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The effect of child marriage on the utilization of maternal health care in Nepal: A cross-sectional analysis of Demographic and Health Survey 2016


Autoři: Kazutaka Sekine aff001;  Daniel J. Carter aff002
Působiště autorů: United Nation Population Fund Myanmar, Yangon, Myanmar aff001;  Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom aff002
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222643

Souhrn

A range of demographic and socioeconomic factors are known to account for enormous disparities in the uptake of maternal health care in low- and middle-income countries. In contrast, contextual factors such as child marriage are far less explored as a deterrent to the uptake of maternal health care. The present study aimed to assess the total effect of child marriage on the utilization of maternal health services in Nepal. This study drew on data from the Nepal Demographic and Health Survey 2016. The study restricted its analysis to a subsample of 3,970 currently married women of reproductive age who had at least one live birth in the five years preceding the survey. After descriptive analysis, logistic regression models were constructed to estimate adjusted odds ratios. The results of logistic regression controlling for confounders suggested child marriage decreased the likelihood of antenatal care visits (AOR 0.74; 95% CI 0.63–0.86), skilled attendance at delivery (AOR 0.66; 95% CI 0.56–0.78), facility-based delivery (AOR 0.65; 95% CI 0.56–0.77), and postnatal care use (AOR 0.80; 95% CI 0.67–0.96). The findings of this study reinforced the existing evidence for the adverse effect of child marriage on maternal health-seeking behaviors. Women’s restricted access to household resources, limited autonomy in decision-making, social isolation, and the dominant power of husbands and mothers-in-law may play a role in the findings. Addressing women’s social vulnerability as a barrier to accessing health care may help to increase the uptake of maternal health services.

Klíčová slova:

People and places – Geographical locations – Medicine and health sciences – Pediatrics – Health care – Women's health – Maternal health – Birth – Labor and delivery – Obstetrics and gynecology – Public and occupational health – Socioeconomic aspects of health – Child health – Behavioral and social aspects of health – Asia – Antenatal care – Nepal – Postpartum care – Postnatal care


Zdroje

1. WHO, UNICEF, UNFPA, World Bank Group, the United Nations Population Division. Trends in maternal mortality: 1990–2015: World Health Organization; 2015.

2. UNFPA. State of world population 2005: the promise of equality. New York: United Nations Population Fund; 2005.

3. Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, et al. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. International Journal of Obstetrics & Gynaecology. 2014;121(s1):40–8. doi: 10.1111/1471-0528.12630 24641534

4. Nove A, Matthews Z, Neal S, Camacho AV. Maternal mortality in adolescents compared with women of other ages: evidence from 144 countries. Lancet Glob Health. 2014;2(3):e155–64. doi: 10.1016/S2214-109X(13)70179-7 25102848.

5. Unknown author. Maternal mortality: helping women off the road to death. 1986. Last accessed on 14 April 2018. Available from: http://www.who.int/iris/handle/10665/46514.

6. Freedman LP, Graham WJ, Brazier E, Smith JM, Ensor T, Fauveau V, et al. Practical lessons from global safe motherhood initiatives: time for a new focus on implementation. Lancet. 2007;370(9595):1383–91. doi: 10.1016/S0140-6736(07)61581-5 17933654.

7. Obaid TA. No woman should die giving life. The Lancet. 370(9595):1287–8. doi: 10.1016/S0140-6736(07)61550-5

8. Starrs AM. Delivering for women. Lancet. 2007;370(9595):1285–7. doi: 10.1016/S0140-6736(07)61549-9 17933629.

9. Graham WJ, Bell JS, Bullough CHW. Can skilled attendance at delivery reduce maternal mortality in developing countries? Safe motherhood strategies: a review of the evidence. Antwerp: ITGPress; 2001. p. 97–130.

10. Campbell OM, Graham WJ, Lancet Maternal Survival Series steering group. Strategies for reducing maternal mortality: getting on with what works. Lancet. 2006;368(9543):1284–99. doi: 10.1016/S0140-6736(06)69381-1 17027735.

11. World Health Organization. Antenatal care in developing countries. Promises, achievements and missed opportunities: an analysis of trends, levels and differentials, 1991–2001. 2003 Last accessed on 12 June 2018.

12. Victora CG, Requejo JH, Barros AJ, Berman P, Bhutta Z, Boerma T, et al. Countdown to 2015: a decade of tracking progress for maternal, newborn, and child survival. Lancet. 2016;387(10032):2049–59. doi: 10.1016/S0140-6736(15)00519-X 26477328.

13. Say L, Raine R. 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. Bulletin of the World Health Organization. 2007;85(10):812–9. doi: 10.2471/BLT.06.035659 18038064 PubMed PMID: PMC2636485.

14. Moyer CA, Mustafa A. Drivers and deterrents of facility delivery in sub-Saharan Africa: a systematic review. Reproductive Health. 2013;10:40-. doi: 10.1186/1742-4755-10-40 23962135 PubMed PMID: PMC3751820.

15. Gabrysch S, Campbell OM. Still too far to walk: literature review of the determinants of delivery service use. BMC Pregnancy Childbirth. 2009;9:34. doi: 10.1186/1471-2393-9-34 19671156; PubMed Central PMCID: PMC2744662.

16. Shahabuddin A, De Brouwere V, Adhikari R, Delamou A, Bardaji A, Delvaux T. Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey, 2011. BMJ Open. 2017;7(4):e012446. doi: 10.1136/bmjopen-2016-012446 28408543; PubMed Central PMCID: PMC5594213.

17. Sharma SR, Poudyal AK, Devkota BM, Singh S. Factors associated with place of delivery in rural Nepal. BMC Public Health. 2014;14:306. doi: 10.1186/1471-2458-14-306 24708511; PubMed Central PMCID: PMC3977667.

18. Joshi C, Torvaldsen S, Hodgson R, Hayen A. Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC Pregnancy Childbirth. 2014;14:94. doi: 10.1186/1471-2393-14-94 24589139; PubMed Central PMCID: PMC3943993.

19. Khanal V, Adhikari M, Karkee R, Gavidia T. Factors associated with the utilisation of postnatal care services among the mothers of Nepal: analysis of Nepal demographic and health survey 2011. BMC Womens Health. 2014;14:19. doi: 10.1186/1472-6874-14-19 24484933; PubMed Central PMCID: PMC3911793.

20. United Nations Population Fund (UNFPA). Marrying too young: End child marriage. New York, USA: UNFPA; 2012.

21. Godha D, Hotchkiss DR, Gage AJ. Association between child marriage and reproductive health outcomes and service utilization: a multi-country study from South Asia. J Adolesc Health. 2013;52(5):552–8. doi: 10.1016/j.jadohealth.2013.01.021 23608719.

22. Nasrullah M, Zakar R, Kramer A. Effect of child marriage on use of maternal health care services in Pakistan. Obstet Gynecol. 2013;122(3):517–24. doi: 10.1097/AOG.0b013e31829b5294 23921855.

23. Santhya KG, Ram U, Acharya R, Jejeebhoy SJ, Ram F, Singh A. Associations between early marriage and young women's marital and reproductive health outcomes: evidence from India. Int Perspect Sex Reprod Health. 2010;36(3):132–9. doi: 10.1363/ipsrh.36.132.10 20880798.

24. Godha D, Gage AJ, Hotchkiss DR, Cappa C. Predicting Maternal Health Care Use by Age at Marriage in Multiple Countries. J Adolesc Health. 2016;58(5):504–11. doi: 10.1016/j.jadohealth.2016.01.001 26984836.

25. Shrestha SK, Banu B, Khanom K, Ali L, Thapa N, Stray-Pedersen B, et al. Changing trends on the place of delivery: why do Nepali women give birth at home? Reprod Health. 2012;9:25. doi: 10.1186/1742-4755-9-25 23050689; PubMed Central PMCID: PMC3538619.

26. Pradhan A, Suvedi BK, Barnett S, Sharma SK, Puri M, Poudel P, et al. Nepal maternal mortality and morbidity study 2008/2009. Kathmandu, Nepal: Family Health Division, Department of Health Services, Ministry of Health and Population, Government of Nepal; 2010.

27. Ministry of Health (Nepal), New ERA, ICF. Nepal Demographic and Health Survey 2016. 2017.

28. Ministry of Health (Nepal), New ERA, Micro International Inc. Nepal Demographic and Health Survey 2011. 2012.

29. Ministry of Health (Nepal), New ERA, Micro International Inc. Nepal Family Health Survey 1996. 1997.

30. Ministry of Health (Nepal), New ERA, Micro International Inc. Nepal Demographic and Health Survey 2016. Kathmandu, Nepal: Ministry of Health, Nepal; 2017.

31. Adhikari R. Effect of Women's autonomy on maternal health service utilization in Nepal: a cross sectional study. BMC Womens Health. 2016;16:26. doi: 10.1186/s12905-016-0305-7 27177683; PubMed Central PMCID: PMC4867085.

32. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience. Geneva, Switzerland: WHO; 2016.

33. World Health Organization. Definition of skilled health personnel providing care during childbirth: the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA2018.

34. Ministry of Health and Population (Nepal). National safe motherhood and newborn health—long term plan (2006–2017). Kathmandu, Nepal: Ministry of Health and Population (Nepal); 2006.

35. World Health Organization. WHO recommendations on postnatal care of the mother and newborn. Geneva, Switzerland: World Health Organization,; 2013.

36. Sah N. How useful are the demographic surveys in explaining the determinants of early marriage of girls in the terai of Nepal. J Popul Res. 2008;25(2):207–22.

37. Textor J, Hardt J, Knuppel S. DAGitty: a graphical tool for analyzing causal diagrams. Epidemiology. 2011;22(5):745. doi: 10.1097/EDE.0b013e318225c2be 21811114.

38. Mullany BC. Barriers to and attitudes towards promoting husbands' involvement in maternal health in Katmandu, Nepal. Social science & medicine. 2006;62(11):2798–809. doi: 10.1016/j.socscimed.2005.11.013 16376007.

39. Simkhada B, Porter MA, van Teijlingen ER. The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study. BMC Pregnancy Childbirth. 2010;10:34. doi: 10.1186/1471-2393-10-34 20594340; PubMed Central PMCID: PMC2910658.

40. Saikia N, Singh A. Does type of household affect maternal health? Evidence from India. J Biosoc Sci. 2009;41(3):329–53. doi: 10.1017/S0021932008003209 19036173.

41. Kc S, Neupane S. Women's Autonomy and Skilled Attendance During Pregnancy and Delivery in Nepal. Matern Child Health J. 2016;20(6):1222–9. doi: 10.1007/s10995-016-1923-2 26979612.

42. Karei EM, Erulkar AS. Building programs to address child marriage; the Berhane Hewan experience in Ethiopia. 2010. Last accessed on 4 August 2018. Available from: https://www.popcouncil.org/uploads/pdfs/2010PGY_BerhaneHewanReport.pdf.

43. Thaddeus S, Maine D. Too far to walk: Maternal mortality in context. Social science & medicine. 1994;38(8):1091–110. https://doi.org/10.1016/0277-9536(94)90226-7.


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