Travel Time, Availability of Emergency Obstetric Care, and Perceived Quality of Care Associated with Maternal Healthcare Utilisation in Afghanistan: A Multilevel Analysis

Overview

Journal Glob Public Health

Publisher Informa Healthcare

Specialty Public Health

Date 2021 Jan 18

PMID 33460359

Citations 1

Authors

Christine Kim

Hannah Tappis

Laila Natiq

Bruce Fried

Kristen Hassmiller Lich

Paul L Delamater

Morris Weinberger

Justin G Trogdon

Affiliations

Soon will be listed here.

Abstract

Limited understanding of factors such as travel time, availability of emergency obstetric care (EmOC), and satisfaction/perceived quality of care on the utilisation of maternal health services exists in fragile and conflict-affect settings. We examined these key factors on three utilisation outcomes: at least one skilled antenatal care (ANC) visit, in-facility delivery, and bypassing the nearest public facility for childbirth in Afghanistan from 2010 to 2015. We used three-level multilevel mixed effects logistic regression models to assess the relationships between women's and their nearest public facilities' characteristics and outcomes. The nearest facility score for satisfaction/perceived quality was associated with having at least one skilled ANC visit (AOR: 2.02, 95% CI: 1.21, 3.36). Women whose nearest facility provided EmOC had a higher odds of in-facility childbirth compared to women whose nearest facility did not (AOR: 1.24, 95% CI: 1.04, 1.48). Nearest hospital travel time (AOR: 0.95, 95% CI: 0.93, 0.98) and nearest facility satisfaction/perceived quality (AOR: 0.34, 95% CI: 0.14, 0.82) were associated with lower odds of women bypassing their nearest facility. Afghanistan has made progress in expanding access to maternal healthcare services during the ongoing conflict. Addressing key barriers is essential to ensure that women have access to life-saving services.

Citing Articles

Factors impacting antenatal care utilization: a systematic review of 37 fragile and conflict-affected situations.

Alibhai K, Ziegler B, Meddings L, Batung E, Luginaah I Confl Health. 2022; 16(1):33.

PMID: 35690840 PMC: 9188725. DOI: 10.1186/s13031-022-00459-9.

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