Factors Associated with Maternal Health Services Utilization Among Lao Adolescents: A Nationwide Retrospective Cross-sectional Study

Authors

  • Hitomi Suzuki Department of Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan.
  • Erika Ota Department of Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, Tokyo, Japan, and Tokyo Foundation for Policy Research, Tokyo, Japan.

DOI:

https://doi.org/10.60099/prijnr.2023.262034

Keywords:

Adolescent health, Antenatal care, Facility delivery, Lao PDR, Maternal health, Maternal health care services

Abstract

           Addressing the social determinants of health that affect adolescent pregnancy is paramount to eliminating disparities and achieving health equity toward reducing the maternal mortality rate. The Lao People’s Democratic Republic has a high adolescent childbearing rate, which can negatively impact maternal and child health. We conducted a retrospective cross-sectional study that used data from the pooled Lao Social Indicator Survey II of 2017 to clarify the social contextual factors associated with the utilization of adolescent antenatal care and facility deliveries. We analyzed data from 663 adolescents aged 10-19 years at delivery and extracted the factors associated with maternal healthcare utilization based on social determinants. Those factors were area and region of residence, educational status, marital status, the ethnolinguistic group of the household head, and economic strata. A multiple logistic regression analysis was performed to determine the factors associated with those factors.
           The results showed that social factors strongly associated with the use of antenatal care were higher educational status and higher economic strata. On the other hand, the social factors associated with facility delivery were being in an ethnic majority and having a higher economic status. Thus, it is essential to establish interventions targeting those factors, such as lower educational status, lower socioeconomic status, and being from an ethnic minority, to increase adolescents' antenatal care visits and facility deliveries. This study’s results can be used to inform nurses and midwives in their efforts to eliminate socioeconomic disparities. This can be done by enhancing the provision of antenatal care consultations and facility deliveries in Lao, thus helping to achieve better health for adolescent mothers, their infants, and their families.

References

World Health Organization. Adolescent pregnancy [Internet]. 2022 [cited 2022 Nov 11]. Available from: http://www.who.int/mediacentre/factsheets/fs364/en/

Sully EA, Biddlecom A, Darroch JE, Riley T, Ashford LS, Lince-Deroche N, et al. Adding it up: investing in sexual and reproductive health 2019 [Internet]. 2020 [cited 2022 Nov 11]. Available from: https://www. guttmacher.org/report/adding-it-up-investing-in-sexual-reproductive-health-2019

World Health Organization. Adolescent Birth rate: data by UN region [Internet]. 2022 [cited 2022 Nov 11] Available from: https://apps.who.int/gho/data/view.main.1610 AUNREGION?lang=en

Tibingana-Ahimbisibwe B, Katabira C, Mpalampa L, Harrison R. The effectiveness of adolescent-specific prenatal interventions on improving attendance and reducing harm during and after birth: a systematic review. Int J Adolesc Med Health. 2016;30(3). doi:10.1515/ijamh-2016-0063.

Brand G, Morrison P, Down B. How do health professionals support pregnant and young mothers in the community? A selective review of the research literature. Women Birth. 2014;27(3):174-8. doi:10.1016/j.wombi. 2014.05. 004.

Leftwich HK, Alves MV. Adolescent pregnancy. Pediatr Clin North Am. 2017;64(2):381–8. doi:10.1016/j. pcl.2016.11.007.

World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience [Internet]. 2016 [cited 2022 Nov 11]. Available from: https://apps. who.int/iris/rest/bitstreams/1064182/retrieve

World Health Organization. Preventing early pregnancy and poor reproductive outcomes among adolescents in developing countries [Internet]. 2011 [cited 2022 Nov 11] Available from: https://www.who.int/maternal_child_ adolescent/documents/preventing_early_pregnancy/en/

Darmstadt GL, Bhutta ZA, Cousens S, Adam T, Walker N, de Bernis L. Evidence-based, cost-effective interventions: how many newborn babies can we save? Lancet. 2005;365 (9463):977-88. doi:10.1016/s0140-6736(05)71088-6.

Graham WJ, Bell JS, Bullough CHW. Safe motherhood strategies: a review of the evidence. Antwerp: ITGPress; 2001.

Chankham T, Yamamoto E, Reyer JA, Arafat R, Khonemany I, Panome S, et al. Knowledge of free delivery policy among women who delivered at health facilities in Oudomxay Province, Lao PDR. Nagoya J Med Sci. 2017;79(2):135-45. doi:10.18999/nagjms.79.2.135.

Sato C, Phongluxa K, Toyama N, Gregorio ER, Miyoshi C, Nishimoto F, et al. Factors influencing the choice of facility-based delivery in the ethnic minority villages of Lao PDR: a qualitative case study. Trop Med Int Health. 2019;47(1)50. doi:10.1186/s41182-019-0177-2.

Lao Statistics Bureau. 2018. Lao Social Indicator Survey II 2017, Survey Findings Report. Vientiane, Lao PDR: Lao Statistics Bureau and UNICEF. [Internet]. 2018. [cited 2021May 20] Available from: https://dhsprogram.com/ methodology/survey/survey-display-520.cfm

Fuller TR, White CP, Chu J, Dean D, Clemmons N, Chaparro C, et al. Social determinants and teen pregnancy prevention: exploring the role of nontraditional partnerships. Health Promot Pract. 2018;19(1):23-30. doi:10.1177/ 1524839916680797.

World Health Organization. Social determinants of health. [Internet]. 2022 [cited 2022 Dec 13] Available from: https:// www.who.int/health-topics/social-determinants- of-health

Cunnington AJ. What’s so bad about teenage pregnancy? J Fam Plann Reprod Health Care. 2001;27(1):36-41. doi:10.1783/147118901101194877.

Amjad S, MacDonald I, Chambers T, Osornio-Vargas A, Chandra S, Voaklander D, et al. Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2019;33(1):88-99. doi:10. 1111/ppe.12529.

World Bank. Rural population (% of total population) -Lao PDR [Internet]. 2021 [cited 2023 Jan 7]. Available from: https://data.worldbank.org/indicator/SP.RUR.TOTL. ZS?locations=LA

World Health Organization. Lao People’s Democratic Republic health system review [Internet]. 2014 [cited 2023 Jan 7]. Available from: https://apps.who.int/iris/ rest/bitstreams/920950/retrieve

Kawaguchi Y, Sayed AM, Shafi A, Kounnavong S, Pongvongsa T, Lasaphonh, A, et al. Factors affecting the choice of delivery place in a rural area in Laos: a qualitative analysis. PLoS One. 2021;16(8): e0255193. doi:10.1371/journal. pone.0255193.

World Health Organization. Adolescent health [Internet]. 2022 [cited 2022 Nov 11]. Available from: https:// www.who.int/health-topics/adolescent-health

Khatri RB, Karkee R. Social determinants of health affecting utilisation of routine maternity services in Nepal: a narrative review of the evidence. Reprod Health Matters. 2018;26(54):32-46. doi:10.1080/09688080.201 8.1535686.

Wong Shee A, Frawley N, Robertson C, McKenzie A, Lodge J, Versace V, et al. Accessing and engaging with antenatal care: an interview study of teenage women. BMC Pregnancy Childbirth. 2021;21(1):693. doi:10.1186/s12884-021- 04137-1.

Gage AJ. Barriers to the utilization of maternal health care in rural Mali. Soc Sci Med. 2007;65(8):1666–82. doi:10.1016/j.socscimed.2007.06.001.

Amjad S, MacDonald I, Chambers T, Osornio-Vargas A, Chandra S, Voaklander D, et al. Social determinants of health and adverse maternal and birth outcomes in adolescent pregnancies: a systematic review and meta-analysis. Paediatr Perinat Epidemiol. 2019;33(1):88–99. doi:10.1111/ppe.12529.

Japan International Cooperation Agency. LAO PDR: introduction of user’s guide of MCH handbook [Internet]. 2017 [cited 2023 Jan 7]. Available from: https://www. jica.go.jp/english/our_work/thematic_issues/health/ c8h0vm0000f7kibw-att/technical_brief_mc_19.pdf

Givens M, Teal EN, Patel V, Manuck TA. Preterm birth among pregnant women living in areas with high social vulnerability. AJOG MFM, 2021;3(5):100414. doi:10. 1016/j.ajogmf.2021.100414.

Gebrekirstos LG, Wube TB, Gebremedhin MH, Lake EA. Magnitude and determinants of adequate antenatal care service utilization among mothers in Southern Ethiopia. PloS One. 2021;16(7):e0251477. doi:10.1371/journal.pone.0251477.

Kifle MM, Kesete HF, Gaim HT, Angosom GS, Araya MB. Health facility or home delivery? Factors influencing the choice of delivery place among mothers living in rural communities of Eritrea. J Health Popul Nutr. 2018;37(1): 22. doi:10.1186/s41043-018-0153-1.

Sychareun V, Hansana V, Somphet V, Xayavong S, Phengsavanh A, Popenoe R. Reasons rural Laotians choose home deliveries over delivery at health facilities: a qualitative study. BMC Pregnancy Childbirth. 2012;12. doi:10.1186/ 1471-2393-12-86.

Horiuchi S, Nakdouangma B, Khongsavat T, Kubota S, Yamaoka K. Potential factors associated with institutional childbirth among women in rural villages of Lao People’s Democratic Republic: a preliminary study. BMC Pregnancy Childbirth. 2020;20(1):89. doi:10.1186/s12884- 020-2776-7.

Banke-Thomas OE, Banke-Thomas AO, Ameh CA. Factors influencing utilisation of maternal health services by adolescent mothers in low- and middle-income countries: a systematic review. BMC Pregnancy Childbirth. 2017;17(1): 65. doi:10.1186/s12884-017-12 46-3.

Downloads

Published

2023-03-27

How to Cite

1.
Hitomi Suzuki, Erika Ota. Factors Associated with Maternal Health Services Utilization Among Lao Adolescents: A Nationwide Retrospective Cross-sectional Study. PRIJNR [Internet]. 2023 Mar. 27 [cited 2024 Nov. 6];27(2):260-71. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/262034

Issue

Section

Original paper