TY - JOUR
T1 - Relationship between women’s characteristics and continuum of care for maternal health in Kenya
T2 - Complex survey analysis using structural equation modeling
AU - Owili, Patrick Opiyo
AU - Muga, Miriam Adoyo
AU - Chou, Yiing Jenq
AU - Hsu, Yi Hsin Elsa
AU - Huang, Nicole
AU - Chien, Li Yin
PY - 2017/9
Y1 - 2017/9
N2 - The objective of this study was to understand and estimate the complex relationships in the continuum of care for maternal health to provide information to improve maternal and newborn health outcomes. Women (n = 4,082) aged 15–49 years in the 2008/2009 Kenya Demographic and Health Survey data were used to explore the complex relationships in the continuum of care for maternal health (i.e., before, during, and after delivery) using structural equation modeling. Results showed that the use of antenatal care was significantly positively related to the use of delivery care (β = 0.06; adjusted odds ratio [AOR] = 1.06; 95% confidence interval [CI]: 1.02–1.10) but not postnatal care, while delivery care was associated with postnatal care (β = 0.68; AOR = 1.97; 95% CI: 1.75–2.22). Socioeconomic status was significantly related to all elements in the continuum of care for maternal health; barriers to delivery of care and personal characteristics were only associated with the use of delivery care (β = 0.34; AOR = 1.40; 95% CI: 1.30–1.52) and postnatal care (β = 0.03; AOR = 1.03; 95% CI: 1.01–1.05), respectively. The three periods of maternal health care were related to each other. Developing a referral system of continuity of care is critical in the Sustainable Development Goals era.
AB - The objective of this study was to understand and estimate the complex relationships in the continuum of care for maternal health to provide information to improve maternal and newborn health outcomes. Women (n = 4,082) aged 15–49 years in the 2008/2009 Kenya Demographic and Health Survey data were used to explore the complex relationships in the continuum of care for maternal health (i.e., before, during, and after delivery) using structural equation modeling. Results showed that the use of antenatal care was significantly positively related to the use of delivery care (β = 0.06; adjusted odds ratio [AOR] = 1.06; 95% confidence interval [CI]: 1.02–1.10) but not postnatal care, while delivery care was associated with postnatal care (β = 0.68; AOR = 1.97; 95% CI: 1.75–2.22). Socioeconomic status was significantly related to all elements in the continuum of care for maternal health; barriers to delivery of care and personal characteristics were only associated with the use of delivery care (β = 0.34; AOR = 1.40; 95% CI: 1.30–1.52) and postnatal care (β = 0.03; AOR = 1.03; 95% CI: 1.01–1.05), respectively. The three periods of maternal health care were related to each other. Developing a referral system of continuity of care is critical in the Sustainable Development Goals era.
KW - Antenatal care
KW - continuum of care
KW - delivery care
KW - maternal health care utilization
KW - postnatal care
KW - structural equation modeling
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U2 - 10.1080/03630242.2016.1222327
DO - 10.1080/03630242.2016.1222327
M3 - Article
C2 - 27613111
AN - SCOPUS:84986230687
SN - 0363-0242
VL - 57
SP - 942
EP - 961
JO - Women and Health
JF - Women and Health
IS - 8
ER -