Why is maternal health important

However, we have solutions: Most maternal deaths can be prevented if pregnancies are attended by skilled health care workers — doctors, nurses, or midwives — before, during, and after childbirth.

Additionally, access to proper equipment, supplies, reliable energy helps improve health. Photo Credit: Edward Echwalu. For many young mothers, pregnancies are neither planned nor wanted and could be prevented with access to contraception. Conflict, natural disasters, and displacement amplify risks for everyone, but especially for millions of girls and women who are already vulnerable.

When crises unfold, women and girls may lose access to family planning and other essential health services, face unintended pregnancies, and become far more vulnerable to sexual violence and HIV.

This study demonstrates suboptimal access and utilization of maternal healthcare in rural districts of Ghana, which are influenced by socio-economic characteristics of pregnant mothers. This suggests the need for tailored intervention to improve maternal healthcare utilization for mothers in this and other similar settings.

Peer Review reports. According to the world health organization WHO , specific interventions such as iron or folic supplementation for pregnant and postpartum women, vitamin A supplementation for children and postpartum women, malaria prophylaxis intervention such as insecticide-treated nets ITNs , as well as Intermittent Preventive Treatment in pregnancy IPTp and dietary supplementation for pregnant or lactating mothers, have helped improve maternal and child healthcare [ 2 ].

In spite of these developments, more than half a million women die during pregnancy or childbirth or within a few weeks of delivery, with most of them living in developing countries [ 3 ]. These have been partly attributed to the low utilization of maternal healthcare services, and are also influenced by social, economic, and cultural factors as well as healthcare availability and accessibility [ 4 , 5 , 6 , 7 , 8 , 9 ]. In limited-resource settings, pregnant women do not receive the full benefits of maternal health services, with the benefits waning towards the rural and deprived communities.

We define maternal healthcare for the purpose of this manuscript to include antenatal care ANC , skilled birth attendance and postnatal care PNC. Focused ANC has been found to offer the opportunity for early detection and timely treatment of diseases, leading to improved maternal health outcomes. The detection and treatment of high blood pressure, for example, help to prevent eclampsia, and greatly reduce mortality [ 10 ].

Similarly, improved maternal outcomes have been observed through the detection and treatment of anemia [ 11 ]. The attendance of ANC is known to help augment healthcare during pregnancy through the provision of preventive health services, such as prophylactic treatment of malaria, the immunization against neonatal tetanus [ 12 ] and screening for sexually transmitted diseases such as HIV infection and hepatitis.

The assistance by a skilled birth attendant at delivery is also an important aspect of maternal care. Several babies or mothers are lost due to critical issues such as the inability to recognize delivery complications and ensuring quick referrals. Skilled delivery encompasses the presence of professionals midwives, doctors, nurses, and others during delivery. It also includes an enabling environment where the equipment, drugs and other supplies required for the effective and efficient management of obstetric complications are available [ 13 ].

The presence of skilled birth attendants SBAs in the community may help to reduce maternal mortality [ 14 , 15 ] and this is regarded as, probably, one of the most critical interventions for reducing pregnancy-related deaths and disabilities in developing countries [ 13 ].

However, the provision of skilled attendance during delivery is only possible in the presence of functioning health systems [ 13 ], which include adequately trained and motivated workers, well-equipped facilities, transportation, and rapid referral systems.

The death of a mother further exposes her newborn child to high risks of morbidity and mortality. In developing countries, the most common causes of maternal deaths during the postpartum period are hemorrhage, infections and hypertensive disorders [ 17 ]. These conditions and any other life-threatening or debilitating conditions that may require urgent medical attention could be identified during PNC. Other services and information, such as maternal and child nutrition, immunization, hygiene, and sanitation can all be provided during PNC.

Ghana has seen an improvement in the utilization of maternal health services over the years [ 19 ]. These improvements are however minimal in regions with more rural communities [ 19 ]. Moreover, there is a paucity of evidence on the specific factors that explain access and utilization of maternal healthcare in deprived and rural communities in Ghana. This paper presents an analysis of factors that influence access and utilization of maternal healthcare in one of the deprived districts in the Ashanti Region of Ghana, Amansie-West.

The details of the methods of the study have been described elsewhere [ 21 ]. An analytical cross-sectional study was conducted from February to May in the Amansie-West district of Ghana. The district is one of the most deprived districts in the Ashanti region and uniformly rural. It had a population of , and an annual growth rate of 2. The health system in the district is very weak, low health staff-to-patients 1: 74 ; doctor to population ; nurse to population , and midwife to women in reproductive age WIRA [ 22 ] ratios.

Seven hundred and twenty pregnant women were systematically sampled from the various ANCs. The participating ANCs were selected from five of the 10 sub-districts in the district. The required respondents from selected health facilities were proportional to the size of total eligible population per community.

The distribution of respondents according to the sub-district was Manso Nkwanta , Edubia , Agroyesum , Antoakrom and Esuowin Additional file 1 : Table S1. At the five selected sub-districts, systematic random sampling technique was employed to select respondents from ANCs of private and public hospitals and health centers.

This was guided by the sampling interval, K , estimated as the required sample size divided by the total attendants per facility. During the visit hours, a first participant was identified and interviewed as the starting point and the Kth respondent is approached, starting the count at the selected starting participant.

This was repeated until the required sample size was attained. All participants involved in the study signed an informed consent form after explaining the objectives of the study. Participants had the right to withdraw from the study at any point in time during the data collection process.

The outcome variable was maternal healthcare during the previous pregnancy, defined as ANC visits, skilled delivery, and PNC during previous pregnancy. The explanatory variables were socio-economic characteristics age, education, religion, marital status, employment status, number of children, household wealth , access to healthcare valid health insurance, proximity to health facility , healthcare seeking behavior breastfeeding, use of family planning, preference of healthcare and knowledge about pregnancy and danger signs.

Scores were assigned to assets by using a Principal Component Analysis PCA and then standardized before grouping into quartiles. Details of the study variables are shown in Table 1. Univariable associations were tested using Chi-squared test and student t-test for categorical and continuous or discrete variables respectively.

The influence of the explanatory variables on the odds of antenatal care, skilled delivery and postnatal care was estimated using generalized estimating equations GEE [ 26 ]. This helped to address the possible correlations of data within clinic groups. Most women had basic education primary, Junior High School or middle school and With respect to their marital status, Two hundred respondents, constituting The distribution of wealth was quite proportional among the women, with The socio-economic characteristics of the mothers significantly influenced maternal healthcare services.

The proportion of mothers who optimally utilized ANC or either utilized skilled delivery and PNC differed significantly by the number of children a mother had. Pelvic or abdominal pain was the most cited pregnancy related condition followed by vaginal bleeding. Regular contractions and swelling of hands or face were the least known among women in this study.

As shown in Fig. Other danger signs mentioned included lethargy, diarrhea, and respiratory distress with cyanosis being the least mentioned.

Overall knowledge level was low among the respondents with Most Only Marital status was associated with their utilization of ANC, with mothers who were cohabiting having higher odds of attending ANC compared to those who were married, Table 5.

Lassi, Z. Essential interventions for maternal, newborn and child health: background and methodology. Reprod Health 11, S1 Download citation. Published : 21 August Anyone you share the following link with will be able to read this content:.

Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Volume 11 Supplement 1. Abstract Worldwide, ,—, women die during pregnancy and childbirth every year and an estimated 6.

Why maternal, newborn and child health? Selection and inclusion of Interventions The interventions were prioritized according to the following criteria: Interventions expected to have a significant impact on maternal, newborn and child survival , addressing the main causes of maternal, newborn and child mortality.

Classification of interventions The interventions were classified into categories A, B and C, according to the framework provided in Table 1. Table 1 Classification of interventions according to evidence and delivery strategies Full size table. Table 2 Full size table. Data extraction and analysis The review authors set up a triage process with standardized criteria for evaluating outputs from the search strategy and primary screening.

Information was extracted on the following criteria: 1. Characteristics of included reviews - description of each review included brief description of objectives, interventions, types of study design included, and outcomes reported; 2. Whether the review was a Cochrane or non-Cochrane review 3.

And if they pooled the studies included. Table 3 Grading of interventions according to the level of health care delivery Full size table. Conclusion Poor maternal, newborn and child health remains a significant problem and represent two of the most difficult to achieve targets among the MDGs particularly in LMICs. Peer review The reviewer reports for this article can be found in Additional File 1.

References 1. Article PubMed Google Scholar 5. Article PubMed Google Scholar Acknowledgment The publication of these papers and supplement was supported by an unrestricted grant from The Partnership for Maternal, Newborn and Child Health Declarations This article has been published as part of Reproductive Health Volume 11 Supplement 1, Essential intervention for maternal, newborn and child health.

View author publications. Additional information Competing interests We do not have any financial or non-financial competing interests for this review. Electronic supplementary material. Additional file 1: Peer review.

PDF KB. About this article. Cite this article Lassi, Z. Newborn screening for cystic fibrosis: evaluation of benefits and risks and recommendations for state newborn screening programs. Identifying infants with hearing loss—United States, — Newborn screening: Toward a uniform screening panel and system [executive summary]. The black-white disparity in pregnancy-related mortality from 5 conditions: Differences in prevalence and case-fatality rates. Am J Public Health. US Socioeconomic and racial differences in health: Patterns and explanations.

Ann Rev Soc. Broadening the focus: the need to address the social determinants of health. Am J Prev Med. Am J Obstet Gynecol. Do racial inequities in infant mortality correspond to variations in societal conditions? A study of state-level income inequality in the U. Soc Sci Med. Despite an overall decline in U. J Community Health. Racial and ethnic variation in low birthweight in the United States: individual and contextual determinants. Barclay, et al. Am J Pub Health.