9.
- Rezende Chrisman J, Mattos IE, Koifman RJ, et al. Prevalence of very low birthweight, malformation, and low Apgar score among newborns in Brazil according to maternal urban or rural residence at birth. J Obstet Gynaecol Res 2016;42(5):496-504.
- Setia MS, Methodology Series Module 3: Cross-sectional Studies. Indian J Dermatol. 2016 May-Jun;61(3):261-4. doi: 10.4103/0019-5154.182410. PMID: 27293245; PMCID: PMC4885177.
- UNICEF. About UNICEF. [online] Available at: https://www.unicef.org/about-unicef. Accessed February 20, 2023.
- UNICEF. Maternal and Newborn Health Coverage. [online] Available at: https://data.unicef.org/resources/dataset/maternal-newborn-health/. Accessed February 14, 2023.
- Hamadeh N, Van Pompaey C, Metreau E. et al. New World Bank country classifications by income level: 2022-2023 [online]. Available at: https://blogs.worldbank.org/opendata/new-world-bank-country-classifications-income-level-2022-2023. Accessed August 1, 2023.
- Partridge S, Balayla J, Holcroft CA, et al. Inadequate prenatal care utilization and risks of infant mortality and poor birth outcome: a retrospective analysis of 28,729,765 US deliveries over 8 years. Am J Perinatol 2012;29(10):787-794.
- Margaret E, Nkechinyere C, Adeyanju O, et al. Emergency obstetric care: Urban versus rural comparison of health workers’ knowledge, attitude and practice in river state, Nigeria-implications for maternal health care in rivers state. Clinical Medicine and Diagnostics;2013:3(2).
- Saaka M, Akuamoah-Boateng J. Prevalence and determinants of rural-urban utilization of skilled delivery services in Northern Ghana. Scientifica 2020.
- Ghazi Tabatabaie M, Moudi Z, Vedadhir A. Home birth and barriers to referring women with obstetric complications to hospitals: a mixed-methods study in Zahedan, southeastern Iran. Reprod Health 2012;9:1-10.
- World Health Organization. Newborns: Improving survival and well-being. Newborns: Improving survival and well-being. [online]. Available at: https://www.who.int/news-room/fact-sheets/detail/newborns-reducing-mortality. Accessed February 20, 2023.
- Anand S, Bärnighausen T. Human resources and health outcomes: cross-country econometric study. The Lancet 2004;364(9445):1603-1609.
- Paul VK. The current state of newborn health in low income countries and the way forward. In Seminars in Fetal and Neonatal Medicine 2006;11(1):7-14. WB Saunders.
- Ruktanonchai CW, Ruktanonchai NW, Nove A, Lopes S, et al. Equality in maternal and newborn health: modelling geographic disparities in utilisation of care in five East African countries. PLoS One 2016;11(8):e0162006.
- Machira K, Palamulen M. Rural–urban differences in the use of postnatal care services in Malawi. Journal of Egyptian Public Health Association 2017;92(1):1-10.
- Samuel O, Zewotir T, North D. Decomposing the urban–rural inequalities in the utilisation of maternal health care services: evidence from 27 selected countries in Sub-Saharan Africa. Reprod Health 2021;18(1):1-12.
- Ushie BA, Udoh EE, Ajayi AI. Examining inequalities in access to delivery by caesarean section in Nigeria. PLoS One 2019;14(8):e0221778.
- Leone T, Padmadas SS, Matthews Z. Community factors affecting rising caesarean section rates in developing countries: an analysis of six countries. Soc Sci Med 2008;67(8):1236-1246.
- Sudhof L, Amoroso C, Barebwanuwe P, et al. Local use of geographic information systems to improve data utilisation and health services: mapping caesarean section coverage in rural Rwanda. Tropical Medicine & International Health 2013;18(1):18-26.
- Wyatt S, Silitonga PII, Febriani E, et al. Socioeconomic, geographic and health system factors associated with rising C-section rate in Indonesia: a cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017. BMJ open 2021;11(5): e045592.
- Long Q, Kempas T, Madede T, et al. Caesarean section rates in Mozambique. BMC pregnancy and childbirth 2015;15(1):1-9.
- Mumtaz S, Bahk J, Khang YH. Rising trends and inequalities in cesarean section rates in Pakistan: Evidence from Pakistan Demographic and Health Surveys, 1990-2013. PloS one 2017;12(10):e0186563.
- Hernández-Vásquez A, Chacón-Torrico H, Bendezu-Quispe G. Prevalence of home birth among 880,345 women in 67 low-and middle-income countries: a meta-analysis of demographic and health surveys. SSM Popul Health 2021;16:100955.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Erken Görünüm Tarihi | 20 Nisan 2024 |
| Yayımlanma Tarihi | 26 Nisan 2024 |
| Gönderilme Tarihi | 21 Şubat 2023 |
| Kabul Tarihi | 16 Mart 2024 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 22 Sayı: 1 |
Kaynak Göster
TURKISH JOURNAL OF PUBLIC HEALTH - TURK J PUBLIC HEALTH. online-ISSN: 1304-1096
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