Abstract
Aim
This study examines the factors associated with the utilisation of maternal healthcare services by married adolescent women in the age group 15–19.
Subjects and methods
Using the nationally representative cross-sectional data from the fourth wave of Mali Demographic and Health Survey (MDHS), 2006, the present study tries to demonstrate the factors associated with the indicators of maternal healthcare service utilisation among women who had the experience of childbirth in their adolescence (age 15–19) during the 5 years preceding the survey date. Three indicators were measured: adolescent women who had at least four antenatal care visits, those who had undergone safe delivery care, and those who had received post natal care after delivery. Bivariate analyses including chi-square tests to determine the difference in proportion, and logistical models to understand the net effect of explanatory variables on selected outcomes were applied.
Results
Results show the poor performance in maternal healthcare utilisation in Mali. Factors such as women’s education, husband’s education, women’s personal barrier index, mass media exposure, place of residence and previous delivery services used appeared to be the most significant factors associated with the utilisation of maternity services by Malian adolescents.
Conclusion
The present study indicates that a strong community based campaign is necessary to raise awareness about the adverse effects of early marriage and childbearing. It is important to tailor programs to meet the unique needs of the varied teen populations and take into consideration how the family environment and relationships influence decision making about sex, contraception and childbearing.
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References
Aa I, Grove MA, Haugsja AH, Hinderaker SG (2011) High maternal mortality estimated by the sisterhood method in a rural area of Mali. BMC Pregnancy Childbirth 11:56
Agha S, Carton TW (2011) Determinants of institutional delivery in rural Jhang, Pakistan. Int J Equity Health 10:31
Amin R, Shah M, Becker S (2010) Socioeconomic factors differentiating maternal and child health-seeking behavior in rural Bangladesh: a cross-sectional analysis. Int J Equity Health 9:9
Awadalla HI, Kamel EG, Mahfouz EM, Refaat TM (2009) Evaluation of maternal and child health servicesin El-Minia City, Egypt. J Public Health 17:321–329
Babalola S, Fatusi A (2009) Determinants of use of maternal health services in Nigeria: looking beyond individual and household factors. BMC Pregnancy Childbirth 9:43
Babatunde O (2011) Population and development. Science 333:499
Becker S, Costenbader E (2001) Husbands’ and wives’ reports of contraceptive use. Stud Fam Plann 32:111–129
Beegle K (2001) Bargaining power within couples and use of prenatal and delivery care in Indonesia. Stud Fam Plann 32:130–146
Bloom SS, Tsui AO, Plotkin M, Bassett S (2000) What husbands in northern India know about reproductive health: correlates of knowledge about pregnancy and maternal and sexual health. J Biosoc Sci 32:237–251
Burgard S (2004) Race and pregnancy-related care in Brazil and South Africa. Soc Sci Med 59:1127–1146
Celik Y, Hotchkiss DR (2000) The socio-economic determinants of maternal health care utilization in Turkey. Soc Sci Med 50:1797–1806
Cellule de Planification et de Statistique du Ministère de la Santé (CPS/MS), Direction Nationale de la Statistique et de l’Informatique du Ministère de l’Économie, de l’Industrie et du Commerce (DNSI/MEIC) et Macro International Inc (2007) Enquête Démographique et de Santé du Mali 2006. CPS/DNSI et Macro International Inc., Calverton, MD, USA
Chan MF, Van IK, Ng WI (2010) Exploring the relationship of socio demographic changes, economic instability and the availability of health resources with birth rates. J Public Health 18:591–596
Chowdhury M, Ronsmans C, Killewo J, Anwar I, Gausia K, Das-Gupta S, Blum LS, Dieltiens G, Marshall T, Saha S, Borghi J (2006) Equity in use of home based or facility-based skilled obstetric care in rural Bangladesh: an observational study. Lancet 367:327–332
D’Ambruoso L, Abbey M, Hussein J (2005) Please understand when I cry out in pain: women’s accounts of maternity services during labour and delivery in Ghana. BMC Public Health 5:140
Dudgeon MR, Inhorn MC (2004) Men’s influences on women’s reproductive health: medical anthropological perspectives. Soc Sci Med 59:1379–1395
Fatusi AO, Hindin MJ (2010) Adolescents and youth in developing countries: health and development issues in context. J Adolesc 33:499–508
Filippi V, Ronsmans C, Campbell OM, Graham WJ, Mills A, Borghi J, Koblinsky M, Osrin D (2006) Maternal health in poor countries: the broader context and a call for action. Lancet 368:1535–1541
Fotso JC (2006) Urban–rural differentials in child malnutrition: trends and socioeconomic correlates in sub-Saharan Africa. Health Place 13:205–217
Fournier P, Dumont A, Tourigny C, Dunkley G, Drame S (2009) Improved access to comprehensive emergency obstetric care and its effect on institutional maternal mortality in rural Mali. Bull WHO 87:30–38
Franco LM, Diop FP, Burgert CR, Kelley AG, Makinen M, Simpara CHT (2008) Effects of mutual health organizations on use of priority health care services in urban and rural Mali: a case–control study. Bull WHO 86:830–838
Furuta M, Salway S (2006) Women’s position within the household as a determinant of maternal health care use in Nepal. Int Fam Plan Perspect 32:17–27
Gabrysch S, Campbell OMR (2009) Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth 9:34
Gage AJ (2007) Barriers to utilization of maternal health care in rural Mali. Soc Sci Med 65:1666–1682
Hampton T (2010) Child marriage threatens girl’s health. JAMA 34:509–510
Kaggwa EB, Diop N, Storey JD (2008) The role of individual and community normative factors: a multilevel analysis of contraceptive use among women in union in Mali. Int Fam Plan Perspect 34:79–88
Kesterton AJ, Cleland J, Sloggett A, Ronsmans C (2010) Institutional delivery in rural India: the relative importance of accessibility and economic status. BMC Pregnancy Childbirth 10:30
King R, Mann V, Boone PD (2010) Knowledge and reported practices of men and women on maternal and child health in rural Guinea Bissau: a cross sectional survey. BMC Public Health 10:319
Klingberg-Allvin M, Graner S, Phuc HD, Höjer B, Johansson A (2010) Pregnancies and births among adolescents: a population-based prospective study in rural Vietnam. Sex Reprod Healthcare 1:15–19
Kyomuhendo GB (2003) Low use of rural maternity services in Uganda: impact of women’s status, traditional beliefs and limited resources. Reprod Health Matters 11:16–26
LeGrand TK, Mbacke CSM (1993) Teenage pregnancy and child health in urban Sahel. Stud Fam Plann 24:137–149
Magadi M, Diamond I, Rodrigues RN (2000) The determinants of delivery care in Kenya. Soc Biol 47:164–188
Malhotra A, Warner A, McGonagle A, Lee-Rife S (2011) Solution to end child marriage: what the evidence shows. International Center for Research on Women (ICRW), Washington, DC
Mesko N, Osrin D, Tamang S, Shrestha BP, Manandhar DS, Manandhar M, Standing H, Costello AM (2003) Care for perinatal illness in rural Nepal: a descriptive study with cross-sectional and qualitative components. BMC Int Health Human Rights 3:3
Mpembeni RMN, Killewo JZ, Leshabari MT, Siriel N, Massawe SN, Jahn A, Mushi D, Mwakipa H (2007) Use pattern of maternal health services and determinants of skilled care during delivery in Southern Tanzania: implications for achievement of MDG-5 targets. BMC Pregnancy Childbirth 7:29
Mullany BC (2010) Spousal agreement on maternal health practices in Kathmandu, Nepal. J Biosoc Sci 42:689–693
Ndidi EP, Oseremen IG (2010) Reasons given by pregnant women for late initiation of antenatal care in the Nigeria delta, Nigeria. Ghana Med J 44:47–51
Ochako R, Fotso JC, Ikamari L, Khasakhala A (2011) Utilization of maternal health services among young women in Kenya: insights from the Kenya Demographic and Health Survey, 2003. BMC Pregnancy Childbirth 11:1
Odimegwu C, Adewuyi A, Odebiyi T, Aina B, Adesina Y, Olatubara O, Eniola F (2005) Men’s role in emergency obstetric care in Osun State of Nigeria. Afr J Reprod Health 9:59–71
Omar K, Hasim S, Muhammad NA, Jaffar A, Hashim SM, Siraj HH (2010) Adolescent pregnancy outcomes and risk factors in Malaysia. Int J Gynecol Obstet 111:220–223
Otchere SA, Kayo A (2007) The challenges of improving emergency obstetric care in two rural districts in Mali. Int J Gynecol Obstet 99:173–182
Pawloski LR (2002) Growth and development of adolescent girls from the Segou region of Mali (West Africa). Am J Phys Anthropol 117:364–372
Paxton A, Wardlaw T (2011) Are we making progress in maternal mortality? N Engl J Med 364:1990–1993
Perez F, Ba H, Dastagire SG, Altmann M (2009) The role of community health workers in improving child health programmes in Mali. BMC Int Health Human Rights 9:28
Pirkle CM, Fournier P, Tourigny C, Sangare K, Haddad S (2011) Emergency obstetrical complications in a rural African setting (Kayes, Mali): the link between travel time and in-hospital maternal mortality. Matern Child Health J 15:1081–1087
Population Reference Bureau (2011) World population datasheet. Population Reference Bureau, Washington, DC
Potts M, Gidi V, Campbell M, Zureick S (2011) Niger: Too little, too late. Int Perspect Sex Reprod Health 27:95–101
Rai RK, Tulchinsky TH (2012) Addressing the sluggish progress in reducing maternal mortality in India. Asia Pac J Public Health. doi:10.1177/1010539512436883
Rai RK, Ramadhan AA, Tulchinsky TH (2011) Prioritizing maternal and child health in independent South Sudan. Matern Child Health J. doi:10.1007/s10995-011-0886-6
Raj A, Saggurti N, Balaiah D, Silverman JG (2009) Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study. Lancet 373:1883–1889
Rasheed S, Abdelmonem A, Amin M (2011) Adolescent pregnancy in Upper Egypt. Int J Gynecol Obstet 112:21–24
Retherfored RD, Choe MK (1993) Statistical models for causal analysis. Wiley, New York
Reynolds HW, Wong EL, Tucker H (2006) Adolescents’ use of maternal and child health services in developing countries. Int Fam Plan Perspect 32:6–16
Ronsmans C, Graham WJ, on behalf of the Lancet Maternal Survival Series Steering Group (2006) Maternal mortality: who, when, where and why. Lancet 368:1189–1200
Rosenfield A, Charo RA, Chavkin W (2008) Moving forward on reproductive health. N Engl J Med 359:1869–1871
Say L, Raine R (2007) A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context. Bull WHO 85:812–819
Save the Children (2011) Champion for children: state of the world’s mothers 2011. Save the Children, Westport, CT
Short SE, Zhang F (2004) Use of maternal health services in rural China. Popul Stud 58:3–19
Singh KK (1998) Husbands’ reproductive health knowledge, attitudes, and behaviour in Uttar Pradesh, India. Stud Fam Plann 29:388–399
Singh L, Rai RK, Singh PK (2012a) Assessing the utilization of maternal and child health care among married adolescent women: evidence from India. J Biosoc Sci 44:1–26
Singh PK, Rai RK, Alagarajan M, Singh L (2012b) Determinants of maternity care services utilization among married adolescents in rural India. PLoS One 7:e31666
Statacorp (2007) Stata statistical software: release 10. Statacorp LP, College Station, TX
Stekelenburg J, Kyanamina S, Mukelabai M, Wolffers I, van Roosmalen J (2004) Waiting too long: low use of maternal health services in Kalabo, Zambia. Trop Med Int Health 9:390–398
Stephenson R, Baschieri A, Clements S, Hennink M, Madise N (2006) Contextual influences on the use of health facilities for childbirth in Africa. Am J Public Health 96:84–93
Thaddeus S, Maine D (1994) Too far to walk: maternal mortality in context. Soc Sci Med 38:1091–1110
Thind A, Mohani A, Banerjee K, Hagigi F (2008) Where to deliver? Analysis of choice of delivery location from a national survey in India. BMC Public Health 8:29
Titaley CR, Dibley MJ, Roberts CL (2009) Factors associated with non-utilization of postnatal care services in Indonesia. J Epidemiol Comm Health 63:827–831
Titaley CR, Dibley MJ, Roberts CL (2010) Factors associated with underutilization of antenatal care services in Indonesia: results of Indonesia Demographic and Health Survey 2002/2003 and 2007. BMC Public Health 10:485
Tran TK, Nguyen CT, Nguyen HD et al (2011) Urban- rural disparities in antenatal care utilization: a study of two cohorts of pregnant women in Vietnam. BMC Health Serv Res 11:120
United Nations (2011a) World fertility policies 2011. Department of Economic and Social Affairs (Population Division), New York
United Nations (2011b) World fertility report 2009. Department of Economic and Social Affairs (Population Division), New York
United Nations Adolescent Girls Task Force (2010) Accelerating efforts to advance the rights of adolescent girls: a UN Joint Statement. http://www.unfpa.org/webdav/site/global/shared/documents/publications/2010/agtf_jointstatement_en.pdf. Accessed 30 November 2011
United Nations Children’s Fund (2011) Adolescence: an age of opportunity. United Nations Children’s Fund, New York
United Nations Development Programme (2011) Human development report, 2011: sustainability and equity—a better future for all. United Nations Development Programme, New York
Uzochukwu BSC, Onwujekwe EO, Onoka CA, Ughasoro MD (2008) Rural–urban differences in maternal responses to childhood fever in South East Nigeria. PLoS One 3:e1788
Wall LL (1998) Dead mothers and injured wives: the social context of maternal morbidity and mortality among the Hausa of Northern Nigeria. Stud Fam Plann 29:341–359
World Bank (1999) Health care in Mali: building on community involvement, Pre´cis No. 188. World Bank Operations Evaluation Department, Washington, DC
World Health Organization (2006) Provision of effective antenatal care: integrated management of pregnancy and child birth (IMPAC). Standards for Maternal and Neonatal care (1.6). WHO, Department of Making Pregnancy Safer, Geneva, Switzerland
World Health Organization (2010) Trends in maternal mortality: 1990 to 2008, estimates developed by WHO, UNICEF, UNFPA and The World Bank. WHO, Geneva, Switzerland
Zere E, Oluwole D, Kirigia JM, Mwikisa CN, Mbeeli T (2011) Inequities in skilled attendance at birth in Namibia: a decomposition analysis. BMC Pregnancy Childbirth 11:34
Acknowledgements
The authors are grateful to Measure Demographic and Health Survey (ORC Macro), Calverton, USA for the data used in this study.
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The authors declare that they have no competing interests.
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PKS conceived, designed, gathered materials, and participated in preparing the manuscript. LS participated in data analysis and in preparing the manuscript. CK had a major role in writing and revising the manuscript. RKR participated in gathering the required materials/information, preparing the manuscript, and finalizing it. All the authors have read the final manuscript and approved it.
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Singh, P.K., Singh, L., Kumar, C. et al. Correlates of maternal healthcare service utilisation among adolescent women in Mali: analysis of a nationally representative cross-sectional survey, 2006. J Public Health 21, 15–27 (2013). https://doi.org/10.1007/s10389-012-0516-9
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DOI: https://doi.org/10.1007/s10389-012-0516-9